"I recommend that everyone [with any hair loss] take finasteride," says Robert M. Bernstein, MD. Bernstein is associate clinical professor of dermatology at Columbia University and founder of the Bernstein Medical Center for Hair Restoration. "To patients who are younger,” he says, “I also recommend minoxidil. But the mainstay is finasteride. The data show that, over five years, it significantly retards hair loss in 85% of users."
Thank you. This has been the most helpful article I have read! Very much appreciated! Last question (I won’t bug you with anymore after this) . . . I was tested by my doctor and came out perfectly healthy so it is either stress or MPB. My job is extremely stressful so it could be that but I have no way or knowing for sure. As such, do you think there is any harm on me taking finasteride even if it isn’t MPB and is just stress? I suppose if the medicine didn’t work, I would know it was stress and not MPB. Also, I assume this is something I would continue to take for life right?

"There's never been a single study to show they work," Bernstein says of the alternative remedies. "It's conceivable that some might have some minor impact. But the real problem is that people waste valuable time experimenting with them when they'd be much better off spending their money on something proven to work. The window for Propecia passes, and if you've spent two years with this herbal thing instead, that can make a big difference in the results you ultimately get."
SmartGraft is a new, breakthrough device that helps surgeons and their specialized teams perform FUE or Follicular Unit Extraction hair transplantation. Less invasive than traditional linear “strip” harvesting, Follicular Unit Extraction uses no scalpel, no stitches, no staples in the donor area–allowing for faster healing, less discomfort after transplantation, quicker return to athletic activity and leaving absolutely NO tell-tale linear scar. It yields only grafts which contain as little as a single hair follicle, which — when used artistically — can result in a 100% natural appearance.

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.
Minoxidil (Rogaine, generic versions). This drug was introduced as a treatment for high blood pressure, but people who took it noticed that they were growing hair in places where they had lost it. Research confirmed that a 2% solution of minoxidil applied directly to the scalp could stimulate hair growth. How it works is still not clear. Two double-blind studies of women ages 18 to 45 demonstrated its effectiveness. In one study, 13% of female minoxidil users had moderate hair growth, and 50%, minimal growth (compared with 6% and 33%, respectively, in the placebo group). In the second study, 60% of women in the minoxidil group reported new hair growth, compared with 40% in the placebo group. As a result of these studies and others, over-the-counter 2% minoxidil is FDA-approved for treating androgenetic alopecia in women.
The trick about all of these hair-loss products and treatments is that they’ll stop working as soon as you stop using them. “They have to be ready for a lifetime commitment,” says Rieder. But, just like brushing your teeth, as long you keep on keeping on with the scientifically proven preventative treatments, those hairs on your head should be just fine.
1. Minoxidil. It’s the only FDA-approved topical nonprescription medication that can claim to regrow hair — and it should be part of any hair-loss plan if you have serious thinning, says Rogers. Minoxidil has loads of research to back it, but it requires commitment. If you quit using it, your hair will start to lose ground again. Use a 5 percent strength, like Women’s Rogaine 5% Minoxidil Foam ($30), once daily to see results in three to four months, says Rogers.

Revitalize your hair and get the luscious locks you want with Equate Women's Hair Regrowth Treatment. It's ideal for women with non-patchy, localized hair loss who are looking for a budget-friendly solution. This minoxidil topical solution contains two percent minoxidil to revitalize follicles and combat hair thinning. It's FDA approved, unscented and comes in a 3-pack of 2 oz bottles, providing a 3-month supply. This hair fall treatment is most effective for women with general thinning on the top of the scalp. Results may vary depending on the individual. It should not be used if you're experiencing patchy hair loss.
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The earlier you begin treating hair loss, the more effective the treatment will be. Androgenetic alopecia is a condition that gradually worsens over time, so the general rule is that the earlier you seek treatment, the better. “If you’re losing your hair and you have genetic hair loss, using medication such as Propecia or minoxidil is most effective when started early,” says Dr. Robert M. Bernstein, Dr. Wolfeld’s colleague at Bernstein Medical – Center for Hair Restoration. Because not everyone loses hair on the same timeline, you can’t rely on statistics to tell you when you should start treatment. Some men start to notice thinning in their early 20s, while others maintain a thick head of hair well into their 50s. If you suspect that you’re starting to lose your hair and want it to stop, act quickly.

Though, it is important to point out that a lot of these companies are developing procedures that involve implanting hair, which means there is a chance they will be expensive — as we mentioned before, traditional hair transplants are costly. But a few companies and products such as Follicum’s FOL-S-005 and Fidia Pharma’s Brotzu Lotion are being designed as topical treatments.

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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.
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