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The 13 Best Proven Hair Loss Treatments for Men

Dr. Shane Jackson MBBS
Medically reviewed by: Dr. Shane McKeown MBBS

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best hair loss treatment for men

1 in 4 men will start to experience hair loss due to male pattern baldness before the age of 30. By the age of 80, that number jumps to 80 percent! If you are starting to experience male pattern baldness, you are not alone. Most, if not all men will experience hair loss in their lifetime. That is why there are so many products on the market that target this condition.

The problem: there is far more snake oil on the market than there are evidence-based treatments.

That is precisely why we have created this primer on the best hair loss treatment for men; we did the tough work of sifting through the evidence to bring you the best-of-the-best when it comes to reversing and slowing the advancement of male pattern baldness.

Not only is this condition widespread, but it is also an age-old problem. The famous Greek philosopher Aristotle, who was balding himself, noted that eunuchs did not lose their hair. That was our first hint that baldness was related to the hormones known as androgens.

However, this observation was forgotten for the next 2,500 years until James B. Hamilton’s landmark study in 1949 that linked baldness to hormones. This link to androgen hormones is why male pattern baldness is also known as androgenetic alopecia (AGA for short).

Hamilton, a researcher at Yale University at the time, also noted that genetic predisposition and age played a significant role. [1]

The good news: researchers have made a lot of advancements since 1949. Not only do we better understand the three contributing factors and an added fourth factor related to inflammation of hair follicles, but several treatments can reverse or slow a receding hairline. Of course, it is easier to preserve than it is to restore…

We have all heard the adage that an ounce of prevention is worth a pound of cure; treating hair loss is no different. While the treatments we are going to review can and likely will help to regrow some hair, they work even better as preventative measures as they can slow down hair loss to the point where it may take years to see any further recession of your hairline.

In this review, we are going to cover the top evidence-based treatments backed by clinical science. We will also explore a few of the alternative and complementary therapies such as hair transplants—a big thanks to Dr. Alan Bauman from Bauman Medical for giving us the lowdown on modern transplants (these aren’t your dad’s transplants).

Finally, we will review what’s in the pipelines as far as the development of new treatments for male pattern baldness and then answer a few frequently asked questions people have about this all-too-common condition.

Without further ado, let’s take a look at the best ways to slow or even reverse the retreat of your hairline!

The 13 best hair loss treatments for men

There are a lot of treatments out there that target male pattern baldness. In this review, we are going to look at those treatments that are backed by evidence and discuss how they work so that you can make the best choice to treat your receding hairline.

We have organized the list so that the most effective treatments are at the top, working our way down to the alternative or complementary therapies.

Our top-2 (finasteride, aka Propecia and minoxidil, aka Rogaine) are the only treatments that have specific FDA and European Medicines Agency (EMA) approval for treating hair loss due to AGA. However, a new player (dutasteride or Avodart) is emerging on the market and may be even more powerful.

We are placing it at number 4 on the list because more evidence is needed to assess its efficacy, while our top-3 have a longer history of research and use by the public, which all support their effectiveness.

1. Finasteride (Brand names: Propecia, Hims)

propecia finasteride

First used for the treatment of benign prostate hyperplasia, the FDA and EMA have now approved it as a treatment for male pattern baldness, and it has since become the best treatment for male hair loss.

Overview:

Finasteride inhibits the types II and III 5-alpha-reductase (5α-reductase) isoenzyme. This, in turn, inhibits the conversion of testosterone to dihydrotestosterone (DHT), which is why it and other similar products are called DHT inhibitors. It is also minimally selective for type I 5α-reductase. Combined, this means that finasteride can block about 70% of serum DHT. [2]

DHT, in those genetically predisposed to AGA, can affect the hair follicle causing it to miniaturize (shrink), leading to thinner hair and can even cause the hair to fall out. AGA is also the result of a shortening of the growth phase of hair—also called the anagen phase—producing shorter, less visible hairs.

As the follicle shrinks and the growth period gets shorter, hairs eventually do not grow past the scalp’s skin.

The result:

The length and width of hair reduce as the follicle shrinks, resulting in hair that eventually becomes so small that it is virtually imperceptible or doesn’t even protrude out of the skin. It becomes vellus-like hair rather than terminal hair.

Vellus hair is the small hairs that grow on our bodies when we are young; they are short, thin, and have little color. Terminal hairs are the hairs that grow on your head, face, and other body parts as we enter puberty. They are thicker, longer, and have more substantial pigmentation.

A meta-analysis (a review of all) of the research that has been done on finasteride shows that it cannot only slow the process of turning terminal hair into vellus hair, but it can also reverse the process. After a year of continued use, patients saw an increase in terminal hair and a reduction in vellus hair on their head.

Likewise, finasteride use over a 48-week period showed a rise in anagen versus telogen hair. Anagen is that hair that is still growing; it is thicker and more pigmented while telogen hair is dormant, thinner, and less pigmented. [3] Thus, finasteride can help improve hair thickness and length.

How to get it:

Talking to your doctor or a dermatologist is the best way as it can interact with other drugs or conditions. However, it is also available online. Be cautious when purchasing online as there are poor imitations and outright fakes on the market that could even have terrible side effects in your body due to the chemicals used in it. If you want to go the online route, we can recommend Hims as a reliable source.

How to use it:

A once per day 1mg tablet is the standard dose for finasteride.

Note: taking more does not increase its effects but can increase side-effects. [4]

How soon you can expect results:

Some users saw regrowth as early as 3 months, but it can take up to a year. However, the slowing of hair loss should be almost immediate, although some initial shedding may occur (this means the medication is working) as dormant and vellus hairs are replaced with new growth. Remember that in the battle for better hair, a slowing of the process of AGA should be considered a win.

The Good (Pros):

  • It is the most potent way to treat and prevent hair loss.
  • Finasteride comes in an easy to swallow tablet, taken once daily.

Things to Consider (Cons):

  • A minority of users (around 3%) experience serious side effects like loss of libido or erectile dysfunction (ED).
  • Other common side effects include dizziness, weakness, dyspnea (labored breathing), rhinitis (allergy-like nasal symptoms), and skin rash.

Bottom Line:

This is the best hair loss treatment for men that is approved by the FDA. [5] While there are some side effects, they are usually minimal, and many of them fade with prolonged use. In the case of libido and ED, these effects were seen in a small segment of the population and may be mainly psychological and can sometimes be treated without stopping treatment.

If you experience any side effects, you should talk to your doctor and discuss your options. Don’t just ignore them as they may be telltale signs of something serious.

2. Minoxidil (Brand name: Rogaine)

Rogaine Minoxidil Foam (for Men)

Minoxidil is another medication that started as a treatment for another condition (high blood pressure) and was found to have the side effect of slowing hair loss and promoting hair growth.

Overview:

As we discussed above, miniaturization of the hair follicles and the premature termination of the anagen (growth) phase of hair are the primary factors in AGA. Treatments that are effective at halting or reversing male pattern baldness are going to have some effect on one or both of these factors.

While the mechanisms of minoxidil are not fully understood, because our understanding of hair growth and follicles is still limited, its effects are well documented.

The growth of hair is thought to be supported by some cell growth factors, including proteins and hormones such as VEGF, FGF-5S, IGF-1, and KGF, as well as the dermal papilla cells and dermal papillary vascular system.

On the flip side, negative factors bring an end to the anagen phase and put hair into the dormant phase or recessive phase. In AGA, the presence of androgen hormones causes a shift and stops the anagen process prematurely.[6]

Minoxidil appears to recruit follicles that are in the dormant phase and pushes them into the anagen phase, keeping them there for an extended period leading to longer, thicker hair.

The mechanisms of action are believed to be three-fold. First, it helps to boost the aforementioned growth factors. Second, it may also inhibit the effects of negative factors. Finally, it helps to dilate hair follicle arteries increasing the blood flow to the follicle, which improves oxygen and nutrient delivery. [7]

The result:

Hair that grows longer and thicker wherever you apply minoxidil. It has similar effects to finasteride but works via a different mechanism of action. Minoxidil can help to counteract the effects of DHT but does not prevent it from shrinking hair follicles. This is why they are often used in combination, as finasteride helps to avoid damage from DHT, while minoxidil helps to reverse the effects.

Remember:

Always consult with a physician or pharmacist before mixing treatments of any kind, as some drugs can have some pretty serious interactions.

How to get it:

Minoxidil is available over the counter. You can stick to the original, more expensive brand name Rogaine (Regaine in the EU), or you can go for one of the other brands like Lipogaine, Kirkland Minoxidil, Regenepure, Foligain, etc.

Rogaine has been around for longer, and thus, the manufacturer has had a more extended amount of time to hone their formula to deliver maximum results with fewer side effects. If you are concerned about side effects, stick to the original brand.

How to use it:

It comes in two forms, a topical solution, and a topical aerosol foam. Both are equally effective, but the aerosol is easier and quicker to apply and may have reduced side effects—however, it is also a bit more expensive.

Apply a 1ml amount (or 1 pump of foam aerosol) all over your scalp twice per day with at least 8 hours between applications. Some users only use one application per day as minoxidil has a half-life of 22 hours, but this leaves a gap of 2 hours if you are applying it once per 24 hours, which Pfizer says leads to a reduction in results.

We recommend sticking to twice per day as it is the most effective and safe way to use minoxidil to stimulate hair growth for men.

How soon you can expect results:

You should start to see positive changes within 2 to 6 months of regular use, but you should give it 12 months to see the maximum benefit as far as hair regrowth goes. Don’t be in a hurry, it’s not a magic hair growth elixir.

The Good (Pros):

  • This is the most effective way to regrow hair; paired with finasteride, they make a powerful combo.
  • It can now be found in less expensive varieties as the patent has expired.
  • There is no risk of sexual side effects like decreased libido or ED.
  • The newer foam aerosols cause less irritation than the hydroalcoholic formula that uses propylene glycol.

Things to Consider (Cons):

  • Generic brands may have more side effects like itchy scalp and redness.
  • Minoxidil does not stop the damage caused by DHT; instead, it reverses it.

Bottom Line:

You can think of finasteride as a preventive treatment, while minoxidil reverses some of the damage. Used together, they are more powerful than used separately. They are generally well-tolerated as a combo, but you should still consult a doctor or pharmacist before mixing medications.

3. Nanoxidil (Brand name: Spectral.DNC-N)

Spectral DNC-N (For Men)-min

Similar to minoxidil, but current research suggests it may be more effective as it works through multiple mechanisms and is better absorbed by the skin. This effect is further enhanced by the nanosome delivery method developed by DS Laboratories.

Overview:

Nanoxidil has a similar chemical structure to minoxidil but with a lower molecular weight. Compounds with a lower molecular weight are generally better absorbed by skin and hair, which make them more effective at delivering their active compounds to the hair follicle. [8]

Nanoxidil has similar effects to minoxidil but has fewer side effects. The only side effects noted in studies were mild redness and some itching on the scalp, which was reported by a minimal number of participants. Furthermore, Spectral.DNC-N has other active compounds that not only promote hair growth but help to alleviate inflammation of the scalp.

A few of the other key ingredients in Spectral.DNC-N include myristoyl pentapeptide-17, adenosine, piroctone olamine, retinol (vitamin A), and caffeine. The last two help to stimulate growth but also improve the skin’s ability to absorb other active ingredients.

Myristol Pentapeptide-17, Adenosine, and Piroctone olamine have also shown to be effective at stimulating hair growth and promoting the effects of topical hair loss treatments. [9]

This relative newbie to the field is making a strong showing. It opens ion channels within cells, which helps activate cellular mechanisms that enhance stimulate and speed-up hair growth while reducing the negative growth factors associated with AGA.

The delivery system in this product is also novel but backed by solid research. DS Laboratories has developed nanosomes, which are based on the liposome delivery system. Liposomes have proven a more effective way to deliver higher concentrations of active compounds to hair follicles—essentially, they help active ingredients cross the skin barrier. [10] Nanosomes work using similar technology and have been shown to have the same effectiveness but are more stable, providing a longer shelf-life for more reliable delivery. [11]

The result:

This formula not only works to regrow longer and thicker hair like minoxidil, but it helps to inhibit the conversion of testosterone to DHT like finasteride, albeit with less efficacy. It provides a multilateral approach to treating hair loss in one leave-on treatment. Unlike minoxidil, it doesn’t use propylene glycol, which can cause contact dermatitis, irritation, and greasy hair.

How to get it:

You can buy Spectral.DNC-N directly from the manufacturer.

Pro tip: because hair loss is best treated with consistent application of any treatment, check out the 3-month supply at a reduced rate. Go the subscription route for an added 10% off.

How to use it:

Apply 6 sprays, twice daily on clean, dry, compromised hair. This is a leave-in treatment, don’t rinse it out after application and wash your hands with soap and water immediately afterward. You can add the Spectral.F7 Efficacy Booster, which reduces hair loss caused by stress to enhance the effects of DNC-N.

How soon you can expect results:

Participants started to see results after 3 to 6 months.

The Good (Pros):

  • DNC-N works to regrow hair by promoting growth factors and inhibiting negative factors on hair growth, and it reduces hair loss by limiting the conversion of testosterone to DHT.
  • It has fewer side effects than minoxidil and finasteride.

Things to Consider (Cons):

  • Nanoxidil hasn’t been around as long as our top-2, but the evidence for its efficacy is growing.
  • It may not be as effective as a minoxidil and finasteride combo, but the research is ongoing in this case.

