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Topical treatments like Rogaine use the active ingredient minoxidil -- originally used to treat high blood pressure. After researchers discovered that it also promoted hair growth, it was the first drug approved by the FDA to treat male pattern baldness. It is used topically on the scalp, and the success of treatment is dependent on the user's extent of hair loss. Researchers at the AHLA find its efficacy to be marginal in the long run since it has no effect on the hormonal process.
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.
“If you don’t want a scar because you like to wear your hair short, you might opt for a “scarless” hair transplant,” says Dr. Joyce. Also known as follicular unit extraction (FUE), grafts are harvested one at a time with tiny punches that heal virtually undetected so you can still buzz your head. “If you’ve gone so bald that you don’t have a lot of donor hair on your head, we can do FUE extractions with body hair such as on your chest, stomach, back, and sometimes even the pubic area,” says Dr. Joyce.
Finally, avoid damaging your hair and scalp with harsh products and too much time in the sun. Use sulfate-free shampoos, remember to apply conditioner, and cover up outdoors. If you spend time in the pool, use a clarifying shampoo that removes chlorine from your hair. Also, rinse well with lukewarm or cool water. If you take good care of your scalp and hair, you’ll find that it’s easier to keep your locks thick and healthy.
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.
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One common side effect of minoxidil is a red, itchy scalp, but users claim that merely switching brands can sometimes alleviate that symptom. Another possible side effect is excess hair growth in unwanted places, including the face. It is important to point out that unwanted hair growth and other side effects go away once treatment is discontinued.
1. Minoxidil. It’s the only FDA-approved topical nonprescription medication that can claim to regrow hair — and it should be part of any hair-loss plan if you have serious thinning, says Rogers. Minoxidil has loads of research to back it, but it requires commitment. If you quit using it, your hair will start to lose ground again. Use a 5 percent strength, like Women’s Rogaine 5% Minoxidil Foam ($30), once daily to see results in three to four months, says Rogers.
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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Hair transplants will likely lead to better results in the long run (you are introducing new hairs to the balding areas), but you’ll still need to use minoxidil or finasteride after surgery to maintain the results. Like all hair loss treatments, hair transplants are best when combined with other methods, and you’ll want to speak with your doctor to see what combination is best for you.
"This is an oral, prescription-only medication with the brand name Propecia that’s also FDA approved to treat hair loss," says Spencer. Male pattern hair loss occurs when a hormone called dihydrotestosterone (DHT) prevents hair follicles from getting the nutrients they need. Finasteride works by blocking the production of DHT, which protects the follicles.
Like the long-suffering friend who inspired her to undergo the procedure, Ms. Telford quickly saw an improvement in her hair. New hair growth usually take at least four months, but at the two-month mark, she has already spotted some baby hairs. “Not a gazillion,” she said, “but it’s a start.” She’s planning to return for follow-up treatments every six months, and has high hopes of ditching the wigs and wearing her hair in a pixie.
"Despite some of the claims, a shampoo or conditioner won’t be able to stop or slow hair loss, nor help with a receding hairline or thicken hair that’s becoming thinner," says trichologist Anabel Kingsley from The Philip Kingsley Trichology Clinic in London. "At best, a thickening shampoo will make hair temporarily thicker for a short period of time, but they certainly won’t help with hair loss or thinning."
Some doctors prescribe Avodart off-label (meaning to treat something other than illnesses or conditions listed on the drug's label) to patients suffering from male-pattern baldness. Dutasteride, the active ingredient in Avodart, like finasteride, is used to treat enlarged prostate glands, but it blocks both types of the enzyme that create DHT, instead of just one. Studies show that dutasteride is superior to finasteride in treating AGA, but it has yet to be approved by the FDA for that purpose.
Men taking Propecia run the risk of sexual side effects, but most experts say that it only affects a small minority. The risks are greater for women, especially those who are pregnant or may become pregnant. Experts warn that so much as handling the tablets can lead to serious birth defects. Like minoxidil, Propecia use must be continued for as long as results are desired.
4. Tinted dry shampoo. Camouflage spots where you’re seeing more scalp than you want to (your hairline, a widening part, a thinning crown) and add volume with a colored dry shampoo (try Orlando Pita Color Boost Dry Shampoo in Light or Dark Tones, $22). But be sure to give your scalp a vigorous shampoo during your next shower — dermatologists recommend keeping your scalp free of styling products so you’re not clogging already taxed pores.
Again, you’ll want to visit your doctor to get a blood test to check your levels in these vitamins. For example, women who have iron levels lower than 70 nanograms per milliliter are considered deficient. From there, work with your doctor to find an appropriate dose according to your deficiency level. Excessive or unnecessary supplementation can be dangerous.
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Men may also experience some sexual and emotional side effects while taking it: In a study published in the June 2011 issue of The Journal of Sexual Medicine, Dr. Michael Irwig of George Washington University found as many as 92 percent of test subjects reporting problems in the bedroom. The study also reported that “the mean duration of finasteride use was 28 months and the mean duration of persistent sexual side effects was 40 months,” meaning that side effects lingered long after subjects stopped taking the pill.
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.