Finasteride has limitations though, such as the requirement of daily treatment, a limit to how many damaged hair follicles it can revive, and that it may lose its effectiveness overtime for some people. This drug has shown to be better at preventing further hair loss than reversing it (regrowth). Just keep in mind that some side effects might make the hair loss seem more appealing.
Hair transplantation involves harvesting follicles from the back of the head that are DHT resistant and transplanting them to bald areas. A surgeon will remove minuscule plugs of skin that contain a few hairs and implant the plugs where the follicles are inactive. Around 15 percent of hairs emerge from the follicle as a single hair, and 15 percent grow in groups of four or five hairs.
While some medical practitioners are still on the fence about the effectiveness of laser treatments, studies have found that hair growth using laser therapy increased by 19 normal-size hairs per square centimetre. The regrowth is also observed as thicker, shinier and more manageable. It's a non-invasive, painless procedure that works for both men and women. However, the LLLT is not a stand-alone cure and is thus used in combination with other treatments.
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.

"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."
Hollywood has made movies about it. Industries have made billions from it. And if the volume of scripture is any indication, the Almighty God must have placed great value on his creation of the head of human hair. After all, He gave Samson—the strongest man of whom the Bible tells—his immense strength through his hair and declared a woman’s hair "a glory unto" her in the 11th chapter of 1 Chorinthians.
Baldness is not caused by excess testosterone as is commonly thought; nor is it inherited from your maternal grandfather. It’s caused by sensitivity to testosterone: an enzyme converts testosterone into a substance called dihydrotestosterone – which then causes the follicle to shrink and fall out. Male pattern baldness is inherited, but from both or either side of your genetic line. Why men go bald, we’re not sure – though there is a hypothesis that baldness was once a genetic advantage. People tend to associate baldness with virility and wisdom. The bald hunter-gatherer would have been a natural choice for a chieftain back when life expectancies were shorter and bald heads rarer. In our age of appearances not so much. Of 17 male members of Cabinet, two are bald (Chris Grayling and Sajid Javid). Studies correlate baldness with depression; the term “psycho-trichological” is used to describe the feelings of disfigurement, social avoidance and anxiety disorders that often arrive with premature baldness.
*Photograph used with permission of the Journal of the American Academy of Dermatology. This photograph was published in the Journal of the American Academy of Dermatology, Vol. # 60, Gathers RC, Jankowski M, Eide M, et al. “Hair grooming practices and central centrifugal cicatricial alopecia,” 660-8. Copyright Elsevier (2009). Journal of the American Academy of Dermatology.   
Like Anderson, he started to lose hair at 21 and tried similarly baroque remedies. “At the time, there was nothing except the snake oil you found at the back of muscle magazines.” He rubbed cayenne pepper into his scalp; he hung upside down; he visited a company that promised a miracle cure that turned out to involve a wig glued on to his head. He looked up a few British trichologists and surmised that trichology was a “study of bullshit” then visited an eminent hair surgeon whose eagerness to perform surgery immediately put him off the idea. It was the discovery of Propecia that ultimately “saved” him. “The drug stopped my hair loss. I had no adverse side effects. I regrew my hair on the crown.”
But you must start these medical therapies before you lose all your hair. McAndrews likens it to brushing your teeth, in that both are preventative measures. “The sooner you start doing it, the better at slowing down this aging process,” he explains, adding, “Is toothpaste perfect? No, you’re still getting tooth decay with toothpaste, but you’re slowing down tooth decay.”
If you’re a gentleman who’s been noticing a receding hairline or is worried about balding, the first step is to schedule a visit with a doctor or dermatologist and make sure your hair loss isn’t a sign of a more serious health issue. “Not all hair loss is male-pattern hair loss,” explains Dr. Marc Glashofer, a board-certified dermatologist specializing in hair loss and practicing in northern New Jersey. A thyroid disorder, an autoimmune disease, or even a scalp issue could be making you look like Bruce Willis in Die Hard 2. But most hair loss is androgenetic alopecia, also known as male-pattern baldness, and fortunately (or not, depending on your perspective), it’s just a symptom of getting older.
In essence, it is widely known as Microneedling, and it has the power to completely revive your head and scalp from within. It will, among other things, help rejuvenate your scalp skin, help remove old skin cells and embedded oils (sebum) that are currently blocking and clogging your hair follicles, and most of all, it will reactivate the hair follicles in your head to make them grow hairs again. How amazing is that?
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.
Minoxidil is a similar treatment to finasteride and is also available in the UK as a generic or as the well known brand-name “Regaine”. Minoxidil can be bought over the counter, unlike Propecia or finasteride, and comes in the form of a lotion, foam or cream that is rubbed into the scalp every day. Minoxidil is less effective than finasteride (only 60% of men who used Regaine Extra Strength reported regrowth after 48 weeks) but is still a viable option for men seeking treatment. It is also suitable for use by women, and can be used to treat alopecia areata. However, as with finasteride, any beneficial effects will cease once treatment has stopped.