Bottom Line:

Nanoxidil is a robust third-place competitor as the newest topical treatment for hair loss from DS Laboratories. It is potent, backed by science, and has fewer side effects than its competitors. This one is definitely worth a shot, especially if minoxidil or finasteride had too many side effects for you.

4. Dutasteride (Brand name: Avodart)

Dutasteride

While this may actually be the most potent product on the list, the research is still ongoing, which is why we are putting it in the number 4 spot instead of at the top. It’s a DHT inhibitor like finasteride, but it may be even more effective.

Overview:

Dutasteride works on the same mechanisms as finasteride with one slight but very important difference. Finasteride inhibits the types II and III 5-alpha-reductase (5α-reductase) isoenzyme. In this case, inhibiting type II is what helps to limit the conversion of testosterone to DHT in hair follicles.

There is, as you may have deduced, a type I 5-alpha-reductase, and it also turns testosterone into DHT in hair follicles. Dutasteride works on both types I and II 5α-reductase. This dual-action boosts its efficacy significantly from finasteride’s 70% reduction in DHT to a whopping 99% reduction for dutasteride. That’s a big bump in DHT-blocking power! [12]

The increased effectiveness does not appear to come with increased risk for side effects, either. [13] In fact, a meta-analysis that looked at several studies found that dutasteride may have a decreased risk for sexual dysfunction side effects. [14]

The result:

The same effects you can get with finasteride but with potentially greater efficacy and perhaps even reduced side effects.

How to get it:

You’re going to need to talk to your doctor for this one, as it is strictly prescription only.

How to use it:

A tablet is taken once daily; the standard starting dose is 0.5mg (500 micrograms).

How soon you can expect results:

This one is going to take a year to see results. In the first six months, you may even see what appears to be thinning of hair, but this a sign that it is triggering hair renewal and should begin to show positive effects after this phase.

The Good (Pros):

  • It is potentially more potent than the current leader in treating hair loss.
  • Dutasteride may also have a slightly reduced risk for side effects.

Things to Consider (Cons):

  • This is still a new product, and research is ongoing.

Bottom Line:

We expect that if we were writing this article a few years from now, this treatment would be in the number one spot, at least as far as ranking the products already on this list currently. It’s potent and can reduce serum DHT levels even more than finasteride (99% and 70%, respectively).

New research is also indicating that it may have a reduced risk for adverse sexual side effects.

5. Topical Finasteride (Brand name: Formula 82F)

 topical-finasterideTreatments that work systemically (often by taking a pill orally) don’t always work topically. While the topical application of finasteride is not currently an FDA or EMA approved treatment for AGA, the evidence is growing for this type of topical application.

The brand name we have provided here is a combination topical treatment that uses the standard 5% concentration of minoxidil in conjunction with 0.25% concentration of finasteride. However, because the benefits of minoxidil are well established, we will look at the potential benefits and risks of adding topical finasteride to the mix.

Overview:

Our first clue that topical finasteride may be successful was the fact that Dr. Bauman talks about the topical finasteride treatment Formula 82F on his website—and that man knows his research when it comes to AGA and the potential treatments, so we can definitely take his word for it.

When we started looking into the studies, we were not surprised to see that there is a growing body of evidence to support the uses of this compound in a topical delivery method.

Minoxidil and retinoic acid are present in this formula, both are well established for hair loss treatment, and retinoic acid also helps the skin absorb other topical applications.

The real question here is, how well does finasteride work when applied topically? Two meta-analyses were conducted, one in 2018 and one in 2020. They looked at 7 and 28 articles, respectively, that tested finasteride as a topical treatment for hair loss.

They concluded that topical application could indeed reduce DHT levels in the scalp, and some studies even indicated that the systemic effects decreased, i.e., participants reported less sexual dysfunction than oral finasteride use. [15] [16]

The result:

Topical application can indeed reduce DHT levels in the scalp while limiting exposure to the rest of the body; this could mean a reduction, but not the elimination of side effects. As such, it is now possible to get the DHT reducing effects of finasteride while limiting its potential to cause sexual dysfunction.

Researchers note that further studies are required to determine the ideal topical concentration, application frequency, and side effects. But this is promising news, especially for those who want to combine the results of finasteride and minoxidil in a single treatment for ease of application.

As an added benefit, this topical formula is also free of propylene glycol (PG), you get none of the skin irritation that comes from a lot of the other minoxidil treatments that use PG as a delivery method.

How to get it:

Talk to your doctor because this one is another prescription-only option.

How to use it:

Use the dropper to apply 30 drops twice daily and spread it evenly over the at-risk or affected areas with weakened hair growth. It needs 3 hours to set, so no showering, bathing, swimming, or sweating for 3 hours after application. Basically, keep your head dry for 3 hours after you apply it.

How soon you can expect results:

It starts to work in as little as ten weeks, but to see the effects in the mirror, it will take 6 to 12 months.

The Good (Pros):

  • It has the benefits of oral finasteride with a decreased risk for sexual dysfunction and other side effects.
  • Formula 82F combines the benefits of minoxidil and finasteride in a single topical formula, so double strength and efficacy.

Things to Consider (Cons):

  • For women, this one is no-go if you are of childbearing age, finasteride (topical or oral) can lead to significant birth defects.
  • There is still a risk of sexual dysfunction, so talk to your doctor if you experience these or any other side effects.

Bottom Line:

Topical finasteride shows promise as a treatment for AGA, but more research is necessary to home in on the best concentration and frequency of use. You can go with other brands, but Formula 82F has minoxidil and finasteride, so if you can, why not go for the combo of the two best treatments in one bottle.

6. Ketoconazole Shampoo with Hair Thickening and Fortifying Compounds (Brand name: Revita)

Revita Hair Stimulating Shampoo

We are squarely in the complementary treatments now, meaning this is best paired with another treatment to see the best results. Unless you are using this strictly as a preventative measure, we would recommend pairing it with Spectral.DNC-N, minoxidil, or finasteride.

DS Laboratories also notes that it can help transplanted follicles thrive. If you have or are going to have a hair transplant procedure, talk to your specialist about using this shampoo post-transplant.

Overview:

Ketoconazole shampoos were first used to treat dry, itchy scalp, dandruff, and the more severe form of these, seborrheic dermatitis. Then, people started noticing it also made their hair thicker and even stimulated regrowth in balding areas.

The reasons for this were believed to be related to its anti-inflammatory properties, remember inflammation is a fourth significant contributor to androgenetic alopecia. As researchers begun to investigate the mechanisms of action behind ketoconazole on male pattern baldness, they discovered that it also had anti-androgenic (DHT blocking) properties, a previously unknown effect. [17] [18]

The anti-inflammatory properties are also why this shampoo makes for a great add-on to an existing treatment plan (also called adjuvant therapy). It can not only stimulate hair growth, but research shows that it can also counteract some of the side effects of popular treatments, especially minoxidil. [19]

DS Laboratories did not stop there with this formula though, they have also included caffeine, which research shows has anti-androgen properties by blocking DHT and promoting significant, healthy follicle growth. [20] Further research has also indicated that a topical shampoo is one of the best delivery methods for this type of treatment. [21]

Finally, DS Laboratories has included biotin in this formula. While biotin treatment is only helpful in reversing hair loss that is due to a deficiency in this nutrient, it is an essential compound in healthy follicles. It is a welcome addition to the formula as it can help support the healthy function of follicles, giving your hair the best chance for regrowth. [22]

This shampoo can help extended the anagen phase while shortening the telogen phase.

The result:

You see longer, thicker hair growth with healthier looking and feeling hair. You should also see a reduction in redness, itchiness, and skin flaking if that was an issue for you.

How to get it:

Buy it directly from DS Laboratories.

How to use it:

Use 5 times per week, apply to wet hair and scalp, massage it in, and leave it for two minutes, then rinse. Follow it up with the Revita conditioner to further boost the effects.

How soon you can expect results:

Give this shampoo at least 3 months (90 days) to see results. Consistent use is vital, as with most other treatments.

The Good (Pros):

  • This is an excellent adjuvant therapy for those already experiencing hair loss, especially if you are using minoxidil.
  • It is a useful preventative measure for those at risk or concerned about hair loss.
  • This ketoconazole shampoo can reduce the side effects of other treatments that may cause redness, itchiness, and dandruff.
  • The added compounds support the health of hair and their follicles.

Things to Consider (Cons):

  • If you have medium to advanced hair loss, you are going to need another more potent treatment as well as the shampoo.

Bottom Line:

Perfect for those who are concerned about or are at risk of hair loss, this shampoo can also make a great addition to other treatments and can even help to reduce their side effects. This shampoo is excellent for any stage of hair loss, but those with more advanced loss should use this as an add-on to other treatment options.

7. Ketoconazole Shampoo (Brand name: Nizoral)

Nizoral A-D Anti-Dandruff Shampoo

DS Laboratories is not the only option for a ketoconazole shampoo. Nizoral is another brand that offers a similar product but without the added healthy-hair compounds. This shampoo is marketed for anti-dandruff but contains enough ketoconazole (1%), to help alleviate the symptoms of other treatments and offer a boost in blocking DHT.

Overview:

Nizoral is similar to the DS Laboratories shampoo, but it does not have the added caffeine or biotin.

It can block the formation of DHT and help reduce inflammation, both of which are factors that contribute to male pattern hair loss. This means that it also offers the same ability to counteract the side effects of other treatments such as minoxidil.

The result:

You see longer, thicker hair growth with healthier looking and feeling hair. You should also see a reduction in redness, itchiness, and skin flaking if that is something with which you struggle.

How to get it:

You can purchase this one straight off of Amazon.

How to use it:

Use it instead of your regular shampoo twice per week, apply to wet scalp and hair, massage it in, leave it for two to three minutes, and then rinse.

How soon you can expect results:

Again, give this one 3 months (90 days) to begin to see results.

The Good (Pros):

  • This is a good adjuvant therapy for those already experiencing hair loss, especially if you are using minoxidil.
  • It is a great preventative measure for those at risk or concerned about hair loss.
  • This ketoconazole shampoo can reduce the side effects of other treatments.

Things to Consider (Cons):

  • If you have medium to advanced hair loss, you are going to need another more potent treatment as well as the shampoo, as this product isn’t potent enough to handle advanced stages of hair loss..
  • This one does not have the added components that the DS Labs shampoo has, meaning it does not boast the same level of DHT blocking and does not provided add nutrients for hair and follicle health.

Bottom Line:

Another good option for an add-on therapy. Not as potent as the DS Laboratories shampoo but still effective.

8. Low-Level Laser Therapy aka LLLT Helmets/Hats (Brand name: iRestore Hair Growth System)

iRestore Laser Hair Growth System-min

I know it sounds like we are getting into crazy science fiction territory here but stick with us. This was discovered when some laser treatments used to remove hair had the opposite effect, a phenomenon known as “Paradoxical Hypertrichosis.”

Similar therapies are also used by physiotherapists to treat musculoskeletal conditions. Although it sounds like sci-fi, LLLT does have therapeutic effects. Now the question is, how well does it treat AGA? Let’s take a look.

Overview:

Used in the treatment of other conditions, LLLT research and use have shown that laser therapies can indeed have a significant impact on the functioning and health of our bodies. The evidence for LLLT therapy is growing, and numerous studies have been conducted, all of which show significant positive effects.

Two recent meta-analyses of the research studies that have been conducted indicate this and conclude that the evidence in support of LLLT is of high-quality. [23] [24]

As this is a new treatment, certain parameters for its effective use are being determined. Still, the two devices we are going to review here both operate in the optimal ranges specified by preliminary research and have undergone clinical trials which support their efficacy in treating male and female pattern hair loss. [25]

The iRestore system uses 650 nm red light—this refers to the wavelength of light they used and falls within the optimal range specified by several studies.

The methods by which LLLT stimulates follicles and promotes hair regrowth are not entirely known. Current theories from the research above cite improved circulation, improved cellular metabolism, heat that triggers follicles to grow hairs by stimulation of epidermal stem cells, and sub-therapeutic skin disruption that triggers follicles to regenerate and regrow hair—the disruption here is exceptionally minimal and just enough to trigger the healing process.

These appear to trigger follicles to switch from the telogen phase to the anagen phase, which is supported by findings that show post-treatment participants had more terminal hairs than they did during pre-treatment observations. [26] [27] [28]

The results:

You will see a regrowth of hair in areas affected by AGA, resulting in thicker, longer, and more pigmented terminal hairs. This gives your hair a fuller look.

How to get it:

You can get iRestore’s Hair Growth System laser-filled helmet from Amazon.

How to use it:

Use it every other day for 25 minutes.

How soon you can expect results:

iRestore recommends allowing 3 to 6 months to see results. Whether you purchase from Amazon or somewhere else, you can return this product at the 6-month mark for a full refund. Make sure you contact Freedom Laser Therapy directly to process the refund as Amazon only offers a 30-day refund policy.

The Good (Pros):

  • Can be combined with finasteride, minoxidil and other therapies to enhance the effects (be careful not to combine it with treatments that increase photosensitivity as this is a photo-based treatment, this includes products that contain vitamin A in any form such as retinol or retinoic acid)
  • It is a non-invasive, painless treatment with no known side effects.
  • It improves hair strength as well.
  • There is no fatigue from the application; as a helmet, this device requires no active combing or brushing action, which can become tiring.

