Women with androgenic alopecia may consider trying prescription ketoconazole at a strength of 2 percent. This drug comes in the form of a shampoo and also goes by the name Nizoral. It’s an antifungal agent and may help reduce the body’s production of testosterone and other androgens that lead to hair loss. You can also find 1 percent strength at your local pharmacy, but it may not be as effective.
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.
Adam Friedman, a program director at The George Washington University School of Medicine & Health Sciences, is on the same page as Romanowski. "While it does have antimicrobial properties which may be useful in terms of fighting off bacterial or fungal overgrowth on the scalp that can lead to hair-damaging inflammation, there is zero evidence [showing] it is helpful for hair growth," he says, adding that some people can actually be allergic to castor oil and experience inflammation, ultimately doing more damage than good to the scalp. "To propose that castor oil accelerates hair growth, a tightly regulated process (one centimeter per month) for which FDA approved medications for hair loss do not impact, is ridiculous," he states.
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.