Literally jumping right out of the woodwork, the company “HCell” has announced they have been granted an orphan designation from the US FDA for their novel treatment of pediatric alopecia areata. The treatment itself it described as a “topical Injection by regenerating hair through a proprietary blend of commercially procured biologic and autologous tissue.” The company also mentions having a treatment for androgenic alopecia in the works as well. More info to come soon. News release here. 


Medical conditions and medications. A common medical condition that also causes hair loss is hypothyroidism, which can happen in both men and women. Patients suffer from an underactive thyroid gland, which is responsible for producing the hormone, thyroxin, which performs important bodily functions, such as the regulation of body temperature, proper utilization of carbohydrates and fats, and production of protein. Since protein is an important nutrient for the production of keratin, inadequate protein supply in the body due to an underactive thyroid means that hair growth in the follicles is slow. In men especially, hair loss is one of the first signs of hypothyroidism.
In their research, the doctors established a correlation between androgen hormones and hair loss. They found that for reasons not completely understood, some people are susceptible to androgens that attack the hair follicles, while others are not. “They found that the androgen hormone decimates the cell population at the base of the hair follicles,” Buckler said. “The hormone attaches to these cells throughout particular receptors and starts to attack.”
HairMax is known for their lasercomb products — an FDA approved hair loss treatment. They’ve started to branch out and now they offer a supplement, topical, and this shampoo (as well as a matching conditioner). One of the standout ingredients in this shampoo is the gotu kola. We have a full write up about gotu kola and its relationship to hair loss here.
You always hear these stories about people who take a homeopathic approach to fighting baldness. It’s always some off-the-wall remedy like smearing a paste of ginger and cayenne pepper on your scalp three times a day or eating a special type of ginseng farmed only in a rural village in Tibet. We'll go on the record to say that it's highly unlikely that these remedies work at any level.

Minoxidil and oral finasteride are the only treatments currently approved by the U.S. Food and Drug Administration for the treatment of androgenetic alopecia. Both of these drugs stimulate hair regrowth in some men, but are more effective in preventing progression of hair loss. Although there are a number of other treatments listed in various texts, there is not good evidence to support their use.8
Hair loss shampoos are an excellent addition to any hair loss prevention regime. They are also a cost-effective and convenient way to start treating hair loss. Sure, not many of these have long term clinical studies completed on their efficacy. However, some of these shampoos are chock full of botanicals and herbs that do have some clinical data backing them up.

Products like these come from huge pharma companies and are the direct beneficiaries of tens and even hundreds of millions of dollars worth of research and development, compliance, production and advertising. Since drugs have the capacity to significantly change your bodily functions and can cause threatening and undesirable side effects, there’s a need for the government to protect consumers via tough regulations.
The combination of silent suffering, public shame and poorly understood science makes hair loss sufferers easy prey – type “hair loss” into Google and you’ll see what I mean. Kobren tells me that he had to remove the personal messaging function on the Bald Truth message board, as users were being bombarded by scams. Meanwhile, the higher visibility of celebrity transplants means that baldness is at risk of being seen as a sign of poor self-care. Many treat surgery lightly – and enter into punitive financing deals. One of Kobren’s recent guests was The Only Way is Essex star Maria Fowler, who complained that surgery at the controversial KSL Hair in Glasgow left her with an unnatural hairline. “She ended up having a hair transplant because her fiancé was having one. She had always thought her hairline was too high. She went in like she was having her nails painted – and it destroyed her life.”
Our runner-up Clinical Effects Hair Therapy was a very close second to our top pick and our Best Value choice. Several of our testers felt that this was the overall best shampoo both in how their hair felt as well as the light scent.  We feel that it is the best overall value in this category as you can buy it at a price significantly less than the competition.  Clinical Effects is for both men and women and comes with an amazing 90 Day guarantee that is also the best in this category. We highly recommend it if you’re looking for a less expensive option to Shapiro MD.  They have fantastic customer service and stand behind all of their products.

Each follicle produces hair for 2 to 6 years and then takes a break for several months. While the hair follicle is in its rest phase, the hair falls out. There are around 100,000 follicles on the scalp, but because each follicle rests at a different time and others produce hairs, hair loss is usually unnoticeable. More noticeable hair loss occurs when there is a disruption to the growth and shedding cycle, or if the hair follicle is obliterated and replaced with scar tissue.

