The most common kind of hair loss is pattern baldness. It happens when hair follicles shrink and stop working. The first sign is the appearance of strands that are thinner and more fragile. Then the scalp becomes more visible as fewer hairs grow to replace those that shed. That’s because the anagen phase becomes too short for the hair to grow out of the scalp. Plus, the hairs that remain aren’t securely anchored. And this condition happens to both men and women.
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.
The other main hair-loss treatment that was recommended by all four dermatologists I interviewed is finasteride, often called by its brand name Propecia. This FDA-approved medication is only available with a prescription, but these days, it’s found as a generic and ordered online after a virtual consultation, through start-ups like Hims, Keeps, and Lemonaid.
It may seem a peculiar American vanity that men have in-boxes full of hair loss treatment offers and spend billions of dollars on hair loss treatments each year. Not so. As Gersh Kuntzman illustrates in his book Hair! Mankind's Historic Quest to End Baldness, chrome-dome anxiety has tormented us for ages. Caesar's laurel wreaths? Classic red herring, Kuntzman says.

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.
“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.
Massaging the scalp can help to restore hair growth and can be used in conjunction with hair oils and masks. This stimulates the scalp and can improve hair thickness. Taking the time to massage your scalp each day can also help you relieve stress and tension. It’s thought that stretching forces during the massage encourage hair growth and thickness in the dermal papilla cells.
I am a 30 year old woman, after my second child, I noticed that my hair was thinning on the top of my head, I had read it was normal for hair to thin and to loose hair while breast feeding and all that, but my daughter is now 18 months and did not see my hair come back to how it used to, so I decided to try this product. I have been using it for about 22 days and I do see the difference, it is not very thick as it used to but I hope with time using the product it will get better. I also see some hair growth, so far so good!! BTW, you need to apply it twice a day, it comes on liquid form and it is very easy to use.
Clearly, minoxidil is not a miracle drug. While it can produce some new growth of fine hair in some — not all — women, it can't restore the full density of the lost hair. It's not a quick fix, either. You won't see results until you use the drug for two months. The effect often peaks at around four months, but it could take longer, so plan on a trial of six to 12 months. If minoxidil works for you, you'll need to keep using it to maintain those results. If you stop, you'll start to lose hair again.
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.
As with any new technology, there is still a lot of educating that needs to happen, at both the physician and consumer level, when talking about robotic hair transplants. Some people have the misconception that the ARTAS robot is operating on it own when, in reality, the robot is simply an extension of the operator, working within parameters programmed by the surgeon. Its effectiveness, therefore, is tied directly to the expertise of the surgeon and the end result — as with any hair transplant — is only as natural as the artistic skills of the surgeon behind the machine.
I think there’s nothing wrong with advertising that propecia side effects are low, its a flat out lie to say they’re impossible. There are thousands of people posting online about the sexual side effects experienced, and many thousands of others who have experienced the side effects and quit without complaining on the internet. On top of that, there are many patients who take proscar to treat BPH, experience sexual side effects, yet don’t complain because they’re treating a more dangerous condition, and they’re typically older men and people incorrectly expects every man north of 50 will be impotent.
The follicles on the sides of the scalp are more genetically resistant to DHT, which is why male pattern baldness often results in a “crown” of hair. But its downsides are serious. “With women, finasteride is not an option,” says Dr. Wolfeld. “It’s not FDA-approved for women to take, so we don’t prescribe it.” In fact, due to the drug’s effect on hormone levels, pregnant women are advised to not even touch broken or crushed tablets.
"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.
Laser light therapy is not a baldness solution, and the HairMax takes a time commitment: You have to use the product for 15 minutes a day, three days a week and you have to keep using it indefinitely to get results. Still, laser light therapy has no major side effects, and may be best for men who have noticed some increased shedding and want to maintain more of the hair they have on their head.
