Central centrifugal cicatricial (scarring) alopecia: This type of hair loss occurs most often in women of African descent. It begins in the center of the scalp. As it progresses, the hair loss radiates out from the center of the scalp. The affected scalp becomes smooth and shiny. The hair loss can be very slow or rapid. When hair loss occurs quickly, the person may have tingling, burning, pain, or itching on the scalp. Treatment may help the hair re-grow if scarring has not occurred.
Laser treatments are the latest frontier in staving off hair loss, and they’ll be the first choice for fans of sci-fi. As silly as they may sound, these treatments do work — the American Journal of Clinical Dermatology in 2014 reported a “statistically significant difference” in hair density with no “serious adverse events” or side effects.The bad news: Laser treatments tend to be expensive, progress is slow, and they don’t always produce stellar results.
Propecia's 1 mg dose of finasteride can effectively lower DHT levels in the scalp by as much as 60% when taken daily. It is DHT that shrinks or miniaturizes the hair follicle, which eventually leads to baldness. This 60% reduction in DHT has proven to stop the progression of hair loss in 86% of men taking the drug during clinical trials. 65% of trial participants had what was considered a substantial increase of hair growth.
The general medical consensus around laser treatments — caps and combs alike — is that low-level laser light therapy stimulates the cells within the hair follicle. These devices may also increase cell metabolism to promote thicker and more durable hair shafts, something that neither minoxidil or finasteride can do. To use the HairMax Ultima, all you have to do is glide the device over your scalp slowly. Treatments should take about eight minutes, and you should do it three days per week for the best results.

What is your opinion on laser combs? I went to the Men’s Club yesterday and they recommended I spend ~$800 to buy a laser band, comb or hat. What is your opinion on how those work? Sounds like snake oil to me. They also recommended I go to my dermatologist to get a prescription to reduce sebum in my hair. I have been on Fin for 11 months, Minox foam 1x/day yet hair shed hasn’t stopped. I do have a prescription for Ketoconazole shampoo but rarely use it. I read in your article that this shampoo does help with Sebum build up so I will try that. Any other recommendations for sebum reduction?


It works quite well to prevent hair loss and trigger regrowth for most men, and it may work for some women, although women must not take it if they are pregnant. Also, women should not get pregnant while on the drug because of the risk of birth defects in a male infant. Less than 2% of men have transient sexual side effects, including erectile and libido difficulties, while taking finasteride. However, in women these side effects do not occur.
Unfortunately, there has been little research into female-pattern baldness. The AHLA says, "While many drugs may work to some degree for women, doctors are reluctant to prescribe them, and drug companies aren't exactly falling over themselves to test existing or new drugs specifically for their ability to prevent and treat female-pattern baldness." The only FDA-approved treatment for hair loss in women is 2 percent minoxidil, although some doctors will prescribe other drugs off-label.
Castor oil, as some might already know, is one of the most popular all-natural "panaceas." Go ahead, Google it: What you'll find is article after article about how the viscous oil can help with shedding, breakage, and regrowth. But unlike rosemary oil and vitamin B5, both of which have studies that back up their aid in hair growth, scientific evidence surrounding castor oil is lacking. (Any testimonials about castor oil for hair growth are anecdotal, coming mostly from blogs, Reddit, and YouTube.)
You can also get a hair-loss kit from Hims, which comes with both minoxidil and finasteride. Keeps has one, as well. And though it might seem like overkill to take two different hair-loss treatments at once, this is one of those rare instances where more is actually better. McAndrews calls the combination of orally administered finasteride and topically applied minoxidil a “full-court press” against hair loss. “That’s doing the most you can for preventative medicine.” Rieder notes that taking both drugs together is more effective than taking either one alone.
Thanks for your response and awesome article! Do you recommend sticking with minoxidil for a period of time (i.e. 6 months) before starting finasteride or do it all at once? I would be on finasteride now if I wasn’t nervous about the potential side effects so my plan was to wait to see if minoxidal does anything for me over the next 3 months or so (at that point I will have been on it ~ 6 months). My shedding has certainly reduced so hopefully it is starting to work. I’m in the very early stages of hair loss. No one would notice (except me and my wife). Just looks my hair part on the top of my head even though it really is thinning.
Hi, am not promoting any product, just sharing my experience honesty, I have always had fine, thin hair but just recently I’ve become very self-conscious about my scalp showing. I’m only 24 years old and thought this was not the age I should start balding! I’ve tried everything – Biotin, Minoxidil, many type of hair growth supplement. Yes, these supplements supported hair growth but they did not support hair re-growth like Kesha Vardhani did. I’ve been using Kesha Vardhani for six months and hope to continue it.
Domen, I was reading some articles and also the links you’ve provided in your other comments above – they say both Finesteride and Minoxidil only check further hair loss and thicken existing hair – but both can’t re-generate hair that’s already gone from bald spots. I guess the effectiveness of these 2 medications are quite proportionate to age of the native! At 42, I guess, I am old 🙁 Atleast according to Indian standards!!

