The majority of American men and women are affected by hair loss, known as alopecia, at some point in their lives, according to experts. Androgenetic alopecia (AGA), commonly referred to as male- or female-pattern baldness, accounts for about 95 percent of hair loss in the U.S., according to Better Nutrition magazine. Experts say pattern baldness is genetic and inherited equally in men and women. However, the hair-loss gene can only express itself when dihydrotestosterone (DHT), a male hormone, is present. Because estrogen usually suppresses male-hormone production, women don't typically experience pattern baldness until after menopause has begun; although, even the slightest hormone shift can cause hair loss in women.
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.

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The second member of “the big three” and another extremely effective FDA approved hair loss treatment is minoxidil. Minoxidil was originally an oral medication for high blood pressure. But after a while, patients started reporting hair growth — all over their bodies. And not much longer after, the minoxidil topical solution for treating hair loss was born.
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.
There are no parabens or sulfates in the bottle. Instead, the shampoo contains biotin to strengthen hair and caffeine to stimulate the scalp. There’s also argan oil and allantoin to moisturize skin. Then, the conditioner contains another dose of caffeine plus rosemary, vitamin D, lupin protein, glycerin, and niacinamide. When used together, the shampoo and conditioner nourish strands and encourage new growth.
Defy hair loss with ROGAINE®, the #1 dermatologist-recommended, FDA-approved brand with a clinically proven formula to regrow hair. Unlike thickening shampoos that temporarily coat the hair, ROGAINE® penetrates deep into your scalp to revive follicles and increase protein production so you can grow new, fuller, thicker hair. The revolutionary formula begins to work on contact with patented Tricho-Prime™ Technology, a proprietary combination of ingredients that primes your scalp for optimal hair regrowth.
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.
Once male-pattern baldness starts, it’s not going to stop until every last hair on your head has shrunk or shed, though the rate at which this happens differs from person to person and depends on genetics. And since the grind of hair loss is unending, it’s important to start treatment as soon as your hairline starts bothering you. If you’re looking for a more quantitative metric, Dr. Paul McAndrews, clinical professor of dermatology at the USC School of Medicine and member of the International Society of Hair Restoration Surgery, assures me that “you have to lose half your hair before the human eye can tell.” (Of course, if you don’t care about losing your hair and are fine with going full Prince William and shaving your head, go for it. We’ve got some recommendations for razors and hair trimmers to help you out on that front.)
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.
Thanks for the article with great info. I’ve been taking minoxidil 5% for the last 2 years. I’ve tried a generic minoxidil brand and also Kirkland to no effect. I’ve been hoping it’s maybe slowed the hair loss process. The hair around my crown just keeps getting thinner. Do you think changing to another “better quality” brand like Lipogaine or Rogaine could work? Or does it appear that any minoxidil brand is not going to work?
Am using KESHA VARDHANI hair oil for almost a month. Purchased this a couple of bottles already. Wife said hair becomes thicker and really seems to be working (Regrowth of new hair). Tried other brand and did not work as good as this brand. A little on the expensive side but quality seems to be there compare to other brands. Try it for yourself to checkout to result.
Hi, great article. I have an aggressive form of MPB. I am 23 year old with a NW2 hairline, diffuse thinning over the top and crown. Been on 5% Minoxidil and 2% Keto for about 9 months. Went through a period of shedding which has reduced somewhat in the last couple of months. I don’t see any appreciable increase in density anywhere but I do see plenty of thin vellus hair at my hairline. I am waiting for the 1 year mark to see the full effect of this regime. Is there like a test you can do to assess hairfall? Or do we just have to count the hair lost in the shower? Do you reckon I should start the Fin to hold on the the hair I have? Like most guys (actually a bit more than most guys seeing that I am young) I worry a lot about being in the 2% who experience disastrous sides from Fin. I do plan to check my DHT levels before I start, if I do at all, to see if I naturally have high/low DHT. That should tell me what to expect, to an extent.

In clinical studies of mostly white women aged 18-45 years with mild to moderate degrees of hair loss, the following response to 2% minoxidil topical solution was reported: 19% of women reported moderate hair regrowth after using 2% minoxidil topical solution for 8 months (19% had moderate regrowth; 40% had minimal regrowth). This compares with 7% of women reporting moderate hair regrowth after using the placebo, the liquid without minoxidil in it, for 8 months (7% had moderate regrowth; 33% had minimal regrowth).


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.
I have used monoxodil for hair loss now for about 6 years. It works. i no longer have bald spots and have a healthy head of hair. Originally I used the name brand, but i noticed that there was a store brand with the same ingredients. It cost about half of what I was paying. It is very economical to use and simple. I was hesitant at first but it performs beautifully. Once you start using monoxidil you must continue to use it to retain hair growth. Very Important. I took the time to share this because it is a good solution for us with little extra money to spare. Good luck!
Use dropper to apply directly onto scalp on the top and/or crown of head each morning and evening. Apply to towel dry or dry hair (does not need to be freshly shampooed). Allow one to two minutes to dry before applying other treatments or styling products (may apply other treatments, leave-in conditioners or styling product after applying Regrowth Treatment), style as usual.
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.
1. Hair color. Anytime you dye your hair, you’re increasing the diameter of each strand, which can help add volume when your hair is sparse and fine. As a general rule, ask your colorist to make sure highlights are finer at the top of the head, where hair is the thinnest, and more intense at the bottom, where it’s thickest, says Eva Scrivo, a hairstylist and the owner of the Eva Scrivo Salon in New York City. And beware: A color that contrasts with your scalp (blonde tones if your scalp is dark, deep brunettes if your scalp is light) will make any visible scalp more obvious.
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.

