*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.   
Skeptics (among them, Dr. Wesley) are starting to come around after a 2014 randomized double-blind study published in the American Journal of Clinical Dermatology found a “statistically significant” difference in hair density for women who used a laser comb compared with those who used a sham device. (“Comb” is something of a misnomer. The device looks like a hairbrush crossed with a cordless phone; it is glided back and forth across the scalp, roughly a half-inch at a time, usually about 15 minutes three times a week.)
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.
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.
There are many potential causes of hair loss, including medical conditions, medications, and physical or emotional stress. If you notice unusual hair loss of any kind, it's important to see your primary care provider or a dermatologist, to determine the cause and appropriate treatment. You may also want to ask your clinician for a referral to a therapist or support group to address emotional difficulties. Hair loss can be frustrating, but recent years have seen an increase in resources for coping with the problem.
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?
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