Because Hair Loss is such a devastating blow to any man’s self-esteem, we usually begin to panic when first realizing our hair isn’t as thick as it used to be or our hair line looks a little pushed back.
This makes men that are fighting hair loss a prime target for companies selling snake oil that simply doesn’t work. All the hair loss shampoos, oils, and ancient remedies that you think will work to bring back your hair will only waste time and money. Precious time that can be used to start using real working remedies.
Best Hair Loss Routine
The absolute best hair loss fighting routine with our current understanding of the science is the following:
1. Using a DHT lowering prescription drug such as Finasteride or Dutasteride.
2. Washing your hair with a Ketoconazole Shampoo like Nizoral
3. Using some form of minoxidil, topical or oral
4. Microneedling
These are known as the big 4 and they’re the absolute best things we have currently to fight hair loss, everything else is pure noise.
Let’s dive deeper into some of these remedies, and how they work.
Finasteride
Finasteride is a prescription medication that helps block an enzyme known as 5-alpha reductase or 5AR. By blocking this enzyme, your body isn’t able to as easily convert testosterone into dihydrotestosterone (DHT). DHT has a strong link to hair loss and is considered to be the primary cause of male pattern baldness.
Most often, DHT leads to loss of hair via a receding hairline and thinning around the crown. Eventually, this may build to complete or almost complete hair loss. Eventually, the hair follicles may stop producing new hairs altogether.
One myth is that finasteride can reduce testosterone since it inhibits some hormones related to testosterone. However, that isn’t the case. According to studies, there hasn’t been any significant reduction in testosterone recorded from using this medication. All it does is prevent the conversion of testosterone to DHT.
Compared to dutasteride, which works similarly, finasteride is the older drug that was first developed in the 1970s. It is often called Proscar. It was originally produced to treat benign prostatic hyperplasia, which is also caused by DHT.
Under the name Propecia, finasteride was rereleased as a hair loss treatment specifically for men in 1997. The amount used for hair loss is about five times less than the amount used to treat benign prostatic hyperplasia.
It is approved by the FDA for hair loss. There are some side effects including male breast tissue growth, erectile dysfunction, reduced sexual desire, testicular pain, and depression. These effects are pretty minimal though and don’t occur often. To take finasteride, you generally just take a single pill daily. It will often take at least three months to see the results, but it can take up to one year, and you will have to continue to take it forever or you will start to lose the benefits.
Dutasteride
Dutasteride falls into a similar category to finasteride, where it blocks 5AR enzymes. However, there are some slight differences. The most noticeable is that dutasteride isn’t actually approved for hair loss. Like the original release of finasteride, it is approved for benign prostatic hyperplasia but hasn’t been FDA-approved for hair loss.
It still works well for hair loss, but often has to be bought outright as most insurance companies won’t cover its use for that purpose since it isn’t approved by the FDA.
According to some studies, it seems to work a little better than finasteride. After 24 weeks, it was shown that men who took dutasteride had thicker hair and more hair in general than those that took the other medication. This leads to the theory that dutasteride has a higher efficacy.
This is likely because, while finasteride blocks about 70 percent, dutasteride can block up to 90 percent of DHT. This test was done on patients that took the medications for benign prostatic hyperplasia, but it should work similarly for the effects of the two medications on hair loss.
Minoxidil
Also known as Rogaine, minoxidil comes as an over-the-counter drug that is available in liquid or foam form. You apply it directly onto the scalp two times a day. It helps to both encourage hair growth and prevent hair loss. It generally takes between four to six months to start working.
The drug only works specifically for male pattern baldness. It isn’t used to treat a receding hairline or hair loss at the front of the scalp. It can also be used for women with thinning hair.
While it is known that minoxidil does promote hair growth, the exact reason why is not known. It is a vasodilator, and only works with specific hair loss, so there is still a lot to be learned.
Some side effects include fainting, chest pain, weight gain, tiredness, and difficulty breathing. Like the other medications, if you stop using this one, you may start to see your hair go away again.