That meant new products like Hims and Keeps were out.Hims and Keeps are relatively new companies that allow you to set up a subscription for hair loss treatments. Both offer finasteride (after an online consultation with a doctor) or 5 percent minoxidil. However, their minoxidil solutions contain propylene glycol, so we cut them from consideration.
It works. Im on my second three pak. At 6 weeks its scary. You will lose more hair. Then it will grow back. Thicker, in my case with more gray and darker. But lots of healthy shiny hair that is not 'shedding" or coming out in huge amounts. My widows peak has rescinded and my part looks great. Im starting my 5th month. People who know me (because my hair was so thin prior) tell me/ask me if Ive used it. (In a whisper, like its a bad thing. Im like HELL YEAH, cmon, cmon, pull it..it feels great) People who dont know me compliment my thick hair. Get a good haircut and give it three months. Very happy and the best beauty value at 15.00 a month that I can imagine.
Acupuncture is a form of Chinese medicine that has been practiced for thousands of years. Its applications are many, and some researchers believe that it may help with hair loss from alopecia areata. How? The needles inserted into the scalp may help stimulate hair follicles and promote regrowth. More research needs to be done in this area, but consider asking your doctor for a referral to a licensed acupuncturist if this treatment sounds appealing to you. (Learn more about acupuncture for hair loss.)
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.
Utilize caution when utilizing a compost tumbler, however, because hair does not appear to compost completely in them. Hair exists in a number of textures. Cutting the hair also might be an indication of mourning. Human hair is among those important things that form the idea of beauty. Human facial hair grows faster than every other hair physically.
"Others are taking hair follicles out of human scalp and growing them with dermal papilla cells," Cotsarelis says. "If they grow in culture, you might be able to recombine them with skin cells and form new follicles. This would let you expand the number of follicles you get for a hair transplant. This may not be that far off -- five to 10 years, maybe. There's very good evidence you will be able to do that."
First, reduce your stress. It will improve your ability to cope with hair loss as well as help solve the problem. You might find relief with deep breaths, performing physical exercise, or laughing at cat videos online. If your stress level is high because you’re upset about losing your hair, experiment with keratin hair fibers to disguise the thin spots. It’s an inexpensive way to feel better about a tough situation.
*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.   
Adam Friedman, a program director at The George Washington University School of Medicine & Health Sciences, is on the same page as Romanowski. "While it does have antimicrobial properties which may be useful in terms of fighting off bacterial or fungal overgrowth on the scalp that can lead to hair-damaging inflammation, there is zero evidence [showing] it is helpful for hair growth," he says, adding that some people can actually be allergic to castor oil and experience inflammation, ultimately doing more damage than good to the scalp. "To propose that castor oil accelerates hair growth, a tightly regulated process (one centimeter per month) for which FDA approved medications for hair loss do not impact, is ridiculous," he states.
My scalp is dry, itchy, and irritated everywhere. I’ve been using H&S Clinical Strength shampoo for 2-3 years and its been pretty good at keeping it under control. I’ve been using rogaine for about 1 year now and I’m trying to avoid propecia if possible. Recently my hairline has quickly recede, and I’m not sure what to do. My friend said to start using nizoral every couple days. Do you recommend Nizoral for every few days? If so, what conditioner do you recommend and what shampoo do you recommend for the other days of the week when not using Nizoral? Thanks for your help – great site.
Working just like a precise microsurgical extension of the human hand, SmartGraft’s all-in-one ergonomic handpiece and storage system was designed to help accurately separate, extract and store FUE grafts during hair transplantation. Fewer steps, less handling, and manual transferring of grafts allows the FUE procedure to be accomplished at a faster speed, reduced risks of graft failure and poor growth quality as well as with improved patient comfort.
Women with androgenic alopecia may consider trying prescription ketoconazole at a strength of 2 percent. This drug comes in the form of a shampoo and also goes by the name Nizoral. It’s an antifungal agent and may help reduce the body’s production of testosterone and other androgens that lead to hair loss. You can also find 1 percent strength at your local pharmacy, but it may not be as effective.