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.
Women with androgenic alopecia may consider trying prescription ketoconazole at a strength of 2 percent. This drug comes in the form of a shampoo and also goes by the name Nizoral. It’s an antifungal agent and may help reduce the body’s production of testosterone and other androgens that lead to hair loss. You can also find 1 percent strength at your local pharmacy, but it may not be as effective.
Anagen effluvium is usually reversible, with regrowth one to three months after cessation of the offending agent. Permanent alopecia is rare. A large meta-analysis of clinical trials concluded that scalp cooling was the only intervention that significantly reduced the risk of chemotherapy-induced anagen effluvium.27 However, scalp cooling should be discouraged because it may minimize delivery of chemotherapeutic drugs to the scalp, leading to cutaneous scalp metastases.27

Anti-androgens. Androgens include testosterone and other "male" hormones, which can accelerate hair loss in women. Some women who don't respond to minoxidil may benefit from the addition of the anti-androgen drug spironolactone (Aldactone) for treatment of androgenic alopecia. This is especially true for women with polycystic ovary syndrome (PCOS) because they tend to make excess androgens. Doctors will usually prescribe spironolactone together with an oral contraceptive for women of reproductive age. (A woman taking one of these drugs should not become pregnant because they can cause genital abnormalities in a male fetus.) Possible side effects include weight gain, loss of libido, depression, and fatigue.
Laser light therapy is not a baldness solution, and the HairMax takes a time commitment: You have to use the product for 15 minutes a day, three days a week and you have to keep using it indefinitely to get results. Still, laser light therapy has no major side effects, and may be best for men who have noticed some increased shedding and want to maintain more of the hair they have on their head.

And, for all of these collective efforts, Christiano reminded me, the only things that have really worked were discovered accidentally. Soon to join minoxidil and finasteride will be Xeljanz, or tofacitinib: originally developed for rheumatoid arthritis, it has remarkable effects on hair growth for patients with alopecia areata, an autoimmune disorder that causes patients to lose hair in big patches over their entire bodies.

1. Collagen powder. Preliminary studies suggest that marine-sourced collagen may stimulate hair growth, says New York City dermatologist Yoon-Soo Cindy Bae. Though more research is needed, participants in studies reported thicker hair after three to six months of daily use. Crushed Tonic Original Powder ($105) easily mixes into coffee, tea, and water.
While you won’t find a miracle shampoo on the market, nioxin and some other products can help keep your scalp in tip-top shape to improve the look of any hairs you do have left on your head. In fact, feeding your hair with the proper nutrients both inside and out can make it appear healthier, so you might consider using products with natural herbs, such as rosemary and mint.
Along with male pattern baldness, there is also a condition known as female pattern baldness, in which hair thins on the top of the head. Less is known about this type of hair loss, but it is more common in women who have been through the menopause. Female pattern baldness cannot be treated with finasteride (as with male pattern baldness), but it can be treated with minoxidil. Minoxidil is rubbed into the scalp once or twice a day and should start to show results after about four months. After ceasing treatment with minoxidil, hair loss should resume within a few months.
During a hair transplant procedure, a dermatologist or cosmetic surgeon removes tiny patches of skin, each containing one to several hairs, from the back or side of your scalp. Sometimes a larger strip of skin containing multiple hair groupings is taken. He or she then implants the hair follicle by follicle into the bald sections. Some doctors recommend using minoxidil after the transplant, to help minimize hair loss. And you may need more than one surgery to get the effect you want. Hereditary hair loss will eventually progress despite surgery.
Unlike The Big 3 Shampoo from Lipogaine, The Big 5 does not contain ketoconazole or copper peptides. However, it does have everything else The Big 3 has + 17 natural hair stimulating ingredients. We view this shampoo as more of a natural thickening shampoo whereas The Big 3 is going to be a little harsher on the scalp but better at nuking scalp DHT. Both shampoos are excellent products from trusted brand Lipogaine. We do know of some users that had had success rotating the Lipogaine shampoos and use The Big 3 every 3rd day or so and incorporate The Big 5 into their daily routine.
"The majority of men lose their hair not through stress, or bad diet, or lack of sleep, but through the genetic trait of male pattern baldness which is hard to treat through shampoos or supplements alone. Women lose their hair for very different reasons, but the argument still stands that a lot of the hair loss products on the market are just offering false hope. That said, there are a few that really work."
Hey Frederique, I removed it because it was no longer available for some reason. I’m not sure how well can these shampoos work if you are going through chemo. How you consulted your doctor about it? Ask if minoxidil is safe for your situation. It may be the best solution for your case since your cause for hair loss is not due to DHT. But please don’t take my word for it, consult with a doctor first.

