Some 30 million women in the United States have hereditary hair loss (compared with 50 million men), according to the American Academy of Dermatology, though that figure does not include the millions more who struggle with thinning hair because of pregnancy, menopause, stress and other health conditions. Barely 5 percent of women are said to be good candidates for hair transplant surgery because women lose hair everywhere, meaning that, unlike with men, there is rarely a luxuriant spot on the back of the head from which to harvest hairs unobtrusively.
Some women find that the minoxidil solution leaves a deposit that dries and irritates their scalp. This irritation, called contact dermatitis, is probably caused not by the minoxidil itself, but rather by the alcohol that is included to facilitate drying. A 5% solution (available only by prescription and approved only for men) is more effective than the 2% formulation and may be prescribed off-label for women. The 5% version comes in a foam, which appears to cause less irritation than the liquid.
Rogaine’s foam squirts out just like hair mousse and is applied with “cool, dry hands.” Applying means working the foam down to the scalp where you want to see thicker growth — for it to work, “it has to get into your scalp,” Dr. Wolfeld explains. “If it sits on your hair, it’s not really as effective.” Once massaged, it dissolves into a watery liquid that leaves a tingly sensation, “but no burning!” one of our balding testers was happy to discover.

Anti-androgens. Androgen receptor–blocking drugs such as spironolactone (Aldactone) and finasteride (Propecia) are not approved for the treatment of female pattern hair loss, and there is little reliable evidence that they are effective. However, some case studies suggest that women who don't respond to minoxidil may benefit from the addition of spironolactone. In the relatively uncommon cases where there is an excess of androgen, a clinician may prescribe 100 to 200 milligrams of an androgen receptor–blocking drug daily, together with an oral contraceptive for women of reproductive age. (A woman taking one of these drugs should not become pregnant because they can cause genital abnormalities in a male fetus.) Possible side effects include weight gain, loss of libido, depression, and fatigue.
A little farther up the follicle is the mysterious feature called the bulge. That's where follicle stem cells live. When they get the right set of chemical signals, these self-renewing cells divide. They don't divide like normal cells, in which both halves become new cells that keep splitting and developing. Only one half of the follicle stem cell does that. The other half becomes a new stem cell, and stays put for future regeneration.
The test involves plucking about 50 hairs from the head, typically at the back of the scalp, so your dermatologist can look at them under a microscope and determine how much of the hair is in the resting, growth, and fall-out phases. Next, a vial of blood is sent to a lab to check hormone and nutrient levels ($100 and up, depending on insurance). If low levels of iron, or high levels of male hormones, like androgens, are contributing to your hair loss, for example, both can be treated through oral supplements or medication.
A commonly prescribed treatment for women is hormone replacement therapy (HRT). HRT is only prescribed to women with AGA during menopause or women who have low estrogen and/or progesterone for other reasons. These female hormones suppress male hormone production and seem to keep hair loss at bay. Physicians, however, do not recommend long periods of HRT treatment because of the increased risk of breast cancer, heart disease and stroke.
Some treatments in development hold particular promise for women. Angela Christiano, a hair geneticist and Columbia University professor of dermatology, is hoping to begin clinical trials in a year or two on a procedure in which she dissects hair-follicle stem cells, grows them in the lab until she has several million, then injects them into the scalp, where, a very small study done with a human skin model has shown, they induce new hairs.
To us, that meant any product with zero proven ingredients, case studies, or FDA clearance — which shrunk our list by a whopping 180 contenders. That’s right, there are only three treatments that have actually been cleared by the FDA and supported with clinical studies: finasteride (commonly marketed as Propecia), minoxidil, and laser treatments. And, since finasteride is prescription-only, it left us with two.
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.
Coming in at number 10 is a topical solution of 2{fb6dbafde8b07077c47190f01cc66a00f2a1889c1c1e7dc76005cbe93156625a} minoxidil. Minoxidil promotes the blood flow in the roots of the hair and promotes the regrowth of new and shiny strands of hair. Applied twice a day, the solution does have some good results. The formula is unscented and does not leave any residue so that you can confidently wear it while you are out and about as well.
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