I have been on Proscar now (1.25mg/day) for nearly 10 months, rogaine foam 1 to 2 days a time and Nizoral shampoo a few times a week. unfortunately, the shedding never stopped. When I shower, I still see 10-15 hairs on my hand when I shampoo and another 5-10 after I comb my hair after I shower . . . and then another 10-15 when I style my hair with gel in the mornings. I’m going to switch to name brand Propecia and try that out for a few months but I think I may just not responding to this treatment. My hair is absolutely more thin than it was before I started treatment. My thinking is that I go another 3 months on name brand propecia and if that doesn’t work, try Avordart. Thoughts?
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.)
I'll start by saying I actually don't have a serious hair loss problem. However, I have always had calics along my hairline, so I wanted to fill them in a little before my sister's wedding. I started using this product about a month ago. I hate that it never seems to dry, so I ended up throwing my hair in a slick bun to hide the sticky look on a number of occasions. But just last week a coworker pointed out that my hairline was filling in, which is when I finally realized that it was working! The wedding is over, but I plan on using it over the course of the next three months to see if I can obtain more permanent results. So far I'm pleased, but the results take time and it's a little pricier than I would like to admit. The twice a day thing is kind of a pain in the arse.
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?

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.”
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!!
If you’re a lady and can remember the one difference in directions (or just scope out the instructions online) we recommend saving the cash. Similarly, you could go generic with Equate Hair Regrowth Treatment for Men or Costco’s Kirkland Signature Hair Regrowth Treatment Minoxidil Foam for Men. These alternatives offer the same percentage of active minoxidil and near-identical inactive ingredients for as little as half the price — a great option for both genders.

"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.

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.
If you’re a gentleman who’s been noticing a receding hairline or is worried about balding, the first step is to schedule a visit with a doctor or dermatologist and make sure your hair loss isn’t a sign of a more serious health issue. “Not all hair loss is male-pattern hair loss,” explains Dr. Marc Glashofer, a board-certified dermatologist specializing in hair loss and practicing in northern New Jersey. A thyroid disorder, an autoimmune disease, or even a scalp issue could be making you look like Bruce Willis in Die Hard 2. But most hair loss is androgenetic alopecia, also known as male-pattern baldness, and fortunately (or not, depending on your perspective), it’s just a symptom of getting older.
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.

Testosterone replacement is becoming popular for men. Cotsarelis warns that this may accelerate hair loss. Propecia might help -- but because it prevents testosterone breakdown, it might affect the dose of male hormone replacement therapy. Cotsarelis warns men taking both Propecia and testosterone replacement to make sure their doctor carefully monitors their testosterone levels.


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.


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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?

Since birth control pills decrease the production of ovarian androgens, they can be used to treat women's androgenetic alopecia. Keep in mind, however, that the same cautions must be followed whether a woman takes contraceptive pills solely to prevent contraception or to treat female pattern baldness. For example, smokers age 35 and older who take the Pill are at higher risk for blood clots and other serious conditions.
Many physicians recommend that patients engage in a combination therapy that includes minoxidil and Propecia (Est. $75 per 1-month supply) with prescription. Propecia is an oral medication with finasteride being the active ingredient. Finasteride was originally developed by Merck to treat enlarged prostate glands. Excess hair growth was a surprise side effect of the drug and led to the development of Propecia, which was approved by the FDA for treatment of male-pattern baldness in 1997. It has not been approved for women.
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.)
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!
The only nonchemical option offered up by the dermatologists I spoke with — short of a surgical hair transplant or platelet-rich plasma therapy, which is like Kim Kardashian’s vampire facial but for your scalp — was the laser comb. First cleared by the FDA in 2009, the HairMax LaserComb is a handheld laser device that is designed to promote hair growth. As the manufacturer explains in a letter to the FDA, “The device provides distributed laser light to the scalp while the comb teeth simultaneously part the user’s hair to ensure the laser light reaches the user’s scalp,” which, in turn, stimulates the hair follicles.
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?
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.
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. 
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