Androgenetic alopecia is the most common form of hair loss in men and women and is a normal physiologic variant. It is most prevalent in white men, with 30%, 40%, and 50% experiencing androgenetic alopecia at 30, 40, and 50 years of age, respectively 2 (Figure 1). Although this condition is less common in women, 38% of women older than 70 years may be affected3 (Figure 24). Many patients with androgenetic alopecia have a family history of this condition.
Male patten baldness affects about 20% of men by the time they’re 20 and rises roughly in line with age: about 30% of men will experience significant hair loss by 30, 40% of men by 40, half of men aged 50, and so on. If you’ve retained your hair by middle-age, you’re one of the lucky ones. I’m elated to say that I’m well thatched at 37, but the grey specks in my beard bother me enough to know that if I did lose my hair, I’d be dismayed. For some reason, there is something inherently conical, sorry comical, about baldness; some people can deal with that and indeed, emerge stronger and surer of themselves. It’s fair to say Jason Statham wouldn’t have been a match for a prehistoric shark with his 1995 hair. But for others it’s just not so easy.
Hair spa. A hair spa treatment is one of the most convenient, non-invasive, not to mention, most rejuvenating ways to treat hair loss and promote healthy hair growth. Besides hair loss, it has also been known to address other hair issues like dandruff, split ends, and dry and damaged hair. There are many forms of hair spa treatment depending on what's offered at the salon, but it generally includes an oil massage of the scalp, shampoo and deep conditioning. The whole process helps in blood circulation, bringing the needed nutrients to the follicles, and activates the glands to produce oil.
We've heard it all before: clients waking up one day in shock after discovering a coin-sized bald spot on their heads; women agonizing over the strands of hair they see on the shower floor; men looking for topical creams and shampoos to prevent the early onset of balding. Even more are tales of men and women on the search for the perfect wig or toupee to cover up the loss of their hair as a result of medication for a chronic illness.
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. 

Dr. Melissa Piliang, a dermatologist at the Cleveland Clinic, said that Rogaine works better on the top and crown (for reasons not fully understood, the frontal hairline tends to be more resistant to treatment) and ideally should be started as soon as women notice thinning. “Any regrowth you get is a minimal amount,” Dr. Piliang said. “So the more density when you start, the better results you get.”
The more upsetting problem is central centrifugal cicatricial alopecia, a type of baldness that starts at the crown of the head and spreads outward. "It's hugely, hugely difficult," said Susan Taylor, a dermatologist at Penn Medicine who specializes in treating women with CCCA. "It affects quality of life." She said it is seen "almost exclusively" in women of African descent. One study found it in 10 percent to 15 percent of black women, but Taylor thinks it's more common. "I could see women all day, every day, with this problem," she said.

Hair styling products from shampoo, conditioner, to hair dye, bleach, gels and perm and straightening products may contain chemicals that can damage the scalp and cause the shaft to break, resulting in hair thinning. Beware of these products that contain toxic chemicals such as arsenic, thallium, meadow saffron (colchicum autumnale), and lead. These chemical ingredients can manipulate and disrupt the natural hair growth cycle, for example, shortening the anagen phase of growth. Hair procedures like hair relaxing and permanent waving, while do not lead to permanent hair loss, can damage the quality of the hair and make it more prone to hair breakage.

This moisturizing double-duty product is incredibly well rated (and you don’t even have to pay the pink tax to boot). Soy proteins and shea butter add silky strength, while scalp-tingling peppermint and rosemary provide minty freshness and lift at the root. “The thickening properties of the shampoo are great at this price point, so if you have thin or thinning hair, this will add some volume,” wrote one reviewer. “I also noticed that this is the first shampoo/conditioner shampoo that tends to actually condition your hair."

Approved by the FDA and available in over-the-counter form for both men and women, minoxidil has been found to work in two out of three men. However, and this is a huge problem, if you stop using it, then your hair will actually fall out again and potentially faster than before. Plus, you might not even notice any changes until you’ve been using this medication for at least four months!


