The cause of female-pattern hair loss is unknown, but doctors said there is a strong genetic component. The risk can come from male or female relatives. Though it looks as if the hair is falling out, that's not really what's happening. Cotsarelis said hair follicles are becoming smaller and producing hairs that may be so small that you can't see them.  Women tend to retain more normal, thick hairs than balding men do.
To us, that meant any product with zero proven ingredients, case studies, or FDA clearance — which shrunk our list by a whopping 180 contenders. That’s right, there are only three treatments that have actually been cleared by the FDA and supported with clinical studies: finasteride (commonly marketed as Propecia), minoxidil, and laser treatments. And, since finasteride is prescription-only, it left us with two.
“I was 21 when I noticed my hair getting thinner,” says David Anderson, 45, who has had seven hair transplants. He is now senior patient adviser at the Maitland Clinic in Liverpool, one of the country’s leading hair transplant clinics, where he raises awareness of the vulnerability of sufferers. “It was devastating. It completely consumed my existence. Now, I really regret that. But time and again, I’m meeting patients going through the same anxieties. It’s an epidemic. A lot of people don’t understand how it can make you feel.”
Not surprisingly, treatments with 5 percent minoxidil work better than treatments with 2 percent minoxidil. A randomized clinical trial published in the American Journal of Clinical Dermatology in 2002 found that, in men with androgenetic alopecia, “5 percent topical minoxidil was clearly superior to 2 percent topical minoxidil and placebo in increasing hair growth.” The difference was actually pretty astounding — after 48 weeks, the men who used 5 percent minoxidil experienced 45 percent more hair growth than the men who used the 2 percent treatment.
Some of the more commonly known natural DHT blockers are saw palmetto and nettles root but there are many lesser known herbs that have been discovered to act in some way to reduce DHT. DHT blocking shampoos sometimes use as many of these herbs as economically possible, while others only include a few of the more popular ones. All of the shampoos that made are top 5 list below are known to be anti DHT shampoos.
Skeptics (among them, Dr. Wesley) are starting to come around after a 2014 randomized double-blind study published in the American Journal of Clinical Dermatology found a “statistically significant” difference in hair density for women who used a laser comb compared with those who used a sham device. (“Comb” is something of a misnomer. The device looks like a hairbrush crossed with a cordless phone; it is glided back and forth across the scalp, roughly a half-inch at a time, usually about 15 minutes three times a week.)
But in November, after 10 years of research, Rogaine introduced a new 5 percent minoxidil formulation for women. It’s a mousse (instead of a liquid) that needs to be applied only once a day instead of twice, which means that it can be more easily incorporated into a woman’s evening skin-care routine. Teal replaces the blue and silver palette of the men’s Rogaine, and the packaging bears a lotus flower. (Also last year, Pantene introduced its Hair Regrowth Treatment for Women, which is 2 percent minoxidil.)
Now known as RCH-01, RepliCel’s procedure is a patented cellular replication and implantation technology designed to rejuvenate damaged and miniaturized hair follicles in a balding scalp. According to Buckler, the technology involves the extraction of as few as 20 hair follicles from the back of a patient’s scalp where healthy cycling hair follicles reside.  Specific cells are isolated from hair follicles and are cultured using the company’s proprietary cellular replication process.  The cultured cells are reintroduced or injected back into balding areas on a patient’s scalp and are expected to rejuvenate damaged hair follicles leading to the growth of new healthy hair fibers.
The pull test may be used to diagnose hair loss conditions.1 The examiner grasps approximately 40 to 60 hairs at their base using the thumb, index, and middle fingers and applies gentle traction away from the scalp. A positive result is when more than 10% of hairs (four to six) are pulled from the scalp; this implies active hair shedding and suggests a diagnosis of telogen effluvium, anagen effluvium, or alopecia areata. However, a negative test result does not necessarily exclude those conditions. The pull test is difficult to standardize because the pulling force is not distributed uniformly and because it is difficult to approximate the number of hairs grasped, thereby leading to false interpretations.
Always shampoo and condition your hair regularly. Let your hair breath by avoiding wigs that are made with cotton and nylon caps that absorb moisture and lead to drier and more damaged hair. Instead, choose those with netted caps. Make sure your wig isn't too tight. Secure it with hypoallergenic double-sided tapes. Do not put your wig on over wet hair to avoid the growth of mildew and bacteria.
Hair loss is not a hopeless condition. While there are certainly cases of permanent hair loss in men, there are still cases when it's only temporary and therefore can be treated, controlled and prevented. There are treatments and cures available, and many of these, especially those for temporary cases, can be as simple as lifestyle changes -- eating the right foods, learning to manage stress properly, and doing away with unhealthy, nasty habits that can aggravate the condition.
7/26/18 Update: After positive early data, various trials of JAK inhibitors such as Ruxolitinib and Xeljanz are underway. Columbia researchers have had positive results with Xeljanz in 11 out of 12 subjects achieving some regrowth with no adverse side effects over 16 months of treatment. Investigators at Stanford and Yale are conducting three trials of oral and topical tofacitnib and Locks of Love Foundation is fuding another ruxolitinib study. At this time, there are about 15 publications looking at JAK inhibitors and their relationship to alopecia and its variants.