See a doctor. While it may be easy to treat hair loss that's caused by stress or other physical or emotional shock, other types, especially those caused by medical conditions, require expert attention. Do not self-medicate. A medical test is necessary to determine the real cause of your hair loss. A medical diagnosis is important in order to rule out other factors that might be the cause of your hair loss. On the surface, it's easy to attribute hair loss to stress or the lack of sleep, but it is highly possible that the hair loss may be caused by an unknown or undetected condition related to hormones or genetics. With the right diagnosis, you'll be able to get the right medication and course of treatment.
Yet another company has made news this week for phase 2 trial progress. Concert Pharmaceuticals announced today that they have completed enrollment for their phase 2a trial using CTP-543 in alopecia areata. CTP-543 is an oral JAK inhibitor which acts on JAK 1 and 2, it’s also known as ruxolitinib. Concert’s version of ruxolitinib has been modified by the company’s proprietary deuterium chemistry technology which the company hopes will improve its effects on AA.
“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.”
The significance of this study is the new level of accuracy it could bring to the screening of drugs and compounds to induce hair growth. The current model used which has been used in the field for decades is the familiar “mice model” in which chemicals are injected or rubbed onto the back of shaved mice. If the substance gets hair to grow back faster than mice who do not receive the chemical, it is deemed that the substance holds promise for improving hair growth. We have learned time and time again, that substances which grow hair in mice do not always translate well to humans. Ghosh believes his new hair follicle model can provide a solution to this issue.
While the drug is generally safe for use, some possible side effects are mild irritation of the scalp, dryness and growth of hair on some parts of the body, especially the sides of the face and hands. In some cases, you might observe some increased hair loss around the first few days of use. If the hair fall continues after two weeks upon application of minoxidil, stop the treatment first and see a doctor. 

Hair transplant/surgery. A hair transplant or surgery is the quickest treatment for permanent cases of hair loss, although the most expensive. In pattern baldness, for example, where the top of the head is the most affected area, a hair transplant allows the surgeon to use existing hair to implant it into the bald sections of the head. It works by removing a graft or follicular sample in parts of the head that still have hair (usually this is the back of the head as this area is most resistant to hormonal changes), and placing this graft in the areas that are bald.
decrease in your blood Prostate Specific Antigen (PSA) levels. Finasteride can affect a blood test called PSA (Prostate-Specific Antigen) for the screening of prostate cancer. If you have a PSA test done you should tell your healthcare provider that you are taking Finasteride because Finasteride decreases PSA levels. Changes in PSA levels will need to be evaluated by your healthcare provider. Any increase in follow-up PSA levels from their lowest point may signal the presence of prostate cancer and should be evaluated, even if the test results are still within the normal range for men not taking Finasteride. You should also tell your healthcare provider if you have not been taking Finasteride as prescribed because this may affect the PSA test results. For more information, talk to your healthcare provider.
Another type of hair loss is alopecia areata, in which hair on the head (and sometimes on the body) falls out in patches. In most cases this type of hair loss resolves itself within a few months, however in some cases it can lead to more severe forms of hair loss such as alopecia totalis (loss of all hair on the scalp) or alopecia universalis (loss of all hair on the body). Alopecia areata is most common in people aged 15-29 and there are various treatments for it: minoxidil, corticosteroid injections, topical corticosteroid creams or lotions, dithranol cream, immunotherapy and light therapy. However none of these can be thought of as a cure for alopecia areata, as they are only temporary solutions.