Harklinikken does not advertise, but the 25-year-old multinational company is beginning an aggressive expansion into the $3.6 billion hair-loss market in the United States, meaning you’re likely to hear a lot more about it. A New York clinic opened in June inside the Core Club in Midtown (you don’t need to be a member to get an appointment); and in August, Harklinikken consultations became available at some 70 Women’s Care Florida obstetrics and gynecology clinics. (Roughly 75 percent of the company’s 50,000 active users are female.)


An extremely popular organic product. There is significant evidence that biotin aids hair quality, while caffeine and saw palmetto are both somewhat beneficial to hair growth. Saw palmetto blocks the formation of dihydrotestosterone (DHT) and is often described as a natural (but weaker) alternative to finasteride. For more, see my post on natural cures for hair loss. This Botanical Green Care shampoo product also contains numerous other helpful ingredients such as nettle extract, panax ginseng, pumpkin seed oil, amla oil, bhringraj oil,  niacin, vitamin A, vitamin E (alpha tocopherol) and more.
Hair transplantation involves harvesting follicles from the back of the head that are DHT resistant and transplanting them to bald areas. A surgeon will remove minuscule plugs of skin that contain a few hairs and implant the plugs where the follicles are inactive. Around 15 percent of hairs emerge from the follicle as a single hair, and 15 percent grow in groups of four or five hairs.

Trichorrhexis nodosa occurs when hairs break secondary to trauma or because of fragile hair (Figure 7). It affects the proximal hair shaft, although the distal shaft may also be involved.20 Causative traumas include excessive brushing, heat application, tight hairstyles, trichotillomania, and conditions that cause excessive scalp scratching. Chemical traumas include harsh hair treatments (e.g., excessive use of bleach, dye, shampoo, perms, or relaxers21) and excessive exposure to salt water. Examples of congenital or genetic conditions that may cause trichorrhexis nodosa include trichorrhexis invaginata (bamboo hair), intussusception of the hair shaft at the keratinization zone, Menkes disease, keratinization defects due to defective copper metabolism, and argininosuccinic aciduria.22 Rarely, trichorrhexis nodosa can be a manifestation of hypothyroidism.23

The test involves plucking about 50 hairs from the head, typically at the back of the scalp, so your dermatologist can look at them under a microscope and determine how much of the hair is in the resting, growth, and fall-out phases. Next, a vial of blood is sent to a lab to check hormone and nutrient levels ($100 and up, depending on insurance). If low levels of iron, or high levels of male hormones, like androgens, are contributing to your hair loss, for example, both can be treated through oral supplements or medication.
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.

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.
Women’s magazine ‘New Beauty’ recently featured several prospective hair growth therapies in a print article. The feature contains several interesting and worthwhile anecdotes. Check the Articles main page to read about Dr. Cotsarelis’ new research on setipiprant for female alopecia, Histogen’s view on the number of injection sessions which may be necessary to get the most out of HSC, and more.

“If you don’t want a scar because you like to wear your hair short, you might opt for a “scarless” hair transplant,” says Dr. Joyce. Also known as follicular unit extraction (FUE), grafts are harvested one at a time with tiny punches that heal virtually undetected so you can still buzz your head. “If you’ve gone so bald that you don’t have a lot of donor hair on your head, we can do FUE extractions with body hair such as on your chest, stomach, back, and sometimes even the pubic area,” says Dr. Joyce.

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.
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.