The comment about Dutasteride causing more side effects is not correct. All studies performed to this date actually sight that Dutasteride has lower side effects. Especially in regards to decreases in sex drive. The only time Dutasteride has been shown to have greater side effects is when the dosage of Finasteride was well below the recommended dosage of 1mg. In comparison 500mcg of Dutasteride has been shown to be more effective than 2.5mg of Finasteride and 1mg has shown to be more effective than 5mg of Finasteride, the dose used to treat BPH. The research has clearly shown that Dutasteride reduces serum DHT levels much faster and has much higher success rates.


The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of hims, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.
What should I be using for early stages of hair loss? I have some thinning around my crown. It’s not too bad, but it’s obviously not going to get any better. Should I just be using a shampoo for hairloss, or more serious measures like Reganine or Fin tablets etc? I don’t mind, but I don’t want to use products that could somehow make the situation worse. Thanks.
I noticed I was going bald, I panicked and turned the internet upside down in search of a solution and tried lots of products and weird things but none worked. a friend who used to tease me about the hair (in a bid to tease me further) bought a product from Africa during his travels and he mockingly gave me as a present.I tried it and the result is unbelievable. infact he had to call his contacts in Africa to get in touch with the manufacturers. I know how frustrating and confidence-sapping being bald is that’s why I took this painstaking mission to reveal to any who wants to try it. you can contact the manufacturers on (***censored***@gmail.com)I hope this message helps.
At the same time you supplement your diet with nutrients for hair growth and treat your scalp to stop hair loss, it’s a good idea to switch to a better shampoo and conditioner. For example, shampoos without sulfates are rapidly gaining in popularity. People now realize that sulfates strip essential oils from their scalp and leave their hair fragile and dry.
Reality is, if finasterise is so safe, why doesn’t merk market this drug as a vaccine for hair loss? For every man north of 18 to take this drug to prevent the possibility of balding? It’s safe, so why not? Truth is the science isn’t clear that either AR inhibition or DHT reduction is safe. All we know is that merk did a study and were able to publish data that suits their agenda.
If you believe you are beginning to lose your hair at an abnormal speed, you ought to start taking preventive measures so as to make sure that it remains from getting worse. Hair only grows about half an inch a month, therefore it takes some time to find those eight-12 inches required to donate. Falling hair is a somewhat common ailment which affects a massive amount of people.

I’m 33 and I still have quite a full hair line. I was facing mild hair loss until recently I’m noticing a lot of shedding, I’ve been on Propecia for the past year though. I’m not sure if Propecia is not effective on me anymore or it was kind of limiting hair fall until now. I’m even doubting that it could be MPB but do you think The Big Three would also help even if it wasn’t an MPB case?