The most notable ingredients of the Big 3 are Biotin (vitamin B7), castor oil, and Emu oil. The latter helps defend against a variety of scalp and skin issues, including inflammation and allergic reactions. It also moisturizes the skin. While you could buy all three ingredients separately, it wouldn’t be very cost effective and why bother if you can purchase them in a product designed for hair loss?


Thinning hair in women is worth investigating for more than its impact on physical appearance. While many conditions that lead to temporary hair loss will go away without treatment or with simple lifestyle measures, others may be signs of potentially irreversible loss or health conditions. Others yet may respond well to treatments to promote regrowth, so starting sooner rather than later is key.
Dr. Carlos Wesley, a hair restoration surgeon in Manhattan, said that women in his practice respond better to P.R.P. than men do, which may have something to do with the fact that women with genetic hair loss tend to have more inflammatory cells around the follicles. From 2013 to 2014, he said, he had an 83 percent increase in female patients, in part because of P.R.P.
RepliCel’s technology has proven to grow new hair without transplants, creams or pills because it’s using a patient’s own stem cells to regenerate hair. Buckler said the basis for the company’s science comes from research conducted in the early 2000s in Europe by noted hair biology and dermatology experts Dr. Kevin McElwee, PhD, and Dr. Rolf Hoffmann, MD, who originally discovered the critical cell responsible for hair follicle growth. It is now being tested in human Phase II trials that began in July 2016 in Japan. Two other products of the company are for conditions where there are too few healthy fibroblasts, such as chronic tendinosis and damaged skin.

In fact, the Japanese government has recently committed to establish a new approval process for regenerative medicine products focused on accelerating approval timelines. As it turns out, hair loss is a big concern in Asian countries. Buckler said some 21% of adult males and 6% of females in China suffer from hormone-driven hair loss.  And the International Society of Hair Restoration Surgery’s (ISHRS) biennial survey of hair restoration physicians found that the number of hair restoration patients in Asia increased 345% from 2004 to 2010.


Lipogaine is a complete hair care system to treat most hair loss issues. The Big 5 Shampoo is a blend of Biotin, caffeine, Argan oil, Castor oil, and other powerful ingredients. They use only premium organic and natural DHT blocking ingredients with no sulfates or parabens. Lipogaine is for both men and women and all hair types, including color-treated hair. They also have a Minoxidil product and a fantastic 90-day money-back guarantee, including shipping, which is pretty rare.
Scientists from the Indiana University School of Medicine have for the first time created skin with hair follicles using mice stem cells. Research was led by Professor Karl Koehler. The team was able to grow both the epidermis and dermis layers of skin to create a realistic skin model. An interesting quote from Professor Koehler: “It looks like a little ball of pocket lint that floats around in the culture medium. The skin develops as a spherical cyst and then the hair follicles grow outward in all directions – like dandelion seeds.”
 Crown is also great for helping keep frizzy hair under control.  If your hair is quite fine you may find that the aloe vera in Apex Crown is too heavy. You may want to try regenepure nt, as it does not contain aloe vera but uses caffeine as the main ingredient.  Another organic product that has proven effective is PhytoWorx. It has a more pleasant aroma and uses organic ingredients including rosemary oil, olive oil, and fruit extracts. Studies have indicated rosemary oil might work as well as minoxidil.