Coconut oil contains fatty acids that penetrate inside the hair shaft and reduce protein loss from hair. Coconut oil can be used either before or after you wash your hair depending on your hair type. If your hair tends to be oily, you can do a leave-in treatment overnight or for a few hours before you wash it. Massage coconut oil into your scalp and all of your hair. If your hair is dry, you can also use it as a leave-in treatment. There needs to be more research on coconut oil as a promoter of hair growth, but it’s been shown to improve the health and luster of hair and has been used for centuries.
Using ROGAINE doesn't mean giving up your favorite styling products. So spray away. Gel it up and/or mousse around. Just make sure your styling aids don't interfere with letting ROGAINE become absorbed into your scalp. Always remember to wait until ROGAINE dries before you use your styling aids, and be sure to apply styling aids to your hair--not to your scalp.
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.

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.
Green tea is rich in antioxidants that prevent hair loss and boost hair growth (25). Many other herbal teas possess similar properties and can be used just like green tea to rinse your hair. Tea rinses have been tested and tried by many people for hair growth, and the results have been positive. Some of the other teas that you can use are bamboo tea, nettle tea, sage tea, or even regular black tea. Just steep the tea bag or a tablespoon of the dried herb in hot water and use it as described above.
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. 
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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.
In February, though, Ms. Telford, 46, flew from her home in London, Ontario, to Sarasota, Fla., for a new $1,400 hourlong treatment known as platelet rich plasma (P.R.P.), which is said to stimulate dormant hair follicles. The procedure involves drawing blood, spinning it in a centrifuge to extract the plasma, adding various nutrients (like more protein), then injecting the resulting mixture in one-inch intervals in a grid on the top of the scalp, which has been numbed with a local anesthetic.
Minoxidil was the first drug approved by the FDA for the treatment of male pattern baldness. For many years, minoxidil, in pill form (brand name Loniten), was widely used to treat high blood pressure. Just like finasteride, researchers discovered a very interesting side effect of the drug. People taking the medication were growing hair in unexpected places, such as on their cheeks and the back of their hands. Some people grew hair on their foreheads.

Thanks for the article with great info. I’ve been taking minoxidil 5% for the last 2 years. I’ve tried a generic minoxidil brand and also Kirkland to no effect. I’ve been hoping it’s maybe slowed the hair loss process. The hair around my crown just keeps getting thinner. Do you think changing to another “better quality” brand like Lipogaine or Rogaine could work? Or does it appear that any minoxidil brand is not going to work?
Baking soda can remove the excess product and chlorine build-up from your scalp and hair (56). Such build-up usually clogs your pores and stunts hair growth. Massaging with this versatile powder can also exfoliate your scalp, get rid of the dead skin cells, and improve blood circulation to the scalp (57). As baking soda is antifungal, it will also treat any fungal infections that may be present (58).
Vitamin E has been used as a home remedy for hair growth since ages. Vitamin E oil is rich in antioxidants and helps to fight the free radicals. It increases oxygen in the body and enhances blood circulation in the scalp. Regular massage with essential oils promotes hair growth and reduces hair fall and split ends. This makes your hair softer and smoother (6).

P.R.P., considered a nonsurgical treatment, is not covered by insurance, and clinical studies about its effectiveness (and longevity of results) are not conclusive because different doctors use different mixes. But P.R.P. has a long (though also inconclusive) history of use elsewhere in the body. Athletes like Kobe Bryant have received the treatment in an attempt to heal injuries.


Stop use and ask a doctor if chest pain, rapid heartbeat, faintness, or dizziness occurs sudden, unexplained weight gain occurs your hands or feet swell scalp irritation or redness occurs unwanted facial hair growth occurs you do not see hair regrowth in 4 months May be harmful if used when pregnant or breast-feeding. Keep out of reach of children. If swallowed, get medical help or contact a Poison Control Center right away.

Coming in at number 3 is this great product from the trusted name of Biotopic. The main advantage of their product is the fact that this contains only natural ingredients. Formulated with biting, Caffeine and Saw Palmetto, it reduces the hair loss and promotes volume and adds bounce and shine to the existing hair. The product is formulated into a neat spray formulation which is easy to apply and target to the affected area. With a once in a day application, it is easy to stick to the routine. The results wit this formulation are really amazing. If you suffer from MPB especially in the crown region, this product is for you.
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.

A few studies support the use of red ginseng, sometimes called panax ginseng (about $25), for hair regrowth. It can have an anti-apoptotic effect on the hair, Rogers says, meaning it slows cell death so hair follicles can grow for a longer period of time. But before taking any of these supplements, it’s important to consult your doctor; a lab test can confirm whether you need a particular supplement or if taking it will just be a waste of time and money.
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.
A few studies support the use of red ginseng, sometimes called panax ginseng (about $25), for hair regrowth. It can have an anti-apoptotic effect on the hair, Rogers says, meaning it slows cell death so hair follicles can grow for a longer period of time. But before taking any of these supplements, it’s important to consult your doctor; a lab test can confirm whether you need a particular supplement or if taking it will just be a waste of time and money.
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. 
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