Your hair can suffer from many health-related factors. A diet that is lacking in vitamins and minerals lack proper hydration as well as damage from styling. Make sure you eat a varied and balanced diet with plenty of nutrient-rich foods including fruit and vegetables. Try and limit using heat to style. This includes hairdryers and straightening irons.
Even though modern folklore, and even some limited scientific studies, have suggested that the mother's side of the family is largely responsible for a genetic predisposition toward baldness, the truth is balding is not all our mothers' fault. In fact, doctors now say baldness patterns are inherited from a combination of many genes on both sides of the family. There are some environmental factors that come into play, too.
Thanks so much for the guidance! After further research I have to agree with you 100%. Lipogaine Big 3 does containe ketoconazole, which would eliminate the need for Nizoral, however the shampoo only contains a few hair loss/thinning related ingredients. The Big 5 contains 17 and just seems like a better overall product. That plus Nizoral twice weekly seems pretty solid to me.
You may not know it, but stress affects your health in a number of different ways. It can zap your energy, make you feel physically ill, and even cause your hair to fall out. That’s right, stress plays a big role in contributing to thinning hair. On its own, stress-related hair loss is usually temporary and grows back over time. However, it can also speed up other forms of hair loss like male pattern baldness.
What's to know about alopecia areata? Alopecia areata is an autoimmune disorder that usually results in unpredictable, patchy hair loss. Approximately 7 million people in the U.S. have alopecia areata, and it can affect anyone of any age or gender. There is no cure for alopecia areata although some treatments are available to help hair regrow more quickly. Read now
These days, when forced into windy outdoor situations, Trump is nearly always seen wearing a Make America Great Again cap. But, one wintry, blustery day this February, Trump walked up the steps of Air Force One capless. In the engrossing video footage, you can see the hair on the back of Trump’s head part and rise, shooting up with power, almost in two separate flaps—one to the left, one to the right.
Hair Surge contains three key ingredients: caffeine, ketoconazole, and saw palmetto. As already mentioned, all three are essential ingredients in any shampoo that’s truly targeted for hair growth. It doesn’t contain biotin, but you can always take biotin as a supplement if you absolutely feel that you have to have it. Besides, if you still have doubts that Hair Surge actually works, you can sift through the thousands of positive comments and testimonials about it online.

I’ve recently added a new section of the website which will be dedicated to worthwhile products which can be used in an everyday hair growth regimen. The first product to make the list is the Teslabrush. I’ve appreciated the candid and practical commentary from Teslabrush inventor Bernhard Rudert on what his product is capable of. I’m also in favor of the fact that the Teslabrush does not replace other treatments one may be utilizing, but instead, Bernhard has said it works well with other hair growth treatments and has been shown to enhance them through combination. There is more information and commentary from Bernhard on the Featured Products page. I’d like to hear from readers who try this product, please feel free to share your reviews on how it’s working for you in the HairCell: New Website article where the Teslabrush was first mentioned.

Aclaris Therapeutics, the company who acquired the rights from Angela Christiano to use JAK inhibitors in alopecia disorders, is currently involved in a wide range of alopecia trials. The company has multiple ongoing trials for alopecia areata, including a trial for eyebrow regrowth, and also a new trial planned for AGA or androgenic alopecia. Full article here.
Our products are made with high quality ingredients that are non-invasive and 100% safe. Our goal is to provide our customers a hair restoration experience without the negative side effects or increase in health risks in the long term. We are adamant about improving your appearance through the right methods, so you can look good and still maintain great health.

Researchers continue to strive for the holy grail of hair loss cures by trying to gain a better understanding of how the hair growth cycle is controlled. Rather than treating the symptoms of hair loss, scientists aim to target the cause, which, in turn, may yield fewer side effects. Recently, there have been numerous discoveries in the hair loss arena that may lead to new promising treatments.
Where is the bald spot? What exactly are the dimensions of this bald spot? It’s all so stupid, so tiringly stupid. In May, Trump’s former personal physician, Harold Bornstein, revealed that Trump had sent people to seize all of his personal health records. Bornstein called it a “raid” that left him feeling “raped, frightened, and sad.” He also claimed that it was revenge for having revealed to the media that Trump was on Propecia.
Besides cost considerations, a hair transplant is generally prescribed as a last resort for permanent hair loss problems. It is also not allowed for people under the age of 25, those with a continuing problem of hair loss, as well as those with other health conditions like uncontrolled diabetes, serious heart problems and hypertension. Patients whose hair loss is caused by other factors, such as a skin or scalp disorder or who suffer from a psychological condition that causes them to pull at their hair are not recommended for this procedure. Since the procedure requires taking a sample from the back of the head, those who do not have enough follicles from this section that can be used for transplant are not also eligible.
HairMax is known for their lasercomb products — an FDA approved hair loss treatment. They’ve started to branch out and now they offer a supplement, topical, and this shampoo (as well as a matching conditioner). One of the standout ingredients in this shampoo is the gotu kola. We have a full write up about gotu kola and its relationship to hair loss here.