What is your opinion on laser combs? I went to the Men’s Club yesterday and they recommended I spend ~$800 to buy a laser band, comb or hat. What is your opinion on how those work? Sounds like snake oil to me. They also recommended I go to my dermatologist to get a prescription to reduce sebum in my hair. I have been on Fin for 11 months, Minox foam 1x/day yet hair shed hasn’t stopped. I do have a prescription for Ketoconazole shampoo but rarely use it. I read in your article that this shampoo does help with Sebum build up so I will try that. Any other recommendations for sebum reduction?
During a hair transplant procedure, a dermatologist or cosmetic surgeon removes tiny patches of skin, each containing one to several hairs, from the back or side of your scalp. Sometimes a larger strip of skin containing multiple hair groupings is taken. He or she then implants the hair follicle by follicle into the bald sections. Some doctors recommend using minoxidil after the transplant, to help minimize hair loss. And you may need more than one surgery to get the effect you want. Hereditary hair loss will eventually progress despite surgery.
Apply one mL 2 times a day directly onto the scalp in the hair loss area. See carton and enclosed leaflet for complete directions. Using more or more often will not improve results. Continued use is necessary or hair loss will begin again. When using this product do not apply on other parts of the body. Avoid contact with the eyes. In case of accidental contact, rinse eyes with large amounts of cool tap water. Some people have experienced changes in hair color and/or texture.

One hard truth: Hair loss is mostly out of your control. “Baldness comes down to your genes,” says Frederick Joyce, M.D., founder of Rejuvenate! Med Spa and a member of the International Society for Hair Restoration Surgery. “If you have the baldness gene, there are some natural remedies that may make your hair stronger and healthier to slow your hair loss slightly—but they won’t prevent you from going bald. Still, maintaining hair health by eating well and using the right products—combined with medical-grade treatments—can really work all together to help you have a fuller, thicker head of hair.”
The main type of hair loss in both sexes — and the subject of this article — is androgenetic alopecia, or female (or male) pattern hair loss. In men, hair loss usually begins above the temples, and the receding hairline eventually forms a characteristic "M" shape; hair at the top of the head also thins, often progressing to baldness. In women, androgenetic alopecia begins with gradual thinning at the part line, followed by increasing diffuse hair loss radiating from the top of the head. A woman's hairline rarely recedes, and women rarely become bald.

When it comes to prescriptions, Propecia (finasteride) stands as the strongest oral option for treating balding. If used consistently, this hair-loss treatment stops the progression of pattern hair loss, caused by genetics, for most users -- no messy application necessary. Although the drug has yet to earn FDA approval for treatment of women, recent studies have shown that it is both safe and effective for female users. See our full review »

2. Pyrithione zinc shampoo. Traditional volumizing shampoos will give the hair you have a lift so it looks fuller (we like the sulfate-free L’Oréal Paris EverPure Volume Shampoo, $8). But some research suggests shampoos with the antidandruff ingredient zinc pyrithione can mitigate hair loss that’s caused by conditions like dandruff, says Mirmirani. Try Head & Shoulders Deep Moisture Shampoo ($6), and use a conditioner without silicones — they can make hair appear limper, especially if it's applied near the roots (we like Love Beauty and Planet Coconut Water & Mimosa Flower Conditioner, $9).


"I recommend that everyone [with any hair loss] take finasteride," says Robert M. Bernstein, MD. Bernstein is associate clinical professor of dermatology at Columbia University and founder of the Bernstein Medical Center for Hair Restoration. "To patients who are younger,” he says, “I also recommend minoxidil. But the mainstay is finasteride. The data show that, over five years, it significantly retards hair loss in 85% of users."
Like minoxidil, finasteride, the active ingredient in Propecia, was originally created with a different purpose in mind -- to treat enlarged prostate glands -- and researchers observed it came with a side effect of hair growth. Unlike topical minoxidil, finasteride requires a prescription, is taken orally and addresses hormonal causes of hair loss. It inhibits the enzyme type II 5-alpha reductase, which converts testosterone into DHT. As it was the first truly effective treatment for hair loss that provided nearly guaranteed results, finasteride revolutionized the hair-loss-treatment industry.
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