Things to Consider (Cons):

  • Like all LLLT, it cannot be combined with therapies that use vitamin A or other photosensitizing products
  • It can be time-consuming.
  • It is expensive.
  • It has only been shown to be effective in some people, while others are non-responsive (thankfully, they offer a full money-back guarantee on the iRestore system).

Bottom Line:

Backed by solid science and having undergone its own clinical trials, the iRestore Hair Growth System is a reliable LLLT device that can function as an add-on treatment or as an alternative treatment for those who do not respond well to traditional therapies.

9. Low-Level Laser Therapy aka LLLT (Brand name: HairMax LaserComb)

Low-Level Laser Therapy aka LLLT Comb

Another LLLT treatment, this one is going to offer the same results as the iRestore Hair Growth System.

Overview:

The science here is the same as with the iRestore system. We couldn’t find any mention of the parameters for the lasers used in the HairMax combs directly on their website. But when we looked at the clinical trials, we found that their products are within the same range as the iRestore system operating in the 635 to 655 nm range.

The LaserComb is another product not only backed by solid science in LLLT but also by clinical trials of their specific devices. [29]

There are a few key differences here. First, the HairMax combs use lasers instead of LED light, which may contribute to the shorter treatment time and may make it more effective. Second, the comb teeth part the hair allowing the light to reach the follicles unobstructed, which can also contribute to a shorter and more effective treatment.

The downside is that you have to comb it through your hair for 8 or 11 minutes (the classic Ultima 9 is 11 minutes while the Ultima 12 is 8 minutes).

The results:

You will see regrowth of hair in areas affected by AGA, resulting in thicker, longer, and more pigmented terminal hairs. This gives your hair a fuller look.

How to get it:

Another set of products that you can purchase from Amazon: Ultima 9 Classic LaserComb. Ultima 12 LaserComb.

How to use it:

Start at the hairline and turn the device on, after four seconds, the unit will beep, at which point you move it back a half-inch and then leave it for another 4 seconds, then move the comb another half-inch back, repeat until you hit the back of your head.

Do this again over the same area, then jump to the next section, repeating the process until you’ve covered the entire head.

How soon you can expect results:

Give this one the same 6 to 12 months to see results.

The Good (Pros):

  • Can be combined with finasteride, minoxidil and other therapies to enhance the effects (be careful not to combine it with treatments that increase photosensitivity as this is a photo-based treatment, this includes products that contain vitamin A in any form such as retinol or retinoic acid)
  • It is a non-invasive, painless treatment with no known side effects.
  • It improves hair strength as well.
  • The use of lasers and comb teeth to part hair makes for a shorter and more effective treatment.
  • This laser comb is cheaper than the iRestore Hair Growth System.
  • The combs are more portable than helmet or hat systems.

Things to Consider (Cons):

  • It cannot be combined with therapies that use vitamin A or other photosensitizing products
  • It can be time-consuming.
  • Although cheaper than the iRestore helmet, it is still expensive at $200 & $400.
  • You must comb your hair for 8 to 11 minutes in a row, which can become tiring for some.

Bottom Line:

Less expensive and possibly more effective than the iRestore, this is an excellent option for those who don’t mind giving their hair a comb for 11 minutes at a time, 3 times per week.

10. Topical Spironolactone (Brand name: Aldactone or Maxogen-S)

topical spironolactone maxogen-s

Spironolactone is another DHT blocker that appears to have few systemic side effects (i.e., sexual dysfunction) when applied topically. However, it does not appear to be as effective as finasteride.

It is primarily used to treat fluid build-up due to heart failure, kidney disease, liver scarring, high blood pressure, low blood potassium, excessive hair growth in women (hirsutism) and female pattern hair loss. It is also used for transgender hormone therapy

Overview:

For men, this has to be applied topically only; oral use is restricted to women as the systemic effects of oral use result in feminization (i.e., they cause the appearance of female characteristics), which is why it is used in transgender hormone therapy. Applied topically, it does not appear to cause systemic effects in men. [30]

Topical use does appear to have some DHT-blocking effects. However, they are less effective than finasteride. [31] There are plenty of men out there who swear by topical application. It is worth a try if you’ve tried finasteride and did not like the side effects or did not see results, but we recommend pairing it with other DHT blockers for improved outcomes.

The result:

A reduction in the speed with which your hairline recedes and some potential regrowth of hair.

How to get it:

You can purchase the Maxogen-S topical cream from MinoxidilMax.

How to use it:

Apply a small amount to the base of hairs (trying not to get it on your hair) twice daily. Do not apply too much. Check the website for a picture guide, but they are using a dollop about the size of a few rice grains.

How soon you can expect results:

MinoxidilMax does not cite a specific time frame, but as it works similarly to finasteride, you should expect results to show after about 3 months, but significant effects could take a year to begin to show.

The Good (Pros):

  • This is a suitable alternative treatment for those who tried finasteride and saw no results or were unhappy with its side effects.
  • Topical use does not appear to have systemic effects.

Things to Consider (Cons):

  • It is not as potent as finasteride.
  • Oral use is only approved for women as the systemic effects on men may lead to feminization.

Bottom Line:

Spironolactone is a suitable alternative to finasteride, especially if paired with other DHT blockers. Men should avoid oral administration of spironolactone due to hormone-related side effects.

11. Hair Transplant (FUE SMARTGRAFT)

hair transplant surgeon

Dr. Alan Bauman provided this section. Dr. Bauman is an ABHRS-board-certified and IAHRS-accepted medical and surgical hair restoration specialist. We have adapted this review from the information he provided to BaldingBeards.com.

Dr. Bauman is a leader in hair restoration with a wide breadth of knowledge on the subject, visit his clinic’s website for more information on hair loss and treatment options available at his clinic.

Overview:

If you have advanced hair loss, transplantation is the best hair loss treatment to recover a full head of hair. New advances in technology provide the precision of robotics with the artistry of a hair loss specialist to offer a minimally-invasive procedure that can comfortably and undetectably restore your hairline and hair coverage over your scalp.

SmartGraft is a new technology that helps surgeons and their specialized team of experts perform a Follicular Unit Extraction (FUE) hair transplant. SmartGraft is a precision instrument that allows surgeons to extract as few as a single follicle.

This cutting-edge piece of kit allows more accurate and realistic looking placement of follicles to mimic the natural hairline. SmartGraft allows for non-linear harvesting, which means you do not end up with the zipper-like scars that are common with other techniques.

For you, this means less pain, less scarring, and a quicker recovery that allows you to get back to your normal life in less time.

This state-of-the-art tech helps surgeons extract and store follicles during the transplant procedure leading to a faster process with less handling of the harvested follicles.

What that means for you is a reduced risk of graft failure, a reduced risk of poor growth quality post-transplant, and improved comfort.

One part science and one part artistry, Dr. Bauman advises that you choose your surgeon carefully as the look of the final result ultimately comes down to the experience of the person doing the transplant.

Think of it likes this:

You can buy yourself the best paints, paintbrushes, and canvas in the world but that doesn’t mean you can paint like Rembrandt. That requires practice and expertise.

While Fue SmartGraft represents the best of transplant technology and improves the patient experience, recovery time, and gives surgeons unparalleled precision, how natural your hairline appears post-procedure depends on the knowledge and artistry of the surgeon controlling this follicle plucking and planting robot.

The result:

You will see the recovery of your hairline that looks natural, even for those with significant hair loss, with little or no scarring depending on the expertise of your surgeon.

How to get it:

Find a respected surgeon in your area who specializes in FUE SmartGraft transplants. The cost ranges from $8,000 to $20,000 per procedure.

How to use it:

Hopefully, a trained hair recovery expert is doing this part. We don’t want you performing hair transplant surgery on yourself.

How soon you can expect results:

Immediately, that is the best part of a transplant. There is, of course, some healing time, but the hair is there! It can take 7 to 10 days to recover from the procedure and about 2 weeks for the areas of harvested follicles to grow back. Compare that to the six weeks or more for “your dad’s hair plugs.”

The Good (Pros):

  • This is the best option for those with significant hair loss.
  • It has minimal recovery time when compared to traditional linear transplants.
  • Improved comfort and reduced scarring compared to linear transplants.

Things to Consider (Cons):

  • There is a short healing period.
  • You might experience the occasional sharp pain for several weeks after the treatment.
  • It is the most expensive option available, but it is also the most effective.
  • It requires a high level of expertise, which would determine the outcome.

Bottom Line:

This advanced technology in the hands of a trained specialist is the best option for those with advanced hair loss. Recovery time is down to 7 to 10 days, allowing you to return to your normal activities in a much shorter amount of time than traditional linear transplant techniques.

12. Platelet Rich Plasma (PRP)

prp treatment

Another medical procedure used to treat a multitude of conditions, now being used to treat AGA as well.

Overview:

PRP involves extracting blood from the patient and refining it to remove red blood cells, concentrating the patient’s own platelets and growth factors in the plasma that is to be injected into the treatment area, thus stimulating the healing process.

Sort of like hacking your healing system to promote the regeneration of healthy follicles that grow terminal hairs.

While the method is slightly different, it appears to have some similar effects to LLLT. It stimulates stem cells in the follicle, which promotes healing and the growth of longer, thicker terminal hairs.

It also encourages the formation of new blood vessels around follicles, increasing blood flow and, subsequently, oxygen and nutrient delivery. [32]

Treatment with PPT results in an increase of healthy follicles in the treatment area as well as improved hair thickness and improved results on the hair pull test. Moreover, it appears to have no major side effects in the majority of patients. [33] [34] [35]

PRP can also be combined with a transplant procedure to strengthen non-transplanted hair, reduce donor scarring, and accelerate the healing process. Furthermore, researchers report that PRP can improve graft survival rate and accelerate the growth of transplanted hair. [36]

Dr. Bauman informed us that PRP enhanced with extracellular matrix (ECM), stem cells/signaling cells is even more effective than PRP alone. They not only boost the effectiveness of the treatment, but they prolong the results leading to fewer treatments. [37]

The result:

You should see regrowth of thicker, healthier hair in the affected areas.

PRP also leads to improved recovery and regrowth of both transplanted and non-transplanted hair after a FUE SmartGraft procedure.

How to get it:

Consult a hair loss specialist train in PRP treatment, especially those familiar with the enhanced PRP treatments. The cost is in the range of $2600 to $5900.

How to use it:

Another one that is up to the trained specialist, you just have to show up and follow directions!

How soon you can expect results:

Research indicates that you should see results in 3 to 6 months.

The Good (Pros):

  • There is no recovery time as it is a series of minimally-invasive injections.
  • These are short treatments that are about an hour long.
  • You can get treated during your lunch hour and return to normal activities the same day.

Things to Consider (Cons):

  • The procedure requires a local anesthetic. Not everyone likes injections.
  • All injections come with a risk of infection and scar tissue, but a trained expert minimizes these risks.
  • Cost is a significant factor as we are in the thousands of dollars range.

Bottom Line:

A relatively safe and effective treatment that is further enhanced by added compounds makes this a good stand-alone treatment and a great add-no to hair transplant treatments.

A bit pricey, but if you are already going the transplant route, you might as well give the grafts the best chance of success.

13. Scalp Micropigmentation (SMP)

scalp micropigmentation hair tattoo

SMP comes last on the list because it is not really a treatment for AGA, rather it is a cosmetic procedure that involves a process similar to tattooing on the scalp to give the appearance of fuller hair.

Scalp Micropigmentation (SMP) is a relatively new technique that involves injecting tiny, individualized amounts of pigment into the scalp. The result is a subtle, shaved-head effect. SMP can cover up any bald spots or thinning hair, and it is an affordable solution for those who are uncomfortable with other options.

The procedure takes about three days to complete and lasts for several years, making SMP one of the most cost-effective products on our list. It can be difficult to find an SMP provider in your area, so we recommend doing some research before going forward with this option.

Overview:

Does anyone remember the Ron Popeil infomercial for “hair in a can” formally dubbed Ronco GLH #9 Spray-on Hair? Well, we are in that realm now. SMP is a similar procedure in that it uses color to give the visual illusion of thicker hair, but Ron’s spray is temporary.

In contrast, scalp micropigmentation is permanent or at least semi-permanent—you may be required to go back for touch-ups after about 8 years.

Scalp micropigmentation is a form of cosmetic tattooing, similar to permanent makeup or cosmetics. It utilizes injected pigment on the scalp to give the visual appearance of thicker hair. It reduces the contrast between your hair color and scalp color to make your hair appear fuller.

This is done by placing small dots in different hues of black to simulate the look of shadow, giving depth and definition—basically, pointillism but on your scalp. The ink is not injected as deep into the skin as a tattoo is, and the procedure utilizes smaller needles.

However, it does not at all treat the underlying causes of androgenetic alopecia. Because it is similar to a tattoo, there are no follow-up treatments, get it and forget it! Ok, we’ll stop with the Ron Popeil jokes now.

Some people are combining it with FUE transplants to improve the final look of hair, which has proven effective. [38]

Of course, if you choose to put a permanent tattoo on your scalp, you are going to have to commit to fighting hair loss for the duration of your life, or you will be left with an exposed tattooed scalp.

How to get it:

Visit a trained SMP professional for a consultation. Single sessions can run anywhere from $400 to $1000, but you will likely need more than one session with an SMP practitioner.

How to use it:

Receive the treatment, follow the post-procedure guidelines, and keep up with hair loss prevention.