One key reason that Hair Surge is a cut above other so-called hair loss shampoos is that it’s formulated to maintain the active ingredients on your scalp and hair until they’re absorbed. Average shampoos include a couple of ingredients that are easily washed away before they have any impact on hair loss and hair growth. Hair Surge is also safe for all skin and hair types.


Female pattern baldness: Treatment and genetics While most women lose between 50 and 100 strands of hair per day, this hair is usually quickly replaced by new growth. When bald patches or thinning occurs, however, it may be a sign of female pattern baldness. In this article, learn more about the common causes and treatment of hair loss in women. Read now
According to the press release, a fast track designation is “intended to facilitate the development of new therapies for serious conditions and with the potential to address an unmet medical need. A company with an investigational medicine receiving Fast Track designation may be eligible for more frequent communications with the FDA and may receive an expedited review of the new drug application.”
Hey there, I'm Shawn, the founder of Tools of Men! This site was created to help out other guys by teaching them proper grooming habits and the basics of sensible style. We try to make things here a bit of fun while giving you clear info. If you want to get in touch with us, drop us a line on the contact page or via social media. Thanks for checking out the site - and make sure to come back again!
This is a bestselling shampoo on Amazon. The list of ingredients is extremely lengthy. The product contain a number of natural organic DHT blockers (including saw palmetto) and various nourishing hair vitamins. Additional beneficial ingredients include amla oil, argan oil, pumpkin seed oil, rosemary oil, tea tree oil, green tea extract, niacin and biotin.
Please help. My hair has always been my pride and joy. I figured since it is pretty damn healthy, it could deal with some bleach damage. And I figured the master stylist who did all the color-corrections would know how much would be too much. I was wrong, and now I want to burst into tears every time I look at my hair or touch it. I just don’t know what to do. my hair has also NEVER been shorter than this and it breaks and falls out. What should i do to regrow hair?

I am a 45 yr female that has experienced hair loss to the point of having to hire a plumber twice (over 3 years) to unclog our drain in our main bathroom although I am pretty cautious about picking up my hair. My ponytail is about 1/2 the size that it was 5 years ago. i had excessive hair loss after the birth of my last 2 of 3 children. It is noticeably thinner although my employees, friends and husband seem to think my hair is thick. I can see my scalp very easily. (No patchy alopecia though) I started using viviascal professional strength about 2 months ago and hair surge shampoo only about 2 weeks ago. The bottle has about 1/3 left and i am wondering what is to be expected from this product. I have to use at least 8 pumps ( it seems to be double the volume of normal shampoo that i use) and it does not seem to later that well until after a min or so. Additonally i am using the hair surge supplement. When should i see less hair falling out? When should i expect visible results. Any other suggestions? I know it says to use 5 of 7 days, but i use it daily to make sure i am getting the full benefit ( if any) from this product. Currently i am looking at 100 buck a month for the shampoo alone if i keep this up. Any advice is welcome. Thanks
What's to know about alopecia areata? Alopecia areata is an autoimmune disorder that usually results in unpredictable, patchy hair loss. Approximately 7 million people in the U.S. have alopecia areata, and it can affect anyone of any age or gender. There is no cure for alopecia areata although some treatments are available to help hair regrow more quickly. Read now