This one works best if you start using it sooner rather than later, so it is best to try and pick up this topical treatment right away. It is an off-label treatment for hair loss, as it was originally used to treat high blood pressure, especially with oral applications. This is part of the reason that there aren’t a lot of studies about its effects.
Some studies have shown that using minoxidil as well as a treatment known as microneedling together can increase the effectiveness. This is because microneedling can increase the absorption rate of the topical drug and make it more effective.
Ketoconazole Shampoo
Ketoconazole shampoo is used to treat fungus and yeast infections on the surface of the skin. It is often used as an anti-dandruff shampoo as well. It shouldn’t be taken if you are breastfeeding, pregnant, trying to get pregnant, are allergic to certain things like antifungals, foods, dyes, or preservatives, or have areas of your skin that are damaged unless you consult a doctor first.
While it is a shampoo, it is still a medication. You need to use it as instructed in the right amounts or you risk causing injury to yourself or others. While you don’t necessarily need a prescription to get it unless you want a stronger dosage, it still needs to be treated like a medication.
It should also be noted that ketoconazole shampoo isn’t technically an approved hair loss treatment. It hasn’t been accepted by the FDA for this purpose, but there have been some studies that suggest the fact that it might help.
It works by blocking the enzyme or protein in the body that causes hair loss, called 5-alpha reductase, or 5AR. This not only lowers hair loss but may promote hair growth as well. It works similarly to finasteride in the way it blocks the protein and just isn’t approved. Since this one is an external use, it can be safer for those that are pregnant, and may have less chance of lowering the sex drive in men.
Microneedling
Though it is a cosmetic procedure, microneedling is pretty minimally invasive. It is simply the process of using miniature needles to create small punctures in the skin. Usually, this is done with a roller full of microneedles. In addition to stimulating hair growth, it can often also help with skin elasticity, scars, and dark spots.
For hair loss, there is another benefit as well. The micro punctures can boost the absorption of products that improve hair growth, such as steroids, plasma, and cream prescription medications.
It helps the body by stimulating collagen use and increasing production. In fact, it is often known as collagen induction therapy as well, because of its effects. It is common to lose your high collagen levels as you age, so using microneedling as you get older can improve many physical aspects of yourself.
Generally, it’s cheaper than other options like laser treatments and works well for a larger number of people. This is especially true of people with darker skin tones, as there hasn’t been a lot of research on how lasers affect darker skin tones.
It is primarily used on the face, but can also be used anywhere there is scarring and on the scalp to promote hair growth.
Each microneedling session costs somewhere between $200 and $800. There are light sessions that come in a little bit below $200 though. It often isn’t covered by insurance, as it is normally considered a cosmetic procedure instead of a necessary one.
There are minimal risks, such as bleeding, bruising, and infections. Not everyone can get microneedling, such as if you have eczema or open wounds.
How Long to See Results
None of these have immediate results. At best, you can expect it to take somewhere between three months to over a year. This is why it is important to start treatments as soon as you notice or suspect that you are losing hair.
It is also important to note that you can’t just stop treatment whenever. None of these methods are cures. Just because your hair is growing back while on the treatment doesn’t mean that it will stay that way. In fact, when you stop treatments or change them, you will likely see all the hair that grew back start to go away again.
Hair Transplants
If you are serious about getting your hair back and are willing to try anything, hair transplants are an option. They are usually the last result if nothing else has worked. Some people are against transplants because hair plugs often used to look fake and be obvious that it wasn’t real hair.
However, hair transplants have managed to come a long way, and look pretty much natural now. There are other problems with transplants that you should be aware of, though, before jumping into getting one.
The first is that it is a surgery. This means that you will have to be pretty uncomfortable, and there are some risks involved. If you decide to seriously pursue getting a hair transplant, your doctor will go over the exact risks with you, but you can expect some dangers like scarring and infections, as well as having to undergo surgery several times to get the results you want.