Pura d’or makes a very bold claim with this product: “continued use WILL prevent further hair loss.” While we doubt it will “prevent further hair loss” for everyone, it does have an all-star line up of ingredients. Even if it doesn’t completely stop hair loss, this organic shampoo is certainly the safest for your hair out of our top 5. This shampoo is designed for daily use.


What’s got less evidence supporting its efficacy are the hair-growth shampoos that claim to block DHT (like those sold by Hims in their Rx Hair Kit). Rieder is skeptical that you’re going to see any tangible benefits by rubbing DHT blockers into your scalp. “I find it very difficult to believe that something that’s applied to the scalp and rinsed off is going to have any appreciable effect.” All four doctors also shut down any suggestions that hair-growth supplements or vitamins, like biotin, could help promote hair growth or stop hair loss — though a couple hypothesized that vitamins or supplements could lead to hair regrowth if your hair loss was a result of a nutritional deficiency. But otherwise, if you’re dealing with regular old male-pattern baldness, “There is no such thing as a ‘hair vitamin,’” says McMichael.
“We don’t know why, but we have universally established that the cells back there are immune to the attack,” Buckler said. That’s why doctors have worked at relocating follicles from the back of the head to the front to attempt to cure baldness. “That’s proven. If you relocate those cells, they’ll remain immune. “But that is a messy, bloody surgical procedure.”
The follicles on the sides of the scalp are more genetically resistant to DHT, which is why male pattern baldness often results in a “crown” of hair. But its downsides are serious. “With women, finasteride is not an option,” says Dr. Wolfeld. “It’s not FDA-approved for women to take, so we don’t prescribe it.” In fact, due to the drug’s effect on hormone levels, pregnant women are advised to not even touch broken or crushed tablets.
Blow dryers, flat irons, and other devices: Frequent use of a blow dryer tends to damage hair. The high heat from a blow dryer can boil the water in the hair shaft leaving the hair brittle and prone to breakage. Dermatologists recommend that you allow your hair to air dry. Then style your hair when it is dry. Dermatologists also recommend limiting the use of flat irons (these straighten hair by using high heat) and curling irons.
RepliCel’s technology has proven to grow new hair without transplants, creams or pills because it’s using a patient’s own stem cells to regenerate hair. Buckler said the basis for the company’s science comes from research conducted in the early 2000s in Europe by noted hair biology and dermatology experts Dr. Kevin McElwee, PhD, and Dr. Rolf Hoffmann, MD, who originally discovered the critical cell responsible for hair follicle growth. It is now being tested in human Phase II trials that began in July 2016 in Japan. Two other products of the company are for conditions where there are too few healthy fibroblasts, such as chronic tendinosis and damaged skin.
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.
But there is a Canadian company who has been working diligently to change that. And if they’re right—and so far the research indicates they are—baldness may become a thing of the past for those who choose not to tolerate hair loss anymore. And they're not only attacking baldness, Aging skin and tendon degeneration are on the cutting block as well. It's great news for the tens of millions of older Americans who suffer from these malladies. But the most fascinating part lies in the source of the cure. It’s you. The company focuses on the development of cell therapies using a patient's own cells.
A separate study, published in Skin Therapy Letter — a professional reference site for dermatologists — found that women also benefit from using the more potent 5 percent minoxidil treatment. “Patient-reported improvement in hair volume and coverage appears to be greater with 5 percent minoxidil foam,” reads the report. Plus, because the 5 percent treatment is stronger, women only have to apply it once a day to get the same results as they would with the 2 percent treatment applied twice daily.
Christiano is more of a skeptic. Lab results are nice, she said, but “you can grow mouse or rat hair sixteen ways till Sunday. They grow beautifully!” She laughed. “Humans, not so much.” She points out that there’s so much we still don’t understand. For one: Why does the hair on the back of men’s heads stick around, even when all the rest drops? She also counsels caution when playing God with hair loss. Some companies are seeking hair-restoration cures by attempting to modify developmental-cell pathways. Those pathways, Christiano says, “are potent, and so it’s tempting, but you have to make sure it’s well enough controlled that you don’t initiate a cancer signal.”
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