In fact, hair loss cures and treatments are a dime a dozen. There are cures that are designed for temporary hair loss conditions, and others more are available for permanent cases. It's also important to note that some of these cures are specific to the cause and the type of hair loss, and other treatments don't apply for other cases such as pattern balding. We've listed them all the same in order to give you a good idea of the breadth of choices available.
While you are waiting for the Big breakthrough, You may want to give Rosemary and Lavender essential oil a shot. I have found that my scalp feels much healthier after using this treatment once a week. I’m in hopes it is stimulating new hair growth as well. Check out some recipes online and reply with your thoughts or other techniques you find helpful. Let’s help each other fight the good fight against hair loss!
Researchers from UCLA in the lab of Jing Huang have recently shown that certain molecules which activate the cellular process known as autophagy also drive hair follicles into the anagen (growth) phase. The researchers studied different metabolite molecules and other molecules which are FDA approved and on the market as drugs. The most recognizable drugs from the study were metformin and rapamycin, one is a diabetes medicine and the other an immunosuppressant. Dr. Huang says her lab is looking to study these drugs for human hair growth soon. In my opinion, results from that study are something to look out for. Full article on the Articles page.
Literally jumping right out of the woodwork, the company “HCell” has announced they have been granted an orphan designation from the US FDA for their novel treatment of pediatric alopecia areata. The treatment itself it described as a “topical Injection by regenerating hair through a proprietary blend of commercially procured biologic and autologous tissue.” The company also mentions having a treatment for androgenic alopecia in the works as well. More info to come soon. News release here. 
Anagen is the growth phase. This lasts for about 3 - 5 years, where you can observe your hair growing half an inch every month. Full-length hair from this phase is about 18 - 30 inches long. Studies show that this phase may also be affected by other factors. Asian hair, for example, has been found to have a longer anagen phase. Weather is also a factor; hair growth can be faster in summer than in winter.
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Your hair can suffer from many health-related factors. A diet that is lacking in vitamins and minerals lack proper hydration as well as damage from styling. Make sure you eat a varied and balanced diet with plenty of nutrient-rich foods including fruit and vegetables. Try and limit using heat to style. This includes hairdryers and straightening irons.
It never hurts to do a little bit of research when exploring treatment options for hair loss. But at some point, you'll probably want to talk with a physician so that you can get a professional opinion about how to combat hair loss. We don't recommend cutting corners by exploring cheaper homeopathic and all-natural remedies as an alternative. Drugs like finasteride and minoxidil are clinically proven to treat male pattern baldness and even reverse hair loss with a majority of men, and they’re approved by the FDA.
Choosing where and who will perform your hair transplant is as important a consideration as to what kind of hair transplant to get. Of utmost consideration is that this should be done by the dermatologist /surgeon, and not his/her technician. The surgeon himself/herself should also oversee the design of your hairline and how the extraction of the graft will be done.
“While nutritious eating isn’t going to bring your hair back by any means, eating plenty of protein-rich foods and healthy fats can make the hair that you still have look thicker and shinier.” Skimping on the B vitamins in particular can interfere with the formation of hair cells and, therefore, hair growth. The best sources of Bs are protein-packed foods like chicken, fish, eggs, and pork, as well as leafy greens such as spinach. (These foods are also good for melting belly fat, so it’s a win win). 

Unfortunately, as of now the video is only available on BCC Newsbeat for people living in the UK. I haven’t been able to watch it yet but am searching for a solution for those of us abroad to view the episode. One of the personalities featured in the film, Perry O’Bree, has created an interesting Youtube Video promoting the message that #HairLossHappens and that those who experience it are not alone. I find it to be a courageous and uplifting message. The topic often is often overlooked and understated, and the truth is that hair loss is much more of an important issue than how it is portrayed in society. Kudos to Perry.
Thanks so much for the guidance! After further research I have to agree with you 100%. Lipogaine Big 3 does containe ketoconazole, which would eliminate the need for Nizoral, however the shampoo only contains a few hair loss/thinning related ingredients. The Big 5 contains 17 and just seems like a better overall product. That plus Nizoral twice weekly seems pretty solid to me.
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. 

Examination of the scalp in patients with telogen effluvium typically shows uniform hair thinning. The presence of erythema, scaling, or inflammation; altered or uneven hair distribution; or changes in shaft caliber, length, shape, or fragility may suggest other diagnoses. Laboratory investigations are indicated if the history and physical examination findings suggest underlying systemic disorders (e.g., iron deficiency anemia, zinc deficiency, renal or liver disease, thyroid disease).
The Rogaine rep we spoke to explained that the different packaging (and therefore different prices) has to do with the FDA-approval process: “We discovered in clinical trials that the hair loss patterns between men and women are different,” she said by way of explanation. “Men typically have that bald spot on the crown of their head, where women generally have a general thinning throughout, but concentrated more on the top of the head. So for FDA approval, we had to come up with two different, gender-specific products, so the directions were more explanatory.”

Buckler said it started in 2003 with the academic research of Hoffmann and McElwee at the University of Marburg in Marburg, Germany. At the time they were trying to understand what was happening in the hair follicles of people suffering from androgenetic alopecia—a common form of hair loss in both men and women—or the underlying cause of hair loss.
Because there are a lot of products in the crowded marketplace that claim they can regrow your hair, it’s a necessity for the legitimate ones to have disclaimers on their websites. Essentially, these disclaimers state that the products haven’t been evaluated by the FDA and so can’t be guaranteed to provide the benefits they claim to provide—at least not from the standpoint of the regulators.
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