Revivogen’s shampoo is formulated by dermatologists to do three different things: cleanse and revitalize the scalp while fighting dandruff with aloe vera and menthol, moisturize hair and make it look thicker and fuller with proteins and nutrients – and most importantly, prevent hair follicles and the scalp from being saturated with the DHT blamed for causing most cases of pattern baldness.
Sadick suggests avoiding “products with dyes and preservatives, like parabens and synthetic fragrances.” Ingredients that thicken the hair include amino acids, biotin, ginseng root, and menthol or peppermint oil — these are what you want to look for. “Amino acids provide the building blocks to build new strands, while biotin, part of the B-vitamin complex, is required by hair to metabolize amino acids and can help strengthen hair,” Sadick says. “Antioxidants such as vitamin E and ginseng are beneficial to promote hair growth because they reduce free radicals from sun, stress, or overprocessing and have anti-inflammatory properties.” Last but not least are the botanicals, which are great as they are rich in antioxidants and other compounds that stimulate blood flow and promote hair growth.
In II Kings 2:23-24, the prophet Elisha is mocked by a gang of surly kids. The kids “said unto him, ‘Go up, you bald head! Go up, you bald head!’ ” Elisha “cursed them in the name of the Lord.” Promptly “two she-bears came out of the wood and tore forty-two of them.” Sometime later—in 2013—German researchers published a study indicating that men experienced hair loss as an “enormous emotional burden” that could lead to an “impaired quality of life” and “psychological disorders.” Inversely, one study has shown that people perceive men with bountiful hair as likely having big penises.
My favorite shampoo to tackle dry and itchy scalp problems. Make sure to read my old post on Nizoral. However, do not overdo it! I try to use this product twice a week at most. Keep it in your hair for at least several minutes before rinsing it off for best effect. This product contains 1% ketoconazole, which has anti-fungal as well as anti-androgenic properties. This makes it a top hair loss shampoo for men.
The earlier you begin treating hair loss, the more effective the treatment will be. Androgenetic alopecia is a condition that gradually worsens over time, so the general rule is that the earlier you seek treatment, the better. “If you’re losing your hair and you have genetic hair loss, using medication such as Propecia or minoxidil is most effective when started early,” says Dr. Robert M. Bernstein, Dr. Wolfeld’s colleague at Bernstein Medical – Center for Hair Restoration. Because not everyone loses hair on the same timeline, you can’t rely on statistics to tell you when you should start treatment. Some men start to notice thinning in their early 20s, while others maintain a thick head of hair well into their 50s. If you suspect that you’re starting to lose your hair and want it to stop, act quickly.
Alopecia areata. This condition, called patchy hair loss, is the opposite of pattern baldness. Whereas in the former, thinning hair follows a pattern, alopecia areata is marked by smooth and bald patches anywhere on the scalp. The bald patches are circular, and can be as small as a pencil eraser or as big as a quarter. It begins with one or two spots that multiply on other parts of the head. The condition is caused by an autoimmune disease where the antibodies mistake the hair as the "enemy" and start attacking it, resulting into hair loss.
“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.

Men’s Rogaine Extra Strength Solution is the liquid version of our top pick. It didn’t make our final cut because it includes propylene glycol, which causes irritation in roughly one-third of its users. With that said, Dr. Wolfeld finds that it can be even more effective in practical daily use. In his experience, “the solution can penetrate and get into your scalp a little bit better” than the foam — especially if you’re not taking the time and effort to apply the foam correctly. This seems crazy to us since the foam so quickly dissolved into a liquid in our tests, but if you’re worried, try a one-month supply of the liquid and make the switch to foam if you notice any irritation.

In either sex, hair loss from androgenetic alopecia occurs because of a genetically determined shortening of anagen, a hair's growing phase, and a lengthening of the time between the shedding of a hair and the start of a new anagen phase. (See "Life cycle of a hair.") That means it takes longer for hair to start growing back after it is shed in the course of the normal growth cycle. The hair follicle itself also changes, shrinking and producing a shorter, thinner hair shaft — a process called "follicular miniaturization." As a result, thicker, pigmented, longer-lived "terminal" hairs are replaced by shorter, thinner, non-pigmented hairs called "vellus."

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