How soon you can expect results:

The results are pretty immediate. Just like tattoos, they fade over time, and you may need to have touch-ups around the 8-year mark.

The Good (Pros):

  • There is no downtime with scalp micropigmentation.
  • As a semi-permanent ink injection, it has long-lasting results.

Things to Consider (Cons):

  • It is not a regulated procedure, so the onus is on you to find a suitable practitioner.
  • Some people have an allergic reaction to the ink.
  • There is always a risk of infection with any ink injection procedure.

Bottom Line:

SMP is a purely cosmetic procedure, but it can help to give the appearance of a fuller head of hair.

How we chose these products

Science is our guide here. Because androgenetic alopecia is so common, there is a bevy of options on the market. Of course, they don’t all work, not at reducing hair loss anyways, many of them are incredibly effective at emptying your wallet!

We looked at the research and chose only those treatments that are based on solid evidence and have been tested clinically to assess both their efficacy at treating hair loss and the side effects they may cause.

When we mentioned a brand name for a particular product or treatment, we have ensured that the concentrations or parameters that a brand uses adhere to the guidelines that are backed by research.

When looking at newer treatments with fewer studies, we still checked to ensure that they were conducted with proper research designs.

When compared to a control group (usually a placebo treatment or sham device), actual hair loss treatments should show a reduction in follicle miniaturization or even a reversal of the process.

Researchers should use clinical photography or other methods to count the number of terminal hairs versus vellus hairs and to assess the number of hairs in the anagen versus telogen phase. They should also use other proven methods to evaluate hair shedding, thickness, and health.

We have only included treatments that are backed by research and have received positive assessments from study participants.

The only exception to this is scalp micropigmentation, that is because this is a purely cosmetic treatment that does not address the underlying causes of AGA. As such, there aren’t any scientific studies on its effectiveness.

Products in the pipeline (Potential future treatments)

HairLossTalk.com has put together an illuminating infographic on the progress of new treatments for hair loss that are coming down the R&D pipeline.

However, don’t wait for these new treatments to come out to start treating AGA. If there is one thing we know about hair loss, it is that it is easier to prevent than it is to reverse, and these treatments are all a ways off of being released for the public.

The majority of them are in stage 2 of research or earlier.

You can check out the infographic for yourself, but we will discuss the three that are farthest along the research and development track: RHC-01(s), Hair Stimulating Complex, and Follica.

future treatments hair loss-min

RHC-01(s) & (r)

RHC-01(s) and RHC-01(r) are similar treatments, but the former is being tested in Asia by Shiseido, who acquired the exclusive license to this RepliCel Life Sciences technology for the whole Asia region.

They are conducting the same type of research, but they are farther along in the timeline and are running separate trials to RepliCel.

The basics of this treatment involve taking cells from the unaffected hairs on the head of someone afflicted with AGA and transplanting them to the affected areas.

The hope is that the healthy functioning cells will bring with them their cellular and genetic traits that make them immune to the effects of androgen-related hair loss to the affected areas of the scalp.

We don’t know if this research is going to pan out, but we are excited to see how things develop!

Hair Stimulating Complex

Histogen’s Hair Stimulating Complex is a stem cell treatment that uses neonatal cells grown in a simulated embryonic condition (hypoxia, an environment with a 3-5% concentration of oxygen).

This causes them to become multipotent, which just means that they can both divide and develop into any specialized cell. This complex also contains a mix of several of the growth factors we mentioned in our review above, including KGF, VEGF, and follistatin.

These growth factors are essential for signaling stem cells to differentiate into hair follicle cells and in triggering hair growth, especially follistatin.

Again, we are going to have to wait and see how the research develops, but this injectable treatment looks promising.

Follica

If you looked at the infographic, you might have noticed one entry that read “Wound Device,” it’s an unexpected bit of text to see on a list of treatments for hair loss, but there is some fascinating science behind this one.

Researcher Dr. George Cotsarelis discovered that “skin disruption” or creating small wounds on the skin, applied in a controlled manner, can lead to follicle neogenesis, or the generation of new follicles.

Essentially, carefully wounding the skin causes re-epithelialization (skin regrowth), which leads to the formation of new follicles in the area. This research aims to see if minoxidil is more effective when applied at a very particular point after wounding the skin.

Not only is the process being tested, but Dr. Cotsarelis and his team are developing a device to apply it in a controlled and safe manner.

Crazy but true, let’s see how this one turns out when the final verdict is reached.

Frequently asked questions (FAQ)

Do Hair Loss Treatments Actually Work?

Yes. In case you skipped our review to check out the FAQ, we have linked to several studies conducted by independent researchers backing some of the most common ingredients or devices in hair loss treatments.

These therapies do work to reduce hair loss, and in some cases, help hair grow back. That is not to say there aren’t a lot of bogus treatments out there, but there are also proven methods for fighting hair loss. You do not have to live with a receding hairline; you can fight back!

Can Hair Grow Back After It’s Started Thinning?

Again, yes. You may see hair regrowth after starting treatments for hair loss. If you have advanced hair loss, they aren’t likely to take you back to that full head of hair.

However, if you are starting at the first signs of a receding hairline, you can stop the recession and potentially grow back the small amount of lost hair.

As most treatments take about a year to reach their full potential, you should stick with it for the year and then assess where you are at. If you are still unhappy with the amount of hair you have, then you can seek more aggressive treatments like transplants.

Who Should I See About My Hair Loss?

If you are looking to try minoxidil, you don’t have to visit any doctors as it is available over the counter. However, if you are taking any other medications or have any other underlying conditions, it is wise to consult a physician before starting any kind of treatment for anything, prescription or over the counter.

If you are looking for prescription treatments, your regular doctor will usually suffice to get a prescription. If you need to go further, like transplants, or if you have been unhappy with your doctor’s advice, seek the help of a hair loss specialist.

In the US, this would be a board-certified hair restoration physician. Dermatologists are skin specialists who can also be very helpful when seeking help for treating AGA.

Can I Take Minoxidil and Finasteride Together?

In short, yes—both can help your hair grow back by increasing blood flow to the scalp and keeping the hormone DHT under control. But there are differences between the two. Minoxidil comes in higher concentrations than finasteride, so it can be taken once or twice a day. Finasteride is a daily pill, so it needs to be taken on an empty stomach before you eat (another reason why taking it with food is better).

For most people, this is, in fact, the best way to treat hair loss. Twice daily application of 5% minoxidil and once-daily, oral finasteride appears to be the most effective way to treat hair loss. It tackles both the prevention of hair follicle damage and stimulating hair growth by healing follicular damage. [39]

I Am in My Thirties; Do I Need to Worry About Hair Loss Now?

Worry might be a strong term, but definitely keep an eye on that hairline and jump on it if you start to see it receding. You’ll have a lot more luck at stopping it early than you will have at trying to reverse the effects of advanced hair loss.

Can I Use the Same Products on My Beard?

It depends on the treatment. As an example, DHT has the exact opposite effect on beard hair than it does on the hair on your head. DHT helps beard hair to grow, so trying to use finasteride or other DHT-blockers can thin your beard.

Minoxidil, on the other hand, is effective at helping people to grow a thicker beard. If you are unhappy with your beard growth, check out our article on the proven ways to grow a thicker beard.

Spoiler alert: minoxidil is on that list. But, there are several other promising methods you should check out.

Conclusion

Hair loss starts as early as our 3rd decade of life, if your hairline is beginning to recede, now is the time to start treatments. There are several proven treatments on the market, and we have done the work of sorting the actual from the scams and only give you treatments that are backed by quality research.

Don’t wait to start the battle against thinning or balding hair; the sooner you begin, the more effective the treatments will be.

Have you tried any of these treatments? If so, what were your experiences? What has worked for you? What didn’t work? What side effects have you experienced? By sharing our expertise, we can all be better informed.

If you have any lingering questions, leave them in the comments so we can address them. Don’t forget to share this with others who are experiencing androgenetic alopecia and lets band together in fighting male pattern baldness as we strut off into the sunset with thicker, fuller-looking hair.

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  29. Satino, John L., and Michael Markou. “Hair Regrowth and Increased Hair Tensile Strength Using the HairMax LaserComb for Low-Level Laser Therapy.” International Journal of Cosmetic Surgery and Aesthetic Dermatology 5, no. 2 (August 1, 2003): 113–17. https://doi.org/10.1089/153082003769591209.
  30. Rathnayake, Deepani, and Rodney Sinclair. “Use of Spironolactone in Dermatology.” Skinmed 8, no. 6 (December 2010): 328–32; quiz 333.
  31. Berardesca, E., P. Gabba, G. Ucci, G. Borroni, and G. Rabbiosi. “Topical Spironolactone Inhibits Dihydrotestosterone Receptors in Human Sebaceous Glands: An Autoradiographic Study in Subjects with Acne Vulgaris.” International Journal of Tissue Reactions 10, no. 2 (1988): 115–19.
  32. Cervelli, V., S. Garcovich, A. Bielli, G. Cervelli, B. C. Curcio, M. G. Scioli, A. Orlandi, and P. Gentile. “The Effect of Autologous Activated Platelet Rich Plasma (AA-PRP) Injection on Pattern Hair Loss: Clinical and Histomorphometric Evaluation.” Clinical Study. BioMed Research International. Hindawi, May 6, 2014. https://doi.org/10.1155/2014/760709.
  33. Khatu, Swapna S, Yuvraj E More, Neeta R Gokhale, Dipali C Chavhan, and Nitin Bendsure. “Platelet-Rich Plasma in Androgenic Alopecia: Myth or an Effective Tool.” Journal of Cutaneous and Aesthetic Surgery 7, no. 2 (2014): 107–10. https://doi.org/10.4103/0974-2077.138352.
  34. Kang, J.-S., Z. Zheng, M. J. Choi, S.-H. Lee, D.-Y. Kim, and S. B. Cho. “The Effect of CD34+ Cell-Containing Autologous Platelet-Rich Plasma Injection on Pattern Hair Loss: A Preliminary Study.” Journal of the European Academy of Dermatology and Venereology 28, no. 1 (2014): 72–79. https://doi.org/10.1111/jdv.12062.
  35. Cervelli, V., S. Garcovich, A. Bielli, G. Cervelli, B. C. Curcio, M. G. Scioli, A. Orlandi, and P. Gentile. “The Effect of Autologous Activated Platelet Rich Plasma (AA-PRP) Injection on Pattern Hair Loss: Clinical and Histomorphometric Evaluation.” Clinical Study. BioMed Research International. Hindawi, May 6, 2014. https://doi.org/10.1155/2014/760709.
  36. Miao, Yong, Ya-Bin Sun, Xi-Jin Sun, Ben-Jun Du, Jin-Dou Jiang, and Zhi-Qi Hu. “Promotional Effect of Platelet-Rich Plasma on Hair Follicle Reconstitution in Vivo.” Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.] 39, no. 12 (December 2013): 1868–76. https://doi.org/10.1111/dsu.12292.
  37. “PRP Platelet Rich Plasma Therapy | Bauman Medical Group,” May 23, 2014. https://www.baumanmedical.com/hair-restoration-options/prp-platelet-rich-plasma-acell-ecms/.
  38. Rassman, William, Jae Pak, and Jino Kim. “Combining Follicular Unit Extraction and Scalp Micropigmentation for the Cosmetic Treatment of Alopecias.” Plastic and Reconstructive Surgery Global Open 5, no. 11 (November 7, 2017). https://doi.org/10.1097/GOX.0000000000001420.
  39. Hu, Ruiming, Feng Xu, Youyu Sheng, Sisi Qi, Yumei Han, Ying Miao, Wenlong Rui, and Qinping Yang. “Combined Treatment with Oral Finasteride and Topical Minoxidil in Male Androgenetic Alopecia: A Randomized and Comparative Study in Chinese Patients.” Dermatologic Therapy 28, no. 5 (October 2015): 303–8. https://doi.org/10.1111/dth.12246.

About The Author

Domen Hrovatin
Domen Hrovatin

Domen—a self-confessed facial hair addict—is a grooming professional, style enthusiast, and someone with deep personal experience and knowledge about male pattern baldness. His work was mentioned in countless notable men's grooming and style publications, including Beardbrand and AskMen.

  • Thanks for the great article Domen.

    Would I be right in thinking that it wouldn’t be a good idea to use the SPECTRAL.DNC-N product in conjunction with LLT, as it contains retinol? There is a FAQ article on their website that actually recommends it, but I am sceptical.

      • You mentioned to avoid it in your ‘Pros’ for the LLT helmets:
        “be careful not to combine it with treatments that increase photosensitivity as this is a photo-based treatment, this includes products that contain vitamin A in any form such as retinol or retinoic acid”

          • For anyone that is interested, this is the response I got from DS Laboratories regarding the use of SPECTRAL.DNC-N alongside LLT:
            “The percentage of Retinol in the product is very low, therefore we have not observed any instances of photosensitivity nor an adverse reaction during laser treatments.”

  • Hey there Domen! Great article man. I want to start some treatments for my hair loss that is in a fairly advanced stage now. Do you think its okay to take nanoxidil/Spectral DNC-N with Finasteride instead of taking Rogaine with it? In order to have faster/better results I mean.
    Thank you so much for all of this.

