Minoxidil (Rogaine). Minoxidil is one of the most common and popular forms of medication for hair loss, particularly pattern baldness, but also generally used in cases of alopecia areata. It is an over-the-counter drug that comes in either liquid or foam form and is applied on the scalp, particularly on the bald patches, to promote hair growth and stop further hair loss.
Beyond that, things get more controversial, with some doctors saying there's inadequate evidence for other treatments. Saxena thinks there is enough scientific evidence to support some of the alternatives and recommends them to patients. But they are not for women on tight budgets. There's Nutrafol, a "nutraceutical" that costs about $80 a month. Women can also get injections in the scalp of platelet-rich plasma made from their own blood. The first four treatments cost about $2,000 at Saxena's practice in Fort Washington or Lansdale. Maintenance injections, done every three to six months, cost $515 each. Women can also buy Theradome, a light-emitting helmet, for $895 online. Saxena, who has hair loss herself, said she has had the injections and currently uses minoxidil, spironolactone, and Nutrafol.
That meant new products like Hims and Keeps were out.Hims and Keeps are relatively new companies that allow you to set up a subscription for hair loss treatments. Both offer finasteride (after an online consultation with a doctor) or 5 percent minoxidil. However, their minoxidil solutions contain propylene glycol, so we cut them from consideration.
“Once that hair has stopped shedding, it does regrow, at a rate of about a centimeter a month,” said Dr. Senna, who suffered from the condition after each of her pregnancies. She shares photos of herself with patients, to show she can sympathize. In one, her entire frontal hairline clearly is growing back in. “If I’d used a treatment, I would have thought it was a miracle drug,” she said.
One hard truth: Hair loss is mostly out of your control. “Baldness comes down to your genes,” says Frederick Joyce, M.D., founder of Rejuvenate! Med Spa and a member of the International Society for Hair Restoration Surgery. “If you have the baldness gene, there are some natural remedies that may make your hair stronger and healthier to slow your hair loss slightly—but they won’t prevent you from going bald. Still, maintaining hair health by eating well and using the right products—combined with medical-grade treatments—can really work all together to help you have a fuller, thicker head of hair.”
“This industry can be ruthless—full of liars,” Farrell told me. “Just imagine how emotional people can be about their hair. If it didn’t work, some bruiser could throw me right out the window!” He laughed. “I’d rather sell hamburgers than make people ugly. But they’re always just so beautiful. I’ve done it almost forty-seven thousand times.” (Forty-six thousand and seventy-four, he later clarified, in more than thirty years.) He was originally a hairdresser; he learned the ways of wigs from a stylist on the set of a Ronald McDonald shoot. Now he’s an unabashed proselytizer. It’s all in the details, he said. “Clockwise growth patterns. Counterclockwise retention. Gravity splits according to your growth patterns and gravitational force. Irregularly shaped hairlines. The density, the texture, the colors, the highlights, the grays, the curls, the curl clash. I mean, this is rocket science! We have proprietary techniques!”
The third and fourth stages are known as telogen and exogen, respectively. In telogen, the hair is supposed to be at "rest" until it finally detaches itself from the follicle and enters the exogen or shedding stage. Once the hair is detached from the follicle, the follicle remains inactive for about three months, after which a new cycle begins again.
Giovanni Mele, a stylist who owns Giovanni and Pileggi in Center City, said many women with thinning hair try to wear their hair long. He thinks they're much better off with short, pixie-like styles with light layering on top. He recommends that lighter-skinned women choose colors that are a little darker than blond or gray. He is a fan of a hair-thickening product made by Nioxin.
Key features: Dr. Zeichner recommends the Keratin Oil Shampoo and Conditioner by OGX for thinning or fine hair that needs the extra strength. This budget-friendly option uses keratin proteins mixed with argan oil to nourish, condition, and strengthen strands, and it's only $16 for the set. The smoothing formula can also increase elasticity for less breakage and split ends.