It is also costly. You can expect to spend at least $5,000 on even a simple surgery, and you will spend up to eight hours in the surgery room.
Hair transplants aren’t for everyone either. Since it involves transplanting the hair, you have to have hair that can be transplanted in other spots, such as on the back or sides of your head. This is something you can discuss with your doctor to find out if you are a potential candidate.
This isn’t a fast treatment either, or a permanent solution. You will have to take finasteride for the rest of your life so you won’t lose the hair you just transplanted, or that is still on your head. This drug can cause problems, especially erectile dysfunction.
After the surgery, you will have pain for the first couple of days. Within a few weeks, the hair transplanted will fall out, which is normal. It takes about four months to grow back, and it grows at an average of half an inch per month. Generally, you can expect it to take a total of a year to a year-and-a-half to see the full results.
There are two kinds of hair transplant surgery, which are follicular unit transplantation and follicular unit extraction. There’s been a lot of debate on which one is the most effective. Follicular unit extraction usually is the most expensive but can help to prevent the large scar that comes with follicular unit transplantation and it is less invasive.
Follicular Unit Transplantation
In Follicular Unit Transplantation (FUT), you remove the skin from the back of your scalp, and the follicles are pulled out. Then, those hairs are transplanted into the area where you experience hair loss. This is often considered the most classic method.
Follicular Unit Extraction
Then, there is Follicular Unit Extraction (FUE). This involves removing the hair follicles from the scalp directly, without removing the skin, and then transplanting them to the part of the scalp where they are needed.
There is a modified version of this hair implantation called direct hair implantation or DHI, which uses specialized tools to do the same process. The hair follicles are still removed from the scalp and placed into balding areas.
The tool has a fine tip that extracts the follicles, and then a pen-shape tool implants the follicles into the part of your scalp where they are needed. Many companies claim DHI is the best option, but there haven’t been any studies done to confirm their claim. However, there are indeed fewer chances of complications with DHI.
Other Therapies
While those are the most common and easiest types of hair loss treatments, they aren’t the only ones. There are others as well. These may not be as effective, or they may be considered more invasive or even alternative medicine, but can be worth a shot if you are desperate.
Oral Minox
The first is minoxidil taken orally. When used for hair loss, it often comes as a foam or liquid that gets massaged into the head. However, there is also the option to take minoxidil as a pill. While the oral version isn’t actually FDA-approved for hair loss, some people still take it. It is usually prescribed by doctors when the topical version isn’t working well enough but is showing promise.
The oral version has a lot of side effects, and like the topical counterpart, it is also only for certain types of baldness. There haven’t been a lot of studies on the use of oral minoxidil for hair loss, but the studies that have been done do show promise. Part of the problem and reason why it isn’t FDA-approved is that there isn’t a standard dosage. Somewhere between 0.25mg and 5mg is the most common for hair loss.
Microneedling and Minoxidil
When using topical minoxidil, there are ways to improve the efficacy. The most common method is microneedling. Since microneedling is already used to improve hair growth and reduce hair loss, it provides its own benefits.
But when used with this topical drug, it can increase the absorption rate of the foam or liquid being applied on the scalp. This is because microneedling creates small tears with the needles, which allow the liquid or foam to soak into the scalp faster and better.
Low Laser Light Therapy
Laser treatments can help in cases where inflammation around the follicles of the hair reduces growth. This is the case in alopecia areata. However, it can also help in other ways, even if inflammation isn’t present.
There aren’t many studies to confirm that laser treatment, also known as low-level laser therapy or LLLT, is effective for hair loss. However, there have been some studies to show it can be beneficial for male pattern baldness. Additionally, studies have been done to confirm that it is a safe treatment option with minimal side effects.
More research needs to be done to confirm it is an effective treatment, and the long-term results, as well as how many and how often these treatments need to be done.
PRP Injection
PRP stands for platelet-rich plasma. It is a mix of plasma, which is the liquid part of blood, and platelets, which is a component of blood that is focused on healing. They also contain growth factors that trigger cell reproduction and tissue regeneration. So platelet-rich plasma is simply plasma that has platelets that are in higher concentrations than normal.