  • 5/8/2020 FOR WOMEN: UP SIDE – MINOXIDIL ABSOLUTELY WORKS FOR THE HAIRLINE, ENTIRE SCALP & EYEBROW AREA. DOWN SIDE: Most balding women MUST dye their hair b/c they also seem to go 100% gray prematurely. Gray hair makes most ppl look that much balder. PROBLEM WITH MINOXIDIL … GENERIC & BRAND … IT HAS NEVER BEEN “COLOR-FAST.” Very annoying! It almost IMMEDIATELY strips my 100% gray roots of all dye. I just cant be dying my hair every 2 weeks! No time, expensive & hard on the hair! Im sure all makers of Minoxildil & Rogaine have rec’d thousands of complaint letters from women about this issue over the past 20 years, so I wont waste my time writing a letter that will just be put in “File 13.” I just keep wondering why the makers of Minoxidil & brand Rogaine refuse to make the formula color fast.

    FYI: Causes for my baldness: 3 auto-immune diseases since 1997 & hammered by non-stop, relentless stress since 2016.

    • Hi, thanks for the review !Must you keep applying Minoxidil or can you discontinue after hair growth. Have you tried henna ,because it goes inside the hair strand instead of coating it.Thanks.

  • Domen,

    Do you use minoxidil on the temples and “front” portion of the top of your head? I shed like crazy when I tried it. My apologies if this question has been asked. There are a lot of questions to sift through. Thank you for your help. cheers.

    • I absolutely do. Don’t be afraid of shedding. In order for a new, thicker hair follicle to grow, the old thin one needs to go out.

  • Hi Domen,
    Great article.
    I can’t see this mentioned above but apologies if it has already been asked… is it possible to use 2 or 3 of the above mentioned hair loss remedies at the same time? I.e. can I take the supplements, use the shampoo and also use Rogaine at the same time?
    Thanks

  • Thanks, great article – question about Nanoxidil though, didn’t see it come up in any of the comments and hard to find much info online… a bit concerning as it’s not FDA approved, would you recommend starting off with the more tested/popular products (Rogaine/Lipogaine) first?

      • Domen,
        The lack of longterm studies makes me question that claim – were you able to find any reports other than the single 3-month study?
        Appreciate your help – just want to avoid being the Guinea pig, thx.

    • Yes they are legit and most of there products are made in USA they are bit expensive but they do seem to have the latest products , I only been using there Follics FR12 minoxidil sulfate with finasteride and although i have not regained my youth looking hair but i would say i regained about 70% this is after using it for 9 months. Hope this helps

    • BROUGHT 3 BOTTLES OF THERE REGROWTH LABS TOPICAL DUSTERIDE D5A FEW DAYS AGO LOOKS GENUINE AS I LOOKED IT UP THERE R&D AND MANUFACTURING IN BASED IN USA SO I HOPE IT WORKS.

  • Hi Domen and thanks for the article .

    I have long lasting baldness and after using several products, I regrow few healthy and thick hair and a lot of tiny thin hairs. If I can make the tiny thin hair to become thick and healthy hair that will more than enough fir me.

    Any suggestions!?

  • I found it interesting that you state that one of the best options for hair loss is a hair transplant. My brother-in-law has been losing his hair and wants to find a suitable hair replacement. I will send him this information so he can make sure to look into transplant as an option.

  • If I used both minoxidil and topical spironolactone cream Maxogen-S, how should I use them? The description given by maxogen-s is not quite clear.

  • Hi Domen,
    Thanks for this very comprehensive article.
    I could only find Nizoral solution (2%) where I live. Think I’ll order the shampoo online next time. But do you think the solution will work as well as the shampoo? I’d love any suggestions on how to use it (quantity, frequency of use) etc.

  • Hi domen i really appreciated your article, it is really meaningful and work for everyone. Because you have covered all the major hair problems in men with effective prescription.

  • Hi Domen, Like all others I want to thank you for the really helpful information by the benefit of your research. I just wanted to ask you about the shampoos recommended as whilst reading your site and your comments regarding Sodium Lauryl Sulfate I got the impression that the shampoos didn’t contain this foaming agent – however on checking Nizoral ingredients it contains Sodium Lauryl Ether Sulfate, and Ultrax Labs Hair Surge contains Sodium Laureth Sulfate. and Alpecin also does aswell……. so I’m not now sure what to do now as you shouldn’t use shampoos with Sodium Lauryl Sulfate in as its an irritant that kills off the hair follicles! Could you please advise as I really want to use a hair loss prevention shampoo.

    • Try Lipogaine Big 5 or Big 3. SLS shouldn’t do any harm to your hair follicles. Even more so if you don’t use it every day.

  • It wasn’t too long for me to realize the shampoo i was using was the cause of my hair loss. I had to stop using it and opt for hair booster. Thanks for sharing

  • Does Rogaine become less effective over time? I am on the recipe of rogaine foam 5%, nizoral shampoo and saw palmetto extract. It’s been quite a success since I can feel the roots got thicker. I contribute the success to proper applications of rogaine. if all goes okay, I will stick to this recipe for the rest of my life. my only worry is whether Rogaine will go down in the effect after years like my body growing drug resistance or DHT going overload to break the balance.

    • Rogaine, if not combined with something to inhibit DHT, will become less effective over time. You can be sure of that. Saw Palmetto extract may not be enough.

  • my problem is same as Jon . i also suffer from depression then my hair getting fall. but now I overcame depression but not from hair loss

  • Hey there! I am wondering on what you think about Monat? I am 17 about to turn 18 and my hair is already thinning quite a bit. I had looked at this product before but wasn’t sure on its authenticity. Not only that, but the price is $$$$

    • I haven’t delved too much into it, to be honest, so don’t take my word 100%. But just from looking at it from the surface, it may be a multi-level marketing scheme and has many class action suits against them. I see those as red flags. I would personally stay away and keep using the relatively cheaper tried and true products.

  • I have read/heard that these topicals and orals (not transplants) may not work for Black people hair. On the other hand I think the biological make-up of any hair is the same and maybe it it is the underlying skin type that makes for different outcome. Any thoughts please before I invest in a solution?

    • Can you please give a source for your claims? Though I highly doubt that’s true, I’d love to investigate.

  • Hi Domen, great article! It sorted things out for me regarding my knowledge on hair loss fixes.
    I’m 33 years old. I’ve been using Finasteride (1mg) for over 3+ years now, and it really stopped my hair loss. I say I’m a living proof of the effectiveness of this drug. And yes it really lowered my libido. But then in these past days, I felt this pain around my testicles. Then my leg became partly numb. I tried to experiment on how to stop the pain and numbness by stopping Finasteride for a while. Sequentially, the pain and the numbness went away after stopping it. I’m afraid of coming back on drinking Finasteride again.
    1. Is it safer to use Dutasteride as an alternative?
    2. For hair growth effectiveness, when price is not a problem, which of the two brands would you recommend more, Minoxidil Kirkland or Lipogaine, foam or topical, and how many % ?
    (I now got interested on using one of these two brands upon reading this article because my hair has not been growing more since I’ve only been using Finasteride only to stop my hair loss)
    3. Also, would you recommend using the Big 3 while using a laser cap?

    • Hey Noel,

      I’m on finasteride (1.25 mg) for 4 years and dutasteride (0.5 mg) for about a year. Zero side effects.

      1. Dutasteride is more powerful than finasteride, so there is actually a high chance of experiencing side effects.
      2. Lipogaine. 5%.
      3. Yes, it would work in conjunction. Try the “dermaroller” as well. Some swear by it.

  • I had hair problems issues like dandruff, hair fall and lots more. Frankly speaking tried many allophathic hair products but i was not satisfied with the results of that products… Then someone suggested me ayurvedic product then for trial i bought 3 months package and i started getting results and i complete my course as suggested by Dr. Vipul. Now i am satisfied with my hair and thanks to arogyam hair care kit… Thanks once again.

  • Hey Domen,

    This really a great post! I have some questions to ask but everybody else does it for me. So I decided to give you thanks for your helpful answer.

  • I’ve set up an doctors appointment for next wednesday to get Propecia. What’s you suggestion on the best routine for using it. I’ve been leaning towards either every other day or monday, Wednesday and friday. I heard of one guy who doing it twice a week which is interesting.

  • What should I be using for early stages of hair loss? I have some thinning around my crown. It’s not too bad, but it’s obviously not going to get any better. Should I just be using a shampoo for hairloss, or more serious measures like Reganine or Fin tablets etc? I don’t mind, but I don’t want to use products that could somehow make the situation worse. Thanks.

    • Get on the real stuff I mentioned in the article. No half measures. You’ll thank yourself later.

  • Domen, This is really great hair loss information for your visitors. Thank you for including my information on FUE hair transplant techniques using the ARTAS robotic-assisted system and the latest SmartGraft FUE device. If your visitors have any questions about hair transplants, PRP using ACEll or BioD placental-derived ECM, laser therapy for hair regrowth, or powerful topicals like Formula 82M, etc. they can post them here on your page or at http://www.baumanmedical.com/ask-a-question and I would be happy to answer them. Regards, Dr. Alan J. Bauman, MD, ABHRS, FISHRS, IAHRS – Bauman Medical Hair Transplant & Hair Loss Treatment Center

  • What are your thoughts on the new Subscriptions out there like ForHims and Nutrofal? Do you think they are worthwhile to help stop hair loss and possibly regrow hair?

    • Their websites look pretty and well designed. Though their products are a bit pricier compared what you can get by doing a little research. You are paying for branding and simplicity. Which may not be bad for some people.

  • This was perfect men … i used minoxide regularly but i was hopeless until i was here .. thanx ..

  • Hey, would you say using just Rogaine would be suitable to regrow hair and retain hair in a male age 25 that is experiencing a receiding hairline or would you highly recommend all 3? Or do you believe that Rogaine is more of a “short term solution” as hair folocales will continue to thin ? ;as stated about the benefits of Finasteride .. thanks

    • You can try using just minoxidil but I’m confident you will wish you would have started all three since the beginning. Like you said, using just minoxidil won’t do anything to address the reason why you’re losing hair in the first place. It will just slow your hair loss, not stop it.

  • Hello – thanks for the article. Are the pills (Finasteride, Proscar, Dutasteride) only available by prescription? My doctor is very skeptical – and bald! Also any recommendations about where I can buy Proscar on-line in Canada? The Baldness Doctor link in your site only ships to a few southern states.

  • Hi Domen,

    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?

    I’ve looked into taking finasteride. My father was prescribed it about 30 years ago for some minor prostate issues. After taking it for a year he said it had no effect on his hair regrowth. Do you think since it had no effect on my father, it will not effect me? I’m just a bit worried about giving it a shot after reading articles like this https://raypeatforum.com/community/threads/finasteride-causes-physical-damage-to-nerves-depression-ed-steroid-imbalance.16979/#post-230383

    • Hi Ben,

      Switching to Lipogaine might yield better results, but Rogaine is the same thing as Kirkland minoxidil.

      Finasteride is best at halting hair loss, not regrowing hair. That’s why your father probably didn’t see any effects.

      And don’t bother reading those types of articles, they will just get in your head and make you experience side effects psychologically. If finasteride would be so detrimental to your health, it wouldn’t be available to the general public. There are millions of men taking it with no side effects who just go on about their lives, without reading paranoid articles on online forums.

  • Hey Domen,
    I started using rogaine about 2 years ago. It seems to work better on the top of my head than it does on my hairline. The thing I don’t like about rogaine is it makes my scalp very itchy and flaky. Do you think I would have anything to lose by switching to the lipogaine? And what products other than propecia would you roccomend I add to my regimine. Thanks man. Great article btw

    • Hey Hayden,

      Thanks! You definitely wouldn’t lose anything by switching to Lipogaine — quite probably it would be even more beneficial. Other than Propecia, I would use a hair loss shampoo and possibly look into dutasteride (I take 0.5 mg twice per week with zero side effects, but my crown is becoming thicker).

  • Hi, am not promoting any product, just sharing my experience honesty, I have always had fine, thin hair but just recently I’ve become very self-conscious about my scalp showing. I’m only 24 years old and thought this was not the age I should start balding! I’ve tried everything – Biotin, Minoxidil, many type of hair growth supplement. Yes, these supplements supported hair growth but they did not support hair re-growth like Kesha Vardhani did. I’ve been using Kesha Vardhani for six months and hope to continue it.

  • Hi Domen,

    Thanks for a great article!
    I just have one quick question about the ketoconazole shampoo, should I use Nizoral 1% or 2%?
    (It seems like my hair/scalp gets more dry from the 2%)

    Best,
    Casper

    • Hey Casper,

      Interesting. For better results, go with the 2%. The 1% is not as effective. Are you sure it’s the ketoconazole making your scalp dry and not some other ingredient like SLS? How often do you use it?

      • I use Nizoral (1%) 2-3 times a week.

        I’ll give Nizoral 2% a try then, two times a week, and “La Roche-Posay Kerium Extra Gentle Shampoo” once a week, to help my scalp get less dry.

        Like this:
        Mondag: Nizoral 2%
        Wednesday: Nizoral 2%
        Friday/saturday: La Roche-Posay Kerium Extra Gentle Shampoo

        Thanks 🙂

  • Domen, Great article, I’m 47 and I’ve been on finansreride and RegenPure DR shampoo for 3 years and don’t have much hair loss any more. However, all the loss happened prior. Do you think getting on minoxodil could help with new growth? Or transplant is the only option ?

    • Minoxidil is definitely worth a try before you do a hair transplant. It works differently compared to finasteride, instead of addressing the main cause of hair loss (DHT), it focuses on regrowing hair. So since you’ve got the DHT part covered by finasteride, there’s a good change minoxidil might regrow some hair and help stop future hair loss.

