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.

3. Surgical hair replacement. If you opt for hair transplantation (which runs $5,000 and up), your dermatologist or hair-replacement surgeon will remove single hair follicles from the back of the head, near the nape of the neck, where your hair is fullest. Once those follicles are harvested, they are then dissected and reimplanted into an area of the scalp where hair is thinning. The procedure takes anywhere from three to six hours, and newly implanted hair will usually begin to grow on its own 3 to 12 months after the treatment session. Traditionally, hair transplantation required removal of an entire strip of scalp, Sadick says, but this new follicle-by-follicle technique looks more natural when it heals and allows patients to get heads of hair as dense-looking as before they started losing it.
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).

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 your response and awesome article! Do you recommend sticking with minoxidil for a period of time (i.e. 6 months) before starting finasteride or do it all at once? I would be on finasteride now if I wasn’t nervous about the potential side effects so my plan was to wait to see if minoxidal does anything for me over the next 3 months or so (at that point I will have been on it ~ 6 months). My shedding has certainly reduced so hopefully it is starting to work. I’m in the very early stages of hair loss. No one would notice (except me and my wife). Just looks my hair part on the top of my head even though it really is thinning.
The truth is, the amount of propylene glycol in hair loss treatments is not likely to cause any real harm and the FDA has given the chemical approval for many uses. But even though it is safe, we wanted to ensure that our top picks would be as comfortable to use as possible. So when Dr. Khadavi told us that “a third of my patients get irritated from minoxidil products because of propylene glycol,” we decided to cut any treatments with it. In any case, it’s the minoxidil that helps curb hair loss and not the propylene glycol. 

The follicles on the sides of the scalp are more genetically resistant to DHT, which is why male pattern baldness often results in a “crown” of hair. But its downsides are serious. “With women, finasteride is not an option,” says Dr. Wolfeld. “It’s not FDA-approved for women to take, so we don’t prescribe it.” In fact, due to the drug’s effect on hormone levels, pregnant women are advised to not even touch broken or crushed tablets.
Working just like a precise microsurgical extension of the human hand, SmartGraft’s all-in-one ergonomic handpiece and storage system was designed to help accurately separate, extract and store FUE grafts during hair transplantation. Fewer steps, less handling, and manual transferring of grafts allows the FUE procedure to be accomplished at a faster speed, reduced risks of graft failure and poor growth quality as well as with improved patient comfort.
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.
This innovative product uses the active ingredient called Minoxidil. Lipogain uses the trusted hair growth promotor Minoxidil in a special delivery system. The minoxidil from lipogain is absorbed very efficiently into the scalp thanks to the new and improved Liposomal system. The product is also fortified with biotin, the most important vitamin for hair growth promotion. It also contains some herbal extracts promoting hair growth as well.

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.
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?
"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.
I have taken Propecia for 5 years. The first couple of years the side effects were minimal, but after they became more severe. Lacking morning wood, reduced ejaculate, reduced penile sensitivity are real issues. You’re be hard pressed to accuse some of suffering the nocebo effect in these instances. In which case you’re telling the person to just ignore the problems.
George Cotserelis, MD, is director of the University of Pennsylvania's Hair and Scalp Clinic. He agrees that there's no evidence these alternative hair loss treatments have any effect. "If any of it did work," he says, "I'd be very worried about using that product. The fact that it’s working would mean it's doing something to the testosterone and could be having adverse effects."
The truth is, the amount of propylene glycol in hair loss treatments is not likely to cause any real harm and the FDA has given the chemical approval for many uses. But even though it is safe, we wanted to ensure that our top picks would be as comfortable to use as possible. So when Dr. Khadavi told us that “a third of my patients get irritated from minoxidil products because of propylene glycol,” we decided to cut any treatments with it. In any case, it’s the minoxidil that helps curb hair loss and not the propylene glycol.
As everyone ages, hair follicles begin to shrink, leading to thinning hair (or loss of hair density). Unlike hair loss shampoos or hair thickening products that temporarily plump hair from the outside, Rogaine 2% Minoxidil Solution penetrates into the scalp to reactivate shrunken hair follicles, allowing for new fuller, younger-looking hair to regrow. Rogaine is clinically proven to help regrow hair. No topical treatment works faster to grow fuller hair than Rogaine.
If you think over-the-counter hair loss shampoos are for you or just want to promote growth and strength, Dr. Schwieger recommends formulas with antioxidants such as vitamin E and ginseng, amino acids, and B-vitamins to help rebuild hair and reduce environmental damage. She cautions against those with parabens, sulfates, and fragrances, which can irritate hair and reduce moisture. Ahead, eight vetted hair loss shampoos to try.
Side effects and concerns: Minoxidil is safe, but it can have unpleasant side effects even apart from the alcohol-related skin irritation. Sometimes the new hair differs in color and texture from surrounding hair. Another risk is hypertrichosis — excessive hair growth in the wrong places, such as the cheeks or forehead. (This problem is more likely with the stronger 5% solution.) Because the patent on Rogaine (the brand-name version of minoxidil) has expired, many generic products are available. They all contain the same amount of minoxidil, but some include additional ingredients, such as herbal extracts, which might trigger allergic reactions.
Just letting go is possibly the most challenging of the available options. It’s also the cheapest and ultimately the most effective in the struggle with hair loss. Given the imperfections of surgical, medical, and technological options, there are many who advocate simple acceptance. (BaldRUs.com is one of several sites devoted to embracing the scalp's natural fate.) What's more, the health benefits of happier mirror time -- and fewer years of harmful anxiety -- just might offset the loss of those Samson-like powers.
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