*Photograph used with permission of the Journal of the American Academy of Dermatology. This photograph was published in the Journal of the American Academy of Dermatology, Vol. # 60, Gathers RC, Jankowski M, Eide M, et al. “Hair grooming practices and central centrifugal cicatricial alopecia,” 660-8. Copyright Elsevier (2009). Journal of the American Academy of Dermatology.   

In clinical testing, nearly nine out of 10 men noticed results. The solution is intended for men only and is easy to use on a daily basis. Simply dispense 1/2 capful of foam in your hands, part your hair, and apply in the area where your hair is thinning. Use your fingers to massage throughout the hair loss area twice a day and you should notice regrowth in as little as two months. Results last only as long as you use the medicine.
Beware online stores selling Propecia without a prescription.Finasteride is FDA approved, but buying it online without a prescription can be illegal and dangerous. Prescription-free online stores have a reputation for selling placebos or dangerous replacements. We recommend speaking with a doctor about prescriptions or sticking to save over-the-counter treatments.
Thank you. This has been the most helpful article I have read! Very much appreciated! Last question (I won’t bug you with anymore after this) . . . I was tested by my doctor and came out perfectly healthy so it is either stress or MPB. My job is extremely stressful so it could be that but I have no way or knowing for sure. As such, do you think there is any harm on me taking finasteride even if it isn’t MPB and is just stress? I suppose if the medicine didn’t work, I would know it was stress and not MPB. Also, I assume this is something I would continue to take for life right?
I have always had fine, thin hair but just recently I've become very self-conscious about my scalp showing. I'm only 26 years old and thought this was not the age I should start balding! I've tried everything - Biotin, Viviscal, any type of hair growth supplement. Yes, these supplements supported hair growth but they did not support hair re-growth like Rogaine did. I've been using Rogaine religiously for three months now and I swear by it. I think the pictures do this product justice. Thanks Rogaine!
“While nutritious eating isn’t going to bring your hair back by any means, eating plenty of protein-rich foods and healthy fats can make the hair that you still have look thicker and shinier.” Skimping on the B vitamins in particular can interfere with the formation of hair cells and, therefore, hair growth. The best sources of Bs are protein-packed foods like chicken, fish, eggs, and pork, as well as leafy greens such as spinach. (These foods are also good for melting belly fat, so it’s a win win).
How to use minoxidil: Be sure that your hair and scalp are dry. Using the dropper or spray pump that's provided with the over-the-counter solution, apply it twice daily to every area where your hair is thinning. Gently massage it into the scalp with your fingers so it can reach the hair follicles. Then air-dry your hair, wash your hands thoroughly, and wash off any solution that has dripped onto your forehead or face. Don't shampoo for at least four hours afterwards.
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.
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.
Some women find that the minoxidil solution leaves a deposit that dries and irritates their scalp. This irritation, called contact dermatitis, is probably caused not by the minoxidil itself, but rather by the alcohol that is included to facilitate drying. A 5% solution (available only by prescription and approved only for men) is more effective than the 2% formulation and may be prescribed off-label for women. The 5% version comes in a foam, which appears to cause less irritation than the liquid.

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!!
In the past few years, medicine has made tremendous strides in the treatment of men's hair loss. With the advent of 5-alpha-reductace inhibitors such as Propecia and the evolution of surgical hair restoration, living with noticeable hair loss is no longer inevitable. For the first time in the history it is now possible to stop or slow the progression of hair loss and to replace lost hair through surgery with completely natural results.