  • Thank You, Hrovatin for this informative blog on hair loss treatment, I have been suffering from it some months ago and now I am enjoying my life to get rid of from it by PRP method. Thanks to this treatment and the guys who helped me a lot.

  • Thanks for this. Im 37 and the MPB came on strong about 2 years ago. I have been using minoxidil for about 8 months. Im not sure its working so great, getting pretty discouraged, but always good to know theres people out there in the same boat with the same worries and problems. Thanks again for the advice.

  • Domen,

    24 y/o male. Thinking of starting the big 3 as my hair is a distinct v shape now. Best plan of attack. Get on fin 1mg daily, do I need to use the min all over my head or just the temple areas where it has receeded? That part confuses me the most, why would I need to use it all over my head if only my temples and hairline have receeded?

    Also, common sense right, if I see sides on the fin, get off if it immediately right?

    • Matt,

      You can get away with using it only where your hair has receded, but I would apply it all over my scalp to help prevent further recession. If you experience side effects talk to your doctor. But keep in mind they may well be just psychological.

  • Derma roller may be a good hair loss treatment for others but results may vary. Needles sticking in your skin is still a different matter and needs to be given enough thought before using. The idea of using one is to open up closed pores to take in nutrients for a healthier outcome.

  • Hey man this was life saving article for me thank you so much… but I’ve still a doubt on finasteride. I saw many articles on finasteride all were negative about side affects.. My doctor advised me to take finasteride of 2.5mg daily for 90days.. what do you think is it good advice to take finasteride of 2.5mg daily??? I’m too young to lose my sex drive

    • Hi Sid. I believe 1 – 1.25 mg daily should be enough. Well, finasteride causes negative sexual side effects in less than 1% of users. So I wouldn’t stress over it.

  • Thank you for the insightful article. To be clear, you recommend taking the “big 3” together at the same time? Or just choose 1 option from the list of the “big 3”? I just started heavily thinning and am searching everywhere to figure out how to slow it, and your site was the best I’ve found!

  • If you scared to do Hair transplant and want the solution to hide your baldness instantly then try Toppik Hair products . It’s a Hair Building Fiber and work amazingly .I am also a user of it and there is no any kind of risk You can find it at http://www.toppik.pk

  • This article is COMPREHENSIVE and sticks to the tried and tested (read scientifically proven) treatment methods. For me, if you’re suffering from pattern baldness, then the best chance you have is the Big Three. That said, it is worth potentially trying other, more natural, treatments if your hair loss isn’t aggressive and if you have an aversion to medicated products. I’m not talking about snake oil here. There are some treatments out there that, while not a primary treatment mode, can help to at least arrest hair loss in milder cases. As always with hair loss it’s a question of probabilities. I don’t think I’ve come across a product that works 100% of the time for 100% of the people. But the best chance undoubtedly comes with the FDA approved products to date. Also loved the future pipeline chart. Fantastic view of what will (hopefully) be more effective treatments in the future.

  • A great article. Appreciate the replies in the comments as well.

    I am thinking of using minoxidil to spot treat part of my receding hairline. The patchiness is not really that bad and it’s been concentrated on one side for a few years without getting worse, but I can’t really change the style of my hair much, and that’s the biggest issue for me since I get bored very easily.

    That said, it seems that spot treating with minoxidil does work (even for the front of the hair), but my concern is that I read that after a few months minoxidil can cause shedding in other parts of the hair, even when not applied to those sections. Do you know anything about this?

    Also, what do you make of DHT lowering foods and their effect on hair? I have read about flaxseed, which I occasionally eat, but haven’t noticed any difference in hair health.

    Thanks.

  • Hae, thnx for the infor, just to ask for the best rogaine to use coz my lose of hair stated from part of the front & a small part at the back & the way I see it my be in some years if I don’t do something the front part and the back will combine to make a big bald. Any advice on which to use to fill the two gaps.

  • I have a crazy idea and was wondering what your opinion is. I am a female who takes Ginet a contraceptive pill with cyproterone acetate in it. My boyfriend is balding what if I crushed these pills and made into a cream for him to apply to his head?

    • Sara, that probably wouldn’t be the best idea. You don’t want to you boyfriend to be a lab rat for these type of experiments, it’s dangerous. There is a possibility the drug could go systemic and cause all kinds of hormonal problems.

  • Am using KESHA VARDHANI hair oil for almost a month. Purchased this a couple of bottles already. Wife said hair becomes thicker and really seems to be working (Regrowth of new hair). Tried other brand and did not work as good as this brand. A little on the expensive side but quality seems to be there compare to other brands. Try it for yourself to checkout to result.

  • Hi ,great blog by the way.
    I’m 55 years old and have noticed hair thinning on the top of my scalp could you tell me the best treatment available to prevent further thinning as with all the information on hair loss I’m finding the right solution to my problem rather confusing

    • Hey Julian,

      Basically, get on “The Big Three”: finasteride, minoxidil, and a ketoconazole shampoo.

  • I noticed I was going bald, I panicked and turned the internet upside down in search of a solution and tried lots of products and weird things but none worked. a friend who used to tease me about the hair (in a bid to tease me further) bought a product from Africa during his travels and he mockingly gave me as a present.I tried it and the result is unbelievable. infact he had to call his contacts in Africa to get in touch with the manufacturers. I know how frustrating and confidence-sapping being bald is that’s why I took this painstaking mission to reveal to any who wants to try it. you can contact the manufacturers on (***censored***@gmail.com)I hope this message helps.

  • I find it misleading that you characterise finasteride as ‘safe’. Even the original studies by Merck decided on an incidense of side-effects of about 3% comapred to placebo. those seemed to be reversible by stopping treatment, but still. people should decide for themselves how much risks they’re willing to take to cure they’re hair-loss.

  • Is there a reason the FDA asked the manufacturers to remove azelaic acid from their products. If it’s beneficial which from what I’ve read I think it will be I was thinking of adding it to the minoxidil but I don’t want to do it if there is a risk to my health.

  • Hi

    Very helpful and informative blog!

    I used propecia in the past combined with minoxidil provided by my hairloss clinique. They have provided me with a liquid form of minoxidil which has caused me itchness wherever I applied it so I have given up using minoxidil however I noticed the combination of these two has made the best results and my hair started to grow back.

    I red somewhere in a blog that one of the ingredients of minoxidil products causing itchness so I was just wondering wether do you know what ingredients it is if yes does any minoxidil products comes without that ingredients?

    Thanks

    Henry

    • Hey,

      That’s probably the alcohol. There are actually “low alcohol” minoxidil solutions available. Or, try the foam version.

      I remember years back when I first tried minoxidil it was in liquid form, and for the first 5 days, my scalp was itching red. After that, my body got used to it and the redness went away without changing the product. But maybe that’s just me.

  • Mr Domen (The GOTO Hair regrowth regime -GOD),
    IM 28 and ive been slowly thinking since 22.
    Now that I’m going through a divorce and other problems my hairloss is becoming extreme!
    I have been religiously taking Proscar 5mg tabs (pharmacy quarters them for me so roughly I take 1.25mg findesteride a day!) For the past 4 months (havent taken ANYTHIG else). I still have very healthy hair up top but its now rapidly falling out.
    Money and costs not an issue but my hair is…
    Can you please help me start a regime?
    Obviously I’ll start taxing the expensive rogaine and the expensive shampoo.

    Please help me avoid this embarrassing time, I’ll even pay you to help give me a personal routine. The best of everything with the max amounts of everything…
    Please I’m desperate to start today!

    • Hey Kyle. You are overestimating me, but I’ll take the compliment.

      I can’t take you money. But I understand you are frustrated and will try to help by trying to explain this as simple as possible:

      1. First, realize it much easier to keep the remaining hair than to regrow with the current treatments.
      2. Incorporate the basics: finasteride, minoxidil (preferably one with DHT-blocking ingredients), and a ketoconazole shampoo.
      3. Wait for at least 6 months before evaluating the effectiveness of the regime. Preferably up to a year. You are doing yourself a disfavor if you start judging the efficacy before that. You’ll just frustrate yourself.
      4. Know that now your hairline is pretty much frozen. Your hair loss will not continue, and if you are lucky you can even possibly regrow hair back. At this point, if you are not happy with the results. You can start considering dutasteride (higher chance of sides) and FUE transplant.

      And that’s it.

      Though, I’d recommend you NOT go on dutasteride or do a transplant. But rather wait for the new coming treatments.

      Good luck.

      • Domen, enjoy your work. Can you expand on your suggestion regarding not having a transplant and wait for new coming treatments? Is there something on the horizon that you’ve touched on before that I missed seeing?? Is DHI the new gold standard for transplants? To your knowledge, Is this method being used in the states yet? Thanks Sir!

        • Because a transplant leaves an unnatural hairline if your hair loss progresses. And I don’t know what would happen if you would somehow manage to grow your hair back (hypothetically, using future treatments). Don’t know about DHI.

  • Appreciate the article.
    Do you have any opinions on HairOmega DHT Blocker?
    I have been taking this in pill form for 5 years in addition to a ketoconazole shampoo. I am looking to begin a generic finasteride in addition to generic minoxidil. If I begin taking generic finasteride would you recommend that I continue taking HairOmega DHT blocker or would the Minoxidil topical and ketoconazole shampoo be enough?

    Much appreciated

    • Thank you, Turner. Finasteride should be enough. I wouldn’t take more than one oral DHT blocking treatment, but I wouldn’t shy away from using additional topical DHT blockers – like Lipogaine for Men (minoxidil plus DHT blocking ingredients).

  • My scalp is dry, itchy, and irritated everywhere. I’ve been using H&S Clinical Strength shampoo for 2-3 years and its been pretty good at keeping it under control. I’ve been using rogaine for about 1 year now and I’m trying to avoid propecia if possible. Recently my hairline has quickly recede, and I’m not sure what to do. My friend said to start using nizoral every couple days. Do you recommend Nizoral for every few days? If so, what conditioner do you recommend and what shampoo do you recommend for the other days of the week when not using Nizoral? Thanks for your help – great site.

    • If you want to keep your hair you should get on finasteride. It’s just the way it is. I’d use Nizoral about twice a week, depending on how your hair reacts to it.

  • Very informative!

    One question though, do we stop using these things after the hair has regrown, or do we keep using it like usual?

    • Thanks, Ed. I’m afraid if you want to keep your regrown hair you have to use these treatments indefinitely. Otherwise, you’ll lose all your “gains” and be back to the point as if you had never used them. It’s a commitment.

  • Great article!
    I am actually a female but would love to hear your thoughts about the side effects of using minoxidil on skin. Supposedly it impairs collagen production and so speeds up the appearance of wrinkles. Is that true? Is there anything to support that or to disprove that? That is literally the ONLY reason why I am not using minoxidil like… RIGHT now!

  • If you take Finasteride to stop the hair lost and get success. While you put minoxidyl to regrow hair and are also successful with it. Could one stop minoxidyl after he got the good results of hair regrow and keep the new hair has he is taking Finasteride?

    In conculsion can you take Finasteride and Minoxidyl to stop losing hair and get it to regrow and once it regow then stop Minoxydyl?

    • Possibly. But since they (both) don’t provide miracle results, I wouldn’t recommend it. Why risk losing regrown hair? If you get tired of applying minoxidil twice a day, do it just once per day. It still works.

  • Has anyone had any luck buy propecia online? I would like to buy online but only if someone can give me a suggestion or reference.

  • What worked for me was doing nothing about losing my hair and just letting nature take its course. My hair started receding in my early 20s, but only a little, then it stopped for about 30 years. Then in my early 50s my hair started receding and thinning very rapidly again. I panicked until my wife told me she loves bald men and had been wishing I would go bald. She talked me into just letting myself go bald. In less than two years I went from norwood 2 or 3 to norwood 6. I don’t regret my decision to go bald and have no desire to regrow my hair. My wife and I really enjoyed watching my hair recede and thin away. I love being bald and you couldn’t pay me to regrow my hair. In retrospect, I wish I had kept on balding in my 20s all the way to norwood 7.
    The only downside of baldness is my head gets cold in winter and in summer, sunburn on top of my head really hurts, so I wear a hat.
    I’m still not bald enough. I would like my hair to recede a little more off the sides and the back and end up with a smaller fringe of hair. And I would like to lose that last bit of thin ‘peach fuzz’ I still have on top. It is almost invisible and I can hardly feel it, but I know it’s still there.

  • I think there’s nothing wrong with advertising that propecia side effects are low, its a flat out lie to say they’re impossible. There are thousands of people posting online about the sexual side effects experienced, and many thousands of others who have experienced the side effects and quit without complaining on the internet. On top of that, there are many patients who take proscar to treat BPH, experience sexual side effects, yet don’t complain because they’re treating a more dangerous condition, and they’re typically older men and people incorrectly expects every man north of 50 will be impotent.

    Reality is, if finasterise is so safe, why doesn’t merk market this drug as a vaccine for hair loss? For every man north of 18 to take this drug to prevent the possibility of balding? It’s safe, so why not? Truth is the science isn’t clear that either AR inhibition or DHT reduction is safe. All we know is that merk did a study and were able to publish data that suits their agenda.

    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.

    Try propecia, but just be aware.

