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.
If you do decide to start treatment to save your hair, a good place to start is with minoxidil, more commonly known as Rogaine. Don’t expect this hair-loss treatment to create luscious locks; minoxidil is better at slowing down or preventing more loss rather than promoting hair growth. But, according to Dr. Amy McMichael, professor and chair of Wake Forest Baptist Medical Center’s Department of Dermatology, it is effective “if used as recommended, with evidence of improvement seen around six to nine months.” Simply massage the foam or solution into your scalp once or twice daily, and for best results, use a formula with 5 percent concentration.
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.
The dermatologist also will carefully look at your scalp and hair. During an exam, the dermatologist may pull on your hair. Sometimes a dermatologist needs to pull out a hair to get the necessary evidence. And sometimes a dermatologist needs to look at the hair on the rest of your body to see whether there is too little or too much hair in other areas.
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.
Stay away from tightly bound styles, like braids, buns, or ponytails. Resist twisting or rubbing your hair. And gently wash or brush hair, switching to a wide-toothed comb if necessary to prevent too much pulling at the roots. Hot rollers, curling or straightening irons, hot oil treatments, bleaching, and other chemical processes are other things to avoid.
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Why? Unwanted hair growth (sideburns, for example) is a reported side effect of minoxidil. The belief is that a higher concentration of minoxidil would result in more unwanted hair, which is why women are instructed to use it less often. However, the study in Skin Therapy Letter reports that unwanted hair was more common in 2 percent minoxidil solutions than 5 percent, and women are instructed to use Rogaine’s 2 percent solution twice daily — so what gives?
"I recently started using your hair growth products, and now there is no looking back. My hair has always been really thin and fine and growth around the hairline at the temples has been poor. It almost looked like my hairline was receding. I didn't like putting my hair up as I looked like I was going bald. But, not any more. My hair feels thicker, and growth is improving at the temple area. My hair would never grow beyond my shoulders, that's going to be the next test, how long will it grow!! Thank you, after years of irritation with my fine hair things are looking up."
*all photos are models and not actual patients.If you are interested in a prescription product, Hims will assist in setting up a visit for you with an independent physician who will evaluate whether or not you are an appropriate candidate for the prescription product and if appropriate, may write you a prescription for the product which you can fill at the pharmacy of your choice.

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.
Finally, if these tests come back normal, your dermatologist may suggest a scalp biopsy of a couple of two-millimeter sections taken from your scalp under local anesthesia ($400 and up). It can determine whether genetic hair loss, telogen effluvium (a condition in which hair falls out from stress or rapid weight gain), or a disease (such as lupus) is the cause of your shedding, and your dermatologist can treat you accordingly.
Results from clinical studies of mostly white women ages 18 to 45 years with mild to moderate degrees of hair loss report that after using minoxidil for eight months, 19% of users had moderate regrowth and 40% had minimal regrowth. Of those using a liquid without active minoxidil (a placebo) during the same time period, 7% reported moderate hair regrowth while 33% had minimal regrowth.
This study claims laser therapy does have some sort of effect, but I’ve never found any people who swear by it, like for minoxidil, finasteride, and keto. I wouldn’t waste my money on it. To be honest with you, I’m on minox, fin and keto for about 3 years now and still experience sheds every once in a while. I wouldn’t worry about it. While my hair is shedding my hairline is staying intact. How often do you use the keto shampoo?
As with transplants, the word toupee conjures an outdated and disagreeable image. The 70s-style rugs have mostly been traded in for spiffier "hair replacement systems." But the basic concept -- a foreign object atop your head -- can only evolve so far. Of course, the effectiveness of hairpieces is tough to evaluate. You may spot an awful one now and then, but the ones you do spot are just the awful ones. Who knows how many masterpieces slip undetected under the radar?
Spironolactone, brand name Aldactone, is in a class of drugs called potassium-sparing diuretics (often called water pills). Spironolactone is typically used to reduce fluid in your body without causing the loss of potassium. It is also used to treat potassium deficiency, high blood pressure (hypertension), swelling (edema), and a hormonal disorder called hyperaldosteronism.

Then when you’re shopping for a solution take the time to read the label, the instructions, and the reviews. We know that there are lots of fake reviews out there because we see them too. Stick to products from well-known companies and use sites like Fakespot to help you weed out the scams. Of course, a recommendation from a person you trust is a big help, too.

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.
That said, there are products that don’t have FDA approval or clearance, but may help prevent hair loss. For example, shampoos with ketoconazole, a chemical with anti-DHT properties, is widely used to treat fungal infections but has become popular among consumers as a hair loss treatment. It makes sense — research shows that ketoconazole actually has beneficial effects on hair growth (especially for those with seborrheic dermatitis).
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.”
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.
In-office laser light treatments or at-home handheld devices, such as the HairMax LaserComb, supposedly grow new hair by stimulating blood flow to the area (think: an amped-up version of a scalp-stimulating shampoo). Just don’t expect the device to make your noggin go from looking like George Costanza’s to Jerry Seinfeld’s. “These lasers won’t grow any new hair. If anything, they may just help you hang on to some of the hair that you already have a bit longer,” says Dr. Joyce.