This is made by taking a blood sample from the patient and rapidly spinning it to separate everything so that the platelets are concentrated inside of the plasma. This is then injected into a specific part of the body, such as around the head. In addition to helping with hair loss, it can also help with injuries to tendons, joints, muscles, and ligaments.
When used for hair loss, it is meant to help with male pattern baldness in preventing hair loss and promoting hair growth. It is often used after transplants to help encourage the transplants to stay and actively produce thick, healthy hair.
When getting injections, you usually get three treatments that are spaced about four to six weeks apart, and then maintenance must be done every six months or so. While PRP hasn’t been studied extensively, there have been some signs showing it can be beneficial, and it has been used since the 1980s. Generally, each treatment costs about $400 at a minimum, and the initial three treatments start off at about $1,500.
Since the injection is made up of plasma and cells from inside the patient themselves the risk of a reaction is much lower than other options. However, there are still some side effects like infection, nerve injury, and tissue damage, depending on the area you get injected.
Topical Finasteride/Dutasteride
There isn’t a lot of study on topical agents, as oral is often more common. However, according to some studies, it seems that there may be far fewer side effects for topical application than oral application while offering about the same amount of improvement in hair growth and reducing hair loss.
Some scientists suggest that dutasteride may be better used topically, as it is a lot more greasy, and will then stay on the skin longer than finasteride, but there are no official studies on the difference between their topical agents.
Since there isn’t a lot of research on them, it can be hard sometimes to find topical applications, but you can try to talk to your doctor and see if they will offer you an option for a topical application. Or, if you are experiencing side effects from the oral treatment, they may offer the topical version as a replacement.
Since these aren’t thoroughly tested, they aren’t often covered by insurance, which means you will, unfortunately, have to pay out of pocket.
Rosemary Oil
Rosemary oil and rosemary extract have been studied a little and found to increase blood circulation. When placed on the scalp, it can help with blood flow in the area, which can increase the amount of hair growth in the area.
Rosemary oil can also reduce inflammation and promote nerve growth, which can all be beneficial for improving hair growth and reducing hair loss. Many people in the Mediterranean have used rosemary oil in their hair rinses to promote hair growth throughout history.
Another essential oil that can help with hair loss and increase hair growth is peppermint oil. It also helps with reducing inflammation and increasing blood circulation in the area.
Of course, essential oils haven’t been tested, partially due to the lack of regulation and control of doses and product quality. This means that there hasn’t been much done in determining how accurate these claims are of the benefits of these oils. However, people around the world have been using forms of rosemary and peppermint extract for hair growth and to prevent hair loss for years, so there seems to be a good chance of it being beneficial.
To use these oils, you can either massage them onto your head to get the benefits of scalp massaging and the oil. Generally, when you are putting it directly on the skin, you want to use a carrier oil to dilute it, such as jojoba oil or coconut oil.
You can also put it into a shampoo, whether it be one you’ve bought from the store or one you make yourself. A good guideline to amount is about five drops per ounce of product.
Castor Oil
Like with essential oils, there isn’t a lot to support the use of any other oil. However, many people swear by traditions of using oils like coconut oil, castor oil, and olive oil to promote hair growth, thicken hair, and reduce hair loss.
Again, you can massage it directly onto your scalp, or add some of it to a homemade shampoo. Some people also just put the oil on their scalp before they shower and let it sit for a while before washing their heads like normal.
Scalp Massages
Scalp massages on their own likely won’t be a treatment. However, massaging the scalp can help promote the growth of the follicles. This is one of the reasons microneedling works. However, just rubbing the scalp with your fingers has been proven to be helpful. Just a four-minute massage every day has been found to thicken the hair, so it doesn’t take much time.
Vitamin D
Some research has shown that people with a deficiency in vitamin D tend to have a higher chance of hair loss. This makes sense, considering vitamin D stimulates hair follicles both new and old. With too little vitamin D, your hair follicles may not be properly stimulated, and growth may slow or stop altogether.