  • What is your opinion on laser combs? I went to the Men’s Club yesterday and they recommended I spend ~$800 to buy a laser band, comb or hat. What is your opinion on how those work? Sounds like snake oil to me. They also recommended I go to my dermatologist to get a prescription to reduce sebum in my hair. I have been on Fin for 11 months, Minox foam 1x/day yet hair shed hasn’t stopped. I do have a prescription for Ketoconazole shampoo but rarely use it. I read in your article that this shampoo does help with Sebum build up so I will try that. Any other recommendations for sebum reduction?

    • Hey Michael,

      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?

      • Thanks for the help Domen. I currently use keto about once a week but I will ramp up to 3 times a week. I hear that helps for Sebum reduction. Do you agree? In terms of shedding, I shed very consistently . . . .about 15-20 hairs I notice in the shower when I shampoo, 15 hairs when i come out of the shower and comb my hair, another 5 every morning on my pillow and random hairs throughout the day that I notice on my desk.

        • Hey- no problem. 3 times a week should work. If you see your hair becoming too dry and brittle cut back, use it 1 – 2 times a week.

          • Thanks. My shedding still hasn’t stopped. Now on month 14 of propecia, + keto + minox. I talked to my Dr about trying DUT . . . he said no given it isn’t FDA approved. But I’m thinking of increasing my dose of propocia from 1.25mg (1/4 of a proscar pill) to 2.5mg (so take half a pill. Anything wrong with doing that???

            • Increasing to 2.5 mg will inhibit (almost) the same % of DHT as 1.25 mg. So the effect will be the same.

  • Hi, thanks for the very informative article! Is there a good conditioner option to use with Lipogaine Big 3 please? Thanks

  • Thanks for this nice article.
    Exactly 10 weeks (2 and 1/.2 months) ago I started off with Finestride 1mg and Minoxidil 5%.
    I quit Minoxidil after the first week because of accelerated/increased hair fall. I believe I made the correct decision because from the very next day, being only taking Finestride, my hair-fall completely stopped. That was quick and till now, on week 10, these is no hair loss, just being on Finestride 1 mg daily.
    But, here’s my specific question – I don’t find any hints/signs of regrowth – any explanations?
    I guess, you’d tell me to wait longer. To that,, my argument would be, if hair fall stopped by week 1 end, why there’s no regrowth after week 10 end yet?
    I am 42 years, from India.
    Thanks!

    • Hi Neel,

      Finasteride is usually best at stopping hair loss rather than regrowing hair. You should compare pictures before and after.

      Minoxidil shed is quite common. I’ve had it myself. It’s only a temporary phase and should not last long. Minoxidil is the best treatment for regrowth, I’d recommend you give it another chance.

      • Thanks Domen,
        I will reconsider your suggestion on starting back with Minoxidil.
        I wish to add that a year and half ago, I was on only Minoxidil 10% (not 5% and also not on Finestride – to be safe after reading all the discouraging posts) for almost 9 months. The only thing it did was to give a gel-like effect..but was extremely flaky!

        Not only had I been loosing hair but the hair strands were thinning like crazy – hence, I had to resort to these meds..

        Now on Finestride, I can visibly feel that the hair strands are getting thicker – so that gives a slight dense appearance (obviously, I can’t expect more than that after week 10, realistically) with the hair-fall completely stopped.
        But as I said, there’s zilch increase in the hair count.

        Domen, I was reading some articles and also the links you’ve provided in your other comments above – they say both Finesteride and Minoxidil only check further hair loss and thicken existing hair – but both can’t re-generate hair that’s already gone from bald spots. I guess the effectiveness of these 2 medications are quite proportionate to age of the native! At 42, I guess, I am old 🙁 Atleast according to Indian standards!!
        Thanks again..

        • Hi Domen, an update: I find hair regrowth at the widows peak edges hairline. Surprisingly o contradictorily no difference in the vertex or top or crown. Though my widows peak had been thinning since just last year – so is that why finestride has been effective there and not elsewhere?
          – Neel

          • Hey Neel, that’s a bit odd. It’s usually the other way around. For most, Finasteride works better for regrowing crown hair than the ‘windows peak’. It may be because you may have been receding on your temples only for the last year, yes. Thanks for sharing your update.

  • I got all my hair back within 7 months of use but after leaving finasteride and minoxidil, hair fall again started at double rate.

  • I am only just now seeing the results of using the Somaluxe Shampoo (after about 1 month). I noticed that my hair isn’t falling out like before,..

  • I’m 26 years old and I started to lose my hair right after high school. Hair loss runs in my family. My hairline started to recede and was becoming thin around the temple area.

    I’ve been using the Somaluxe Shampoo now for 4-5 months now and I love it. I’ve noticed a HUGE difference. My hair grows faster and its thicker….Don’t expect this to grow hair where you lost it. It’s not going to happen. But to stop and prevent hair from falling out, this is great

  • Thanks Domen, very comprehensive article.

    I’m 33 and I still have quite a full hair line. I was facing mild hair loss until recently I’m noticing a lot of shedding, I’ve been on Propecia for the past year though. I’m not sure if Propecia is not effective on me anymore or it was kind of limiting hair fall until now. I’m even doubting that it could be MPB but do you think The Big Three would also help even if it wasn’t an MPB case?

    Thank you.

    • Hey Joseph,

      To be absolutely sure, check with your dermatologist. If it’s not MPB, then Propecia and Nizoral won’t do anything. Only Minoxidil may help.

  • Hello great read
    I had a fue hair transplant on top of my crown where I had started thining a lot so it’s been over a year now and I look the same before my hair transplant my surgon said give it a year buts its the same if not worse. I started using 5% minioxodil generic version and not notice any growth it has been a month twice a day application. I don’t want to take any tablets either

    • Hi Adi,

      I’ve honestly never heard of someone having a transplant who is unwilling to go on finasteride. I would have thought that your transplant surgeon would have made it clear that you will have to go on finasteride prior to doing the transplant.

      I always assumed taking finasteride was a given with any transplant procedure, after all what’s the point in having an area of your scalp transplanted with new hairs then all the surrounding areas of hair continue to disappear in the balding process. That would not be a good look at all.

  • Good article! I have been using ketoconazole for my baldness…Surprisingly some results.
    However I sometimes use it on my beard also. Can it affect my facial hair growth somehow?

    • As I mentioned in the article, it should work. But beware of the sun. Azelaic acid increases your chances of sunburn based on a study.

  • Hi, do you believe that finasteride is not as effective in older men, say age 55 and over? Data seems to be mixed. Are you still experiencing minor or no sides on the finasteride? Thanks for a very thorough article with unbiased information.

    • Hey Jeremiah,

      According to this website http://www.bernsteinmedical.com/answers/does-propecia-work-in-older-men/ finasteride may me less effective in ‘regrowing’ new hair – but just as effective at preventing further loss in older men.

      Quote from the website:

      Propecia (Finasteride 1 mg) can hold on to hair at any age, but works best to re-grow hair in those who are younger.

      The reason is that finasteride works to reverse miniaturization (the thinning and shortening of hairs due to DHT). Younger patients, with early hair loss, generally have more hair in the early stages of miniaturization where the changes are readily reversible.

      Older patients are more likely have more advanced miniaturization or areas that are totally bald and will thus not regrow with medical therapy.

  • I have been on minoxidil for 10 years or so,applying the lotion once a day.I am thinning quite noticeably now.Would stepping it up to twice a day make any difference?
    I am looking into propecia,but have been put off by some horror stories.

  • Wow.
    Amazing article thank you so much for sharing this with us. I very much appreciate it. I was just wondering have you heard about Har Vokse. I have been using it for a while and its working really well for me. The reason why I bought it was because it was a good alternative to the other products I was using. I just wanted your thoughts on it. It really helped me tremendously. If you would like to check it out. I have been using it for a while now.

    • Hello,

      I haven’t dwelled much into it, however after typing ‘har vokse’ in google search the prediction suggested the words ‘does not work’. That’s a bad sign. Might be snake oil.

  • Hi, Domen,
    You must know there is real concern out there about finasteride causing severe depression in men, leading to suicide in some cases. I understand there are at least a few major lawsuits in progress. What’s your take on this?

    • Hello,

      I doubt finasteride is the sole contributor for such feelings and actions. But it saddens me nonetheless.

  • I read that using ketoconazole (Nizorol) could lower testosterone levels is this true? Any hope four a balding 62 yr old and any thoughts on apple cider vinegar with cayenne pepper before washing hair with Nizoral.

  • hey am 22.. i used alot of hair dyes and relaxers on my hair when i was younger like two years ago that’s when i started going bald. i decided to cut every hair on my head , now am very shy to walk around bald so i wore a cap or hat on my head everyday even in hot weather. the shape of my head is very bad i feel frustrated like am really young for all this. i started using rogaine early this December but am not seeing any improvement or whatever is because i always cover my head with a cap or what? please i need an advice on what to do cos i don’t think i can go anywhere without covering my ugly head.

    • That’s probably just a coincidence. MPB can’t be caused by dyes and relaxers. You need to give Rogaine time – 6 months before you evaluate. Start considering finasteride.

  • Hello
    Great article , do you hear about Bimatoprost i read is working really well and doesn’t have side effects like minoxidil or propecia

    • Hey Andreu,

      I’ll look into it — I’ll also update this guide in a couple of months with new information.

  • Hi, great article. I have an aggressive form of MPB. I am 23 year old with a NW2 hairline, diffuse thinning over the top and crown. Been on 5% Minoxidil and 2% Keto for about 9 months. Went through a period of shedding which has reduced somewhat in the last couple of months. I don’t see any appreciable increase in density anywhere but I do see plenty of thin vellus hair at my hairline. I am waiting for the 1 year mark to see the full effect of this regime. Is there like a test you can do to assess hairfall? Or do we just have to count the hair lost in the shower? Do you reckon I should start the Fin to hold on the the hair I have? Like most guys (actually a bit more than most guys seeing that I am young) I worry a lot about being in the 2% who experience disastrous sides from Fin. I do plan to check my DHT levels before I start, if I do at all, to see if I naturally have high/low DHT. That should tell me what to expect, to an extent.

    Ray

    • Yes, you could count hairs in the shower, but the best thing you can do is take pictures at the same angles and lighting over a period of time. Fin is your best bet at keeping and regrowing some of the lost hair. Most guys (including myself) who are on Fin have only one regret – not starting sooner.

    • I have DHT levels at the bottom -end of the normal range, so low DHT, however I’m still going bald, so besides DHT levels it also depends greatly on the sensitivity of your hair follicles to DHT. If you have high or low levels of DHT finasteride should obviously still help you maintain your hair as the process remains the same either way.

  • Great article thx!! I’m 38 and still have a full head of hair but I started to shed about 3 months ago. Typically ~15 hairs on my pillow when I wake up and 20 or so hairs on my hand after I shower. I also notice hairs on my desk during the day. I never noticed any hair loss before 3 months ago. I started to use rogaine 5% twice a day about a month and a half ago and the shedding accelerated. I read that is normal but should it still be doing this after 1.5 months? I haven’t tried propecia yet as I want to see if Rogaine will do the trick but will if the shedding doesn’t stop. Also, do you think stress can play a part in hair loss? I started a super stressful job about 6 months ago so thinking my hair loss could be related to that.

    • Yes, stress is a possible cause for hair loss. As for minoxidil and shedding; I shed for over 6 months when I went on 5% minoxidil. Give it time – it works.

      • 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.

        • All at once. If you are sure it’s MPB, start finasteride (and Nizoral) now and move on. Minoxidil will just delay the inevitable, while fin will potentially stop (or even reverse in some cases) the hair loss. The cure for baldness is to start treatment early. The chances for real sides are non-existent.

          • 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?

            • Yes, once you start, there is no stopping at any point if you want to keep the hair.

              Stress is rarely the case. 95% of all hair loss is believed to be MPB. You could compare your hair loss to other pictures online of male pattern baldness and get a better idea.

              Also, why not visit your dermatologist and have him evaluate if it’s MPB or not. He/she can also give you the prescription for finasteride on the spot.

    • I finally gave in and started taking propecia (1.25mg/day) ~15 weeks ago as Rogaine clearly wasn’t going to stop my hair falling out . . . . .the good thing is that I have had ZERO side affects. In fact it also seemed (so I thought) to stop my hair loss for the first 4 weeks or so. However for the last 6 weeks or so, i have been losing hair faster than ever before. I have read that this common typically between the third and fourth month of taking this. Have you heard anything like that? I hope that is the case and it slows soon. I have continued Rogaine liquid twice a day as well as dandruff shampoo a few times a week.

      • From what I’ve read, that’s very common. When I started Minoxidil and Finasteride my hair didn’t stop shedding for at least 8 months.

        • I have been on Proscar now (1.25mg/day) for nearly 10 months, rogaine foam 1 to 2 days a time and Nizoral shampoo a few times a week. unfortunately, the shedding never stopped. When I shower, I still see 10-15 hairs on my hand when I shampoo and another 5-10 after I comb my hair after I shower . . . and then another 10-15 when I style my hair with gel in the mornings. I’m going to switch to name brand Propecia and try that out for a few months but I think I may just not responding to this treatment. My hair is absolutely more thin than it was before I started treatment. My thinking is that I go another 3 months on name brand propecia and if that doesn’t work, try Avordart. Thoughts?

          • Your hair got thinner but did you hairline recede further? Shedding for 10 months is a bit over average. If I remember correctly my hair shredded for about 8 months and has gotten thinner before thicker again. Even after 3 years now basically I’m slowly still regrowing hair I’ve lost.