Beginning treatment as soon as possible after the hair loss begins gives the best results, because prolonged androgenetic alopecia may destroy many of the hair follicles. The use of anti-androgens after prolonged hair loss will help prevent further damage and encourage some hair regrowth from follicles that have been dormant but are still viable. Stopping treatment will result in the hair loss resuming if the androgens aren't kept in check in some other way. Maintaining your vitamin and mineral levels helps while you're on anti-androgen medications.
"Castor oil will not grow hair," says cosmetic chemist and author Perry Romanowski matter-of-factly. "There is no evidence for it and no scientific theory supporting that it would work, so yes, it's a total myth." In better news, he says that castor oil is not damaging to the hair and can provide some conditioning that improves the flexibility of the hair fiber.
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.
2. High-tech regrowth therapies. Laser treatments ($200 and up) expose hair to low levels of laser light, which boosts hair growth by increasing the amount of adenosine triphosphate (ATP) in hair follicles. ATP provides energy to hair-follicle cells, so the more of it that’s around, the more energy hair follicles can use to grow your hair. Sadick says three months of weekly sessions are best when you’re kick-starting a hair-loss treatment.
Dr. Melissa Piliang, a dermatologist at the Cleveland Clinic, said that Rogaine works better on the top and crown (for reasons not fully understood, the frontal hairline tends to be more resistant to treatment) and ideally should be started as soon as women notice thinning. “Any regrowth you get is a minimal amount,” Dr. Piliang said. “So the more density when you start, the better results you get.”

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.
Aqua, Cetearyl Alcohol, Cetyl Alcohol, Cyclopentasiloxane, Cetrimonium Chloride, Bis-Peg-12 Dimethicone Beeswax, Creatine, Quaternium-91, Parfum, Dimethiconol, Hydrolyzed Lupine Protein, Cetrimonium Methosulfate, Hydrolyzed Wheat Protein, Hydroxypropyl Guar Hydroxypropyltrimonium Chloride, Hydrolyzed Vegetable Protein Pg-Propyl Silanetriol, Saccharum Officinarum Extract, Hexyl Cinnamal, Sodium Laneth-40 Maleate/Styrene Sulfonate Copolymer, Betaine, Hexylene Glycol, Methylparaben, Propylparaben, Citrus Limon Fruit Extract, Hydrolyzed Wheat Starch, Phenoxyethanol, Pyrus Malus Fruit Extract, Butylphenyl Methylpropional, Camellia Sinensis Leaf Extract, Sodium Chloride, Linalool, Benzyl Benzoate, Limonene, Coumarin, Magnesium Chloride, Hexapeptide-11, Potassium Sorbate, Disodium Edta, Magnesium Nitrate, Ethylhexylglycerin, Methylchloroisothiazolinone, Methylisothiazolinone, Ci 15985, Ci 60730, Ci 17200.
You can also get a hair-loss kit from Hims, which comes with both minoxidil and finasteride. Keeps has one, as well. And though it might seem like overkill to take two different hair-loss treatments at once, this is one of those rare instances where more is actually better. McAndrews calls the combination of orally administered finasteride and topically applied minoxidil a “full-court press” against hair loss. “That’s doing the most you can for preventative medicine.” Rieder notes that taking both drugs together is more effective than taking either one alone.
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.

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.

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. 

Thanks for the help Domen. I currently use keto about once a week but I will ramp up to 3 times a week. I hear that helps for Sebum reduction. Do you agree? In terms of shedding, I shed very consistently . . . .about 15-20 hairs I notice in the shower when I shampoo, 15 hairs when i come out of the shower and comb my hair, another 5 every morning on my pillow and random hairs throughout the day that I notice on my desk.

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 »
Instead, you may want to add vitamin D (about $15) to your shopping cart. A vitamin D deficiency can exacerbate hair thinning and make it almost impossible for any over-the-counter product to reverse hair loss, says Dhaval Bhanusali, a dermatologist in New York City, who recommends taking 5,000 international units of D3 a day (and it’s generally beneficial for bone health in women over 40). “There’s also a link between low iron and zinc levels and temporary hair shedding, called [telogen] effluvium,” says Rogers.
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.
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.
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.

The HairMax Ultima 12 LaserComb ($395) makes for a great addition to any hair loss regimen — provided you can afford it. Dr. Wolfeld notes that it’s a popular option in his practice. “Some people like the action of combing something through their hair,” he says. “They find that to be a little bit easier to do as part of their routine in the morning.” Dr. Khadavi also recommends using a laser treatment of some kind in conjunction with other treatments. “Lasers do help in stimulating the hair into the growth phase. We don’t know the exact mechanism of how it works, but it definitely helps.”
Hair: It’s a natural part of being a human. But when the temperature climbs, and skin is exposed, it’s one of those things that a good many of us want to control. This week, we’re tackling hairlessness, not just the process of hair removal (electric shavers and ingrown-hair treatments and aesthetician-approved tweezers) but also what to buy when you’re losing your hair, and even how to take care of a Sphynx cat. Here, we’re talking to dermatologists and hair-loss doctors about hair-loss treatments that actually work.
The use of PRP “enhancements” such as Extracellular Matrix (ECMs) as well as Stem Cells/Signaling Cells can be added to the PRP to enhance it’s hair growth properties and prolong its effects. When PRP is performed without these enhancements, multiple repeat treatments are needed as often as every other month. Research has shown that the use of ECMs like ACell–derived from porcine/pig bladder, BioD–derived from donated healthy human placenta, Adipose-Derived Stem/Signalling Cells–harvested and separated from the patient’s own fat, and even special exosome preparations can help strengthen the effectiveness and lengthen the duration of the results from a single PRP treatment.  
Cyproterone acetate is not available in the U.S. Doctors consider it one of the last resorts for treating female pattern hair loss because of its possible toxicity and long-term side effects. As with any drug, side effects other than those listed on the package may occur. Contact your doctor if you notice a side effect that is unusual or particularly bothersome.
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