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Her hope is that the procedure (she has helped start a company named Rapunzel to develop it) will eventually become another lunchtime cosmetic treatment. Once a patient has had her cells harvested and cultured, they could be stored indefinitely; then, after giving her doctor a month’s notice (the time it takes to grow the million needed), she could pop in for injections. Costs would likely be on par with hair transplants, roughly $10,000 and up.
3. Surgical hair replacement. If you opt for hair transplantation (which runs $5,000 and up), your dermatologist or hair-replacement surgeon will remove single hair follicles from the back of the head, near the nape of the neck, where your hair is fullest. Once those follicles are harvested, they are then dissected and reimplanted into an area of the scalp where hair is thinning. The procedure takes anywhere from three to six hours, and newly implanted hair will usually begin to grow on its own 3 to 12 months after the treatment session. Traditionally, hair transplantation required removal of an entire strip of scalp, Sadick says, but this new follicle-by-follicle technique looks more natural when it heals and allows patients to get heads of hair as dense-looking as before they started losing it.
Also known as Rogaine, this over-the-counter (OTC) medication can be used for men or women with alopecia areata or androgenic alopecia. This drug comes in foam or liquid form and is spread on the scalp each day. It may cause more hair loss at first, and new growth may be shorter and thinner than before. You may also need to use it six months or more to prevent further loss and promote regrowth.
The Rogaine rep we spoke to explained that the different packaging (and therefore different prices) has to do with the FDA-approval process: “We discovered in clinical trials that the hair loss patterns between men and women are different,” she said by way of explanation. “Men typically have that bald spot on the crown of their head, where women generally have a general thinning throughout, but concentrated more on the top of the head. So for FDA approval, we had to come up with two different, gender-specific products, so the directions were more explanatory.”
Some treatments in development hold particular promise for women. Angela Christiano, a hair geneticist and Columbia University professor of dermatology, is hoping to begin clinical trials in a year or two on a procedure in which she dissects hair-follicle stem cells, grows them in the lab until she has several million, then injects them into the scalp, where, a very small study done with a human skin model has shown, they induce new hairs.
Physicians are reluctant to prescribe systemic treatments (pills or other form of treatment that affects your entire system) because they can tamper with your body's own androgen levels (see Causes for an explanation of androgens). The doctor will first want to confirm that the hair loss is due to an excess of androgen (another name for male hormones) in the system or a sensitized "over-response" to normal amounts of androgen. Therefore, physicians often choose topical treatments, which are applied directly to the scalp.

Alopecia areata: Researchers believe that this is an autoimmune disease. Autoimmune means the body attacks itself. In this case, the body attacks its own hair. This causes smooth, round patches of hair loss on the scalp and other areas of the body. People with alopecia areata are often in excellent health. Most people see their hair re-grow. Dermatologists treat people with this disorder to help the hair re-grow more quickly.
Hair doesn’t make the man. Remind yourself of everything else you have to offer. Or take care of things you can control, like staying in shape. It’s OK to look to others for support. And if you need a little inspiration, think of bald men or guys with shaved heads who ooze confidence, like The Rock, Vin Diesel, and Pitbull. Consider yourself in good company.
Dr. Carlos Wesley, a hair restoration surgeon in Manhattan, said that women in his practice respond better to P.R.P. than men do, which may have something to do with the fact that women with genetic hair loss tend to have more inflammatory cells around the follicles. From 2013 to 2014, he said, he had an 83 percent increase in female patients, in part because of P.R.P.

*Photograph used with permission of the Journal of the American Academy of Dermatology. This photograph was published in the Journal of the American Academy of Dermatology, Vol. # 60, Gathers RC, Jankowski M, Eide M, et al. “Hair grooming practices and central centrifugal cicatricial alopecia,” 660-8. Copyright Elsevier (2009). Journal of the American Academy of Dermatology.   
Eventually, these follicles close completely and stop producing any new hair at all. In other instances, men will start to notice hair loss because of lifestyle and environmental factors. For example, being overly stressed for extended periods of time can cause for a man’s hair to start falling out in clumps. And if a man isn’t getting proper vitamins and nutrients to nourish his hair, the strands could possibly grow increasingly weaker until they start breaking off and thinning out. Luckily, there are many hair growth products for men on the market today which can help men in these situations to grow their hair back.
Nizoral should be used in conjunction with finasteride and minoxidil. Don’t use it on its own and expect to see immense results. In the “Nizoral studies”, men with MPB who were using Nizoral lost significantly fewer hairs over the months compared to those who weren’t. Don’t expect to regrow hair using it, but rest assured you hair loss progression is slowed down.
Laser devices: Brushes, combs, and other hand-held devices that emit laser light might stimulate hair growth. These devices might make hair look more youthful in some people. Because the FDA classifies these products as medical devices, the products do not undergo the rigorous testing that medicines undergo. The long-term effectiveness and safety for these devices are not known.
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.
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