            Dutasteride is much more potent (haven’t tried it), but much more people report side effects.

  • Hi, great article! I found it very usefull for my research on how to stop my hair loss.
    I’m 33 and sadly just started taking serious steps. Been losing hair since about 25 but very slowly so I still have much to save… I have Chrohn’s disease so I have that against me too.
    The past 6 month I have being taking dietary supplements, using Revivogen spray nightly, Lipogaine topic solution 2 times a day, I use Lipogaine shampoo on mondays, wednedays and fridays and the other days I use the Revivogen Shampoo and Conditioner.
    I don’t take propecia because I take enough pills as it is with my Chrohn’s…
    My question would be, I am on the right track or is it overkill? I’ve read that using too much stuff (solutions or shampoo) maybe detrimental to keeping your hair. I know 6 month might be a little time but I still don’t see noticeable results and I’m afraid I might be doing something wrong or worsening the situation, even though I don’t have worse hair loss than before.
    Could you please give your opinion?
    Finally, being thiking about buying the Hairgrow iGrow Laser Helmet to try out? Any thoughts on that?
    Thanks for all your help!!

    • It’s not overkill – as your regime won’t do a whole lot, only take a lot of time. As for taking Propecia with other pills simultaneously – that’s something you should consult with your doctor.

      I don’t believe the ‘laser helmet’ does much. If it did, everyone would be raving about it.

  • Thank you for such a great article. I have just started notice of my hair fall and want to do something about it. I have seen the Reviews for REGAINE so far, that seem effective. Can you please tell me, are ROGAINE and REGAINE same products ? If not, which one will you recommend ? Also, is there any need to use anything beside with one of the above products ? Thanks for your time,

    • Thank you for your kind words.

      Yes, they are same. You also can’t go wrong with any other minoxidil brand–as long as its 5%.

  • I work with glass cleaners (sprays) and other identical products…Do you think the contact of the chemicals with my hair and/or skin can affect both my hair and my beard?

  • A little bit off topic…But do you think there is a link between masturbation and DHT, or in other words does masturbation affects hair or/and beard?

  • Hi There,

    I’m using 5% minoxidil in my beard for a week, after 3 days it start itchy, and somebody told me that because a new follicles come up. It’s that true?

    Btw, if I want to fill a bald spot, it’s better if I apply minoxidil on that spot only, or spread it to all my beard?

    Thanks.

    • Hey Kris,

      Nope, it’s not itchy because of that. You may need to get used to it (my case), or you don’t tolerate it well. I suggest you keep going and see if the itch goes away after a while and then reevaluate. You could also try a minoxidil with a lower alcohol formula.

      You can use it in the bald spot only if you want. It’s also perhaps better that way since the face is more sensitive to minoxidil compared to the scalp.

      • Hi BaldingBeards,

        Thanks for your fast reply.
        I don’t feel itchy today, maybe because I apply more thin compared to yesterday, not sure,
        but I’ll wait for a week 🙂

      • Hi BaldingBeards,

        I forgot to ask you, after I get a full beard and I stop using minoxidil, my beard will fall out?
        Fyi, I already have follicles in my face so I just using minoxidil to grow it faster and thicker.

        Thanks a lot 🙂

  • What’s your opinion about stemoxydine and aminexil. Both are products sold in Eu by Vichy under the name of Dercos. Are they any better?

    • Hi there,

      Haven’t tried either of them. But from what I’ve read on internet forums, people claimed it had a minor effect. Mostly after stopping; they’ve noticed their hair got a bit thinner.

      If stemoxydine and aminexil had any real impact, rest assured there would be a lot more hype and more people using them.

      I believe the next best things coming that might do something are “setipiprant” and “topical finasteride”. Let’s wait and see.

  • Hey, nice article man!
    Just a question…I am using nizoral shampoo for my face, to treat my seborrheic dermatitis, and I am afraid that due to the anti-androgenic and anti-dht qualities of the product it might be in some way affecting my beard regrowth :/ Please help!

  • Yeah I totally agree, there are many people who take it for years with no apparent side effects then one day decide to read up on the drug on forums etc. and suddenly they have all the side effects appear. The mind is very powerful indeed.

    I can get hold of the 5mg Proscar brand or 5mg generic brand from a licensed doctor here in the UK who kindly prescribes it to be cut in to 4th’s or 5th’s, I’m just not sure about the hassle of chopping it up and trying to get it into equal parts haha But of course I can opt for the expensive route and get Propecia brand 1mg.

    Thanks for your help, it’s good to get a down to earth opinion on it all.

    • Spare yourself the trouble and just cut in 4. That 0,25 mg don’t matter–generic 5mg finasteride is hella cheap. (And not to mention, almost impossible to cut in 5 parts).

      I had to go through 2 doctors before I got the generic prescription. Some are very uninformed about the matter.

      Good luck!

  • Cheers for the swift reply man.

    I’m also seriously considering getting on Propecia only, but like all men I delaying with fear of possible side effects. Have you experienced any sides so far?

    Also do you use generic or brand name? and do you get Proscar 5mg tabs and chop it up or just get the 1mg tabs?

    Cheers fella

    • At some point I thought I did–but I abstained from masturbation for a 2 days and libido came with a vengeance. (So, no.)

      I believe it’s far too weak to cause any sides for most men.

      I used the original brand Propecia until 2 months ago when I’ve managed to get the generic 5mg finasteride. I cut it in 4 parts and take one daily in the evening.

      Finasteride didn’t give me any significant regrowth, just kind of froze my hairline. I used to be a ~NW 3, now a ~2.5.

      If you think you are going to get sides, you’ll probably do. Imagination is a powerful drug.

      • Man, I guess you shouldn’t split pills.

        In regard to the imagination, people tend to to associate physicological problems with a spontaneous or conscious process, but that’s not necessarily the case. So, regardless if you think or not about it, you are propitius to develop side effects.

    • Hey Toki, thanks.

      I’m on minoxidil (regular 5%) and ketoconazole (Nizoral) for about 2.5 years and Propecia for about 1.5 year. I regret not taking Propecia sooner.

  • Hello Domen.
    Are hair transplants effective, and if so, which ones have the most dependable
    results?
    Also who best perform these types of procedures?

    • Hey Frank,

      From what I’ve seen and read they can be quite effective–but come with several risks (scarring and unnatural-looking hairline come to mind). I haven’t dwelled much into it, but basically got FUT (follicular unit transfer), FUE (follicular unit extraction) and DHI (direct hair implant)–which is the newest, similar to FUE, most costly and provides the best results in most cases.

      If your are opting for a hair transplant, do plenty of research. Go with a hair transplant surgeon who has experience and a ton of positive reviews. Also check forums online what “real” people say about a particular hair transplant clinic or surgeon–the internet is infested with fake reviews.

  • I agree everyone should at least try Finasteride to see if they experience side effects, personally I tried it and it gave me side effects even taking 1/4th of a pill, I also tried avodart and wow that REALLY gave me side effects, it gave me retrograde ejaculation, some ppl are just sensitive to androgen suppressors, if you are then your best bet is to stay away from anything that suppresses your androgens, your hair loss may suffer from this though. Currently I’m on lipogaine and Nizoral, I throw in Emu Oil too, I’m going to give the dermaroller a chance. You can still fight hairloss without Finasteride, give it a chance if you experience sides come off of it immediately, weigh the pros and cons, obviously my sex life is more important than hair so I chose to come off of it, but not everyone will experience side effects like I did.

    • Exactly. Give it a go. Even if it does not work for you, using minoxidil and Nizoral will slow down your balding process. Even a shaved head looks better with some hair left on top.

  • The comment about Dutasteride causing more side effects is not correct. All studies performed to this date actually sight that Dutasteride has lower side effects. Especially in regards to decreases in sex drive. The only time Dutasteride has been shown to have greater side effects is when the dosage of Finasteride was well below the recommended dosage of 1mg. In comparison 500mcg of Dutasteride has been shown to be more effective than 2.5mg of Finasteride and 1mg has shown to be more effective than 5mg of Finasteride, the dose used to treat BPH. The research has clearly shown that Dutasteride reduces serum DHT levels much faster and has much higher success rates.

    • Can I have a link to those “all studies”? Dutasteride inhibits type 1 and type 2 5-α reductase while Finasteride inhibits only type 2. Why would it have less side effects?

  • The FDA DID NOT pull azelaic acid. They asked companies that had it in their products to voluntarily take it out. Just to be clear. Don’t u think that the FDA knows that Lipogaine has
    the azelaic acid still in their products ??

  • I know I am a little late to this but I was curious if you had any opinions or experience using the “Nioxin” shampoo brand? Is it snake oil?

    • I haven’t tried it. But from what I’ve read it does not fight (male) pattern baldness. Instead, it makes your hair appear thicker.

      They don’t advertise it as a hair loss treatment — so I would not categorize it as snake oil.

  • Thx Domen for the useful info. Curious to know why you didn’t cover laser therapy as offered by Advanced Hair Studio? Or doesn’t the laser treatment combined with sawpalmtto tabs and minoxodil work? If it does work and you complete the 6 month program, will the growth be reversed if I stop using the products?

    • From what I’ve read Advanced Hair Studio has a bad rep. I will leave it at that.

      I know some laser devices for hair loss are approved by the FDA — but they have never generated any real hype or any conclusive results (at least that’s my impression for now).

      Saw palmetto is a weak DHT blocker, has little evidence and (same as laser therapy) never produced any definite results.

      If you stop using minoxidil you are back to square one. Not only it will stop working, but you will lose all that you’ve “gained” — like you never used it. It’s a lifelong commitment.

  • How come u dint talk about saw palmetto I read that it blocks the formation of dht..can use sawpalmetto tabs with minoxidil ..what is your view about this? thanks a lot for the best post.

    • Hey there,

      I didn’t talk about it because it has insufficient evidence.

      Men who’ve tried it and spoke about on the internet also claimed it didn’t have much effect. This is, of course, anecdotal evidence. But there was never any hype about saw palmetto producing any significant results.

      My impression is — it may help to a lesser extent, but don’t count on it as your primary DHT blocking substance.

  • Great article Domen! I just ordered a bottle of Lipogaine , Nizoral and I also bought Biotin, which is supposed to help.
    I’m going to use for my hair but also try to help with my beard patches and even grow more chest hair. Do you think that these products will work on body hair too?
    Anyways, thanks again for your very detailed article.

    • Thank you, FB. Biotin might help a bit.

      Are you going to use it directly on you face and chest? It will help, but a cheaper alternative would be regular minoxidil. You don’t need DHT blocking properties in minoxidil to grow facial and chest hair.

      • Regaine and Lipogaine were the same price on Ebay so I got the latter. If it works I might continue for a few months. I hope my hair doesn´t start falling / stop growing after I stop using these products….Thanks one more time 🙂

        • They will stop working if you do FB. Minoxidil is a life commitment, same as Propecia. I wish you the best of luck and plenty of hair regrowth.

  • It’s insane to claim that “only a small percentage of people experience sides on propecia”, it’s the contrary, just about everyone experiences some weird sides as the drug has an effect on yoyr hormonal balance, everyone feels that. It’s psychological to believe you have no sidesFor me, sex became really dull

    • In my own experience, my sex life remained exactly the same. There are a lot of other factors which contribute to a higher libido and better erections. (for example healthy food and limiting masturbation).

      I have a few friends as well who take it and never had any adverse effects.

      Side effects might be real for some, but for most I believe Propecia does not have a significant effect on your sex life.

      Don’t think about it. It helps. Don’t fall for the nocebo effect.

      • I would suggest everyone please take a look at the following forum:

        http://www.propeciahelp.com/forum/

        Propecia is no joke. Fair enough, you’ve been fine on it, but I can assure you that there are more people than you think whose lives have been completely destroyed by this drug. Shrinking penis’ and testicles, just 2 of the documented side effects are not nocebo. Many people have not able to reverse the many effects of propecia for years, after only taking the drug in some cases for just a few days !

        Again I would suggest people have a read of some of the suicide notes at the forum/link I posted above and then make up their minds about whether they want to take the risk or not.

        Just make sure you know all the facts before you jump into something you may end up regretting.

        • I would not take propeciahelp seriously. The website is far far too bias. The testimonies against finasteride are unverifiable anecdotes, not to mention the drug itself is not powerful enough to elicit the side effects some of these people are claiming. I have suspicions that it is run by a competitor of finasteride, as I have seen the same kind of tactics used against other FDA approved hairloss drugs. Its harder to sell snake oils when their are legitimate drugs out there.

          • It was actually started by two physicians whose son killed himself after years of being off propecia and still having irreversible life destroying side effects.

  • all your information is constructive..and got answer yo all myquestion.but please help me how to get it.

  • What do you think Domen, is it ok if I use only minoxidil, nizoral and biotin after hair transplantation?

    • Hey, Jox. I don’t believe so. In terms of blocking DHT, Nizoral is not as strong as Finasteride. And minoxidil just helps regrow hair, it does not do anything about the DHT. I suggest you take finasteride or some other potent hair loss treatment like RU, after transplantation.

  • Thanks. This is by far the best article I have read on the subject. Very straight forward with no angle apart from how to help people. Thanks!

  • I noticed that stress was actually playing a considerable part in my hair loss, however despite reducing stress I was still suffering from hair loss. I tried multi-vitamins too, but I don’t believe they helped at all 🙁

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