Getting plenty of sun can help increase vitamin D levels, but there are supplements as well if you live in an area where there isn’t a lot of sun. However, it is a vitamin you can overdose on if you take too much, so always make sure you read how much you need before starting a new supplement.
Speaking of vitamins, iron, vitamin C, and biotin all have been linked to hair growth, so it may be worth looking at starting a regime of vitamins. These will likely not be enough on their own, especially if your hair loss is already pretty severe, but they can be a great addition to your ther treatments.
Hair Supplement Gummies
If you want to grow your hair better, and don’t want to have to deal with remembering a bunch of different supplements to take, look at hair supplement gummies. They usually contain a lot of the vitamins you need, including biotin, zinc, vitamin B12, vitamin C, and vitamin E. These are good for anything with keratin, including skin and nails, so you may find yourself feeling better and healthier all around.
Every company sells gummies that are a little different, so look at the ingredients closely to make sure you are getting the nutrients you want. Many of them don’t contain vitamin D, so you may still want to consider getting a supplement for that.
Saw Palmetto
Saw palmetto is a type of plant. There isn’t a lot of research done on it at all, much less on its benefits for hair growth, but a small review found that it may be effective. It works similarly to dutasteride and finasteride, where it blocks testosterone from changing into DHT.
It would be a natural option instead of the two prescription medications, which usually means it is safer, harder to overdose on, and has far fewer side effects.
Topical Melatonin
Topical melatonin has also been suggested with some studies on its benefits recently. Specifically, it has been suggested to help with retrograde alopecia. This is because melatonin is a strong antioxidant and a modulator of growth. Since this is the most common cause of hair loss, it is an exciting find and more research is being conducted.
The study showed that there was an increase in hair count by about 42 percent in six months, with about 48 percent of those studied showing improvements after 90 days.
You may have heard of melatonin before, as it is often used for sleep when taken in supplement or gummy form. But some research has suggested that applying it to the skin topically can help with stimulating hair. There are little to no side effects so it is a safe method to at least try, even if it doesn’t work perfectly. It is a hormone already produced in the body, so most people can handle it pretty well even when applied topically.
Of course, if you are taking other topical creams or any medications, always confirm with your doctor to make sure there isn’t any chance of an interaction. Like most other treatments, it does its best when used early on in hair loss, so don’t hesitate to give topical melatonin a try.
What Else Can Make Hair Loss Worse?
If you continue with certain practices, you may find your hair loss treatments aren’t as effective as they should or could be. While most male pattern baldness and hair loss is genetic, there are some external factors that can increase your chances or contribute to hair loss.
Smoking
If you want to have the most effective hair loss treatment possible, quitting smoking can be important. Not only does it provide numerous other health benefits like protecting your lungs and reducing your risk of cancer, but studies have shown that smoking can lead to hair loss. In fact, some studies have shown that most people who had hair loss also smoked. Less than half of the men tested for hair loss had never smoked.
Diet
In addition to taking medications and treatments, balancing your diet gives your hair what it needs to grow. Try to reduce the amounts of sugars in your diet, and focus on foods that are high in good fats, especially omega-3 fatty acids, and high protein foods. Meals high in iron are also beneficial.
Some foods that are good to incorporate into your diet include fish, eggs, walnuts, lean meats, green and leafy vegetables, and flax seeds.
Of course, you also want to make sure you are staying hydrated. Pure, clean water is often best and helps to keep your skin soft and supple to make it easier to help the hair break through.
Stress
Finally, stress has been proven to have a huge impact on hair growth. Stress affects all parts of the body in various ways, leading to people catching colds easier, not getting enough sleep, feeling pain in various parts of their body, and even hair loss.
Reducing stress can be hard, but some common practices are trying to get enough sleep, practicing mindfulness and relaxing techniques like yoga or meditation, exercising, and listening to calming music.