A separate study, published in Skin Therapy Letter — a professional reference site for dermatologists — found that women also benefit from using the more potent 5 percent minoxidil treatment. “Patient-reported improvement in hair volume and coverage appears to be greater with 5 percent minoxidil foam,” reads the report. Plus, because the 5 percent treatment is stronger, women only have to apply it once a day to get the same results as they would with the 2 percent treatment applied twice daily.
However, ketoconazole is still not FDA approved for hair loss treatment, which means it cannot be endorsed or marketed as such. Put simply, ketoconazole likely curbs hair loss, but additional research is needed for the FDA to give it approval. While it is safe to use as a supplement to our top picks, we wanted to recommend products with as much scientific backing as possible. So, we stuck with FDA approved minoxidil or FDA cleared laser treatments. But we’ll keep a close eye on products like ketoconazole shampoos and update as new research appears.
Regrow thicker, beautiful hair with Women's ROGAINE® Hair Regrowth Treatment, Once-a-Day Foam. Containing 5% minoxidil, this foam reactivates hair follicles to regrow hair. The only once-daily hair regrowth treatment for women approved by the FDA, this formula is proven to help regrow hair in 81%* of women, with clinical results in as little as 12 weeks and visible results with continuous daily use after 24 weeks. From the #1 dermatologist recommended brand, the once-a-day applied foam can fit into your regular beauty routine. This package of Women's ROGAINE® Foam includes one 60-gram can, a 2-month supply.
Men's Rogaine Extra Strength Hair Regrowth Treatment (5 percent minoxidil) boasts impressive hair growth rates, slowing hair loss for the vast majority of men who use it diligently. The hair-loss treatment is available over the counter and leads to only minimal side effects, all of which go away when treatment is discontinued. See our full review »

For example, if your hair is thinning because you’ve recently started a new medication or a diet, your approach might be to take an oral supplement or use a laser light device. But if you have hair loss from psoriasis or chemical treatments, you might try a new shampoo and invest in a moisturizing scalp treatment. Throwing everything possible at the problem might not be the most effective method.

But in November, after 10 years of research, Rogaine introduced a new 5 percent minoxidil formulation for women. It’s a mousse (instead of a liquid) that needs to be applied only once a day instead of twice, which means that it can be more easily incorporated into a woman’s evening skin-care routine. Teal replaces the blue and silver palette of the men’s Rogaine, and the packaging bears a lotus flower. (Also last year, Pantene introduced its Hair Regrowth Treatment for Women, which is 2 percent minoxidil.)


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?
The first robot designed to help surgeons perform a portion of the hair transplant procedure recently became FDA approved. Called the ARTAS Robotic-Assisted FUE System by Restoration Robotics, it’s an image-guided robot with micron-level precision that harvests up to 1,000 hair grafts per hour – which has made hair transplant surgery even more accurate and efficient.
Keranique Hair Regrowth 3-Piece Treatment Set for Women, Lipogaine for Women, Pantene Minoxidil 2% Hair Regrowth Treatment for Women, Prominox 1 Hair Loss Shampoo, Prominox 2 Hair Loss Conditioner, Prominox 3 Hair Growth Stimulator, Prominox 6 Leave-In Hair Loss Conditioner, REDKEN Cerafil Retaliate 2% Hair Regrowth Treatment for Women, Rogaine for Women Hair Regrowth Treatment
Taking hair supplements can be helpful for anyone who is experiencing hair loss or hair thinning. Dendy Engelman, MD, a board-certified dermatologic surgeon at Medical Dermatology & Cosmetic Surgery in New York City, previously recommended Nutrafol, a research-backed hair supplement, to Prevention. "This uses highly concentrated botanicals to address every stage of the growth cycle," she says. Nutrafol's hair supplements include vitamin E and ashwagandha (an adaptogen that helps balance cortisol levels in the body), among others.
×