Once male-pattern baldness starts, it’s not going to stop until every last hair on your head has shrunk or shed, though the rate at which this happens differs from person to person and depends on genetics. And since the grind of hair loss is unending, it’s important to start treatment as soon as your hairline starts bothering you. If you’re looking for a more quantitative metric, Dr. Paul McAndrews, clinical professor of dermatology at the USC School of Medicine and member of the International Society of Hair Restoration Surgery, assures me that “you have to lose half your hair before the human eye can tell.” (Of course, if you don’t care about losing your hair and are fine with going full Prince William and shaving your head, go for it. We’ve got some recommendations for razors and hair trimmers to help you out on that front.)
Minoxidil, popularly known as brand name Rogaine, works much differently than Propecia. It does not inhibit DHT, but it increases blood flow and therefore nutrition to the scalp and hair follicles. This has been shown to revive dormant follicles to a healthy state of growth in some users. Whereas Propecia has much more consistent results, minoxidil is more dependent on the user. Dramatic results such as new regrowth can be seen in individuals who respond well, but they are the minority. Minoxidil, like Propecia, is much better at hair maintenance. It will help you keep the hair you do have for longer, but only if you use it daily.

I hope you’re having a good Friday. While I am a bit flabbergasted that out of the thousands of people who visit this article every week, still not one person has commented with an idea or practice that they can do to help hair growth treatments succeed, I feel the need to share some upliftment today. It’s coming from the original contributor of Feel Good Friday himself, Deion Sanders. A while back I shared a video of Deion getting his second FUE transplant to thicken his hair. The results are starting to come in and Deion could not be more enchanted by his own hair-restoration miracle. For a guy who was basically NW7 before restoration, the result is impressive. Enjoy his sentiments below.
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.
Follica is developing a wounding device that when coupled with a hair stimulant like minoxidil, is found to be more effective at triggering new growth. They like to call this wounding process ‘skin disruption’. The idea behind this treatment is that after the skin is wounded, cells migrate to that area to repair. They then must choose between two paths: healing the skin (making epidermis) or making hair. It is there where Follica sees the window of opportunity, where they can encourage the cells to do the latter and regenerate new and more hair.
Coconut milk / coconut oil. Coconut milk/oil, like aloe vera, is one of the oldest and most common natural ingredients for promoting hair growth and growing healthy, shiny hair. Coconut is rich in protein, iron and other minerals that promote healthy hair and prevent breakage. Apply the coconut milk/oil on your bald spots or all over the scalp, and leave it on overnight. Rinse the next day with cool water. You can do this every time you wash your hair.
Once male-pattern baldness starts, it’s not going to stop until every last hair on your head has shrunk or shed, though the rate at which this happens differs from person to person and depends on genetics. And since the grind of hair loss is unending, it’s important to start treatment as soon as your hairline starts bothering you. If you’re looking for a more quantitative metric, Dr. Paul McAndrews, clinical professor of dermatology at the USC School of Medicine and member of the International Society of Hair Restoration Surgery, assures me that “you have to lose half your hair before the human eye can tell.” (Of course, if you don’t care about losing your hair and are fine with going full Prince William and shaving your head, go for it. We’ve got some recommendations for razors and hair trimmers to help you out on that front.)
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.
Originally spotted this on HairLossCure100’s twitter page. Concert Pharmaceutical’s therapy for alopecia areata, CTP-543, has been granted fast track designation from the FDA. CTP-543 is an oral JAK inhibitor (ruxolitinib). From what I’ve read, fast track designation encourages early and frequent communications between the FDA and the company during the development process to ensure issues and questions are resolved quickly.
“Re the post 10/17/18 I really liked your response to the request made by one of your readers to email companies asking for information. So I decided to do what you suggested and sent emails to Organ Technologies, Rivertown and Follicum (no particular reason) basically thanking them for their work and wishing them success with their products. Interestingly I received a very nice response from Organ Technologies which really surprised me. Correct me if I’m wrong but I think the sentiment is to be thankful and encouraging to what is being done appose to being negative that we have yet to get what we all want.”
It is no surprise that Donald Trump is obsessed with hair loss. “Never let yourself go bald,” he once told a Trump Organization executive. “The worst thing a man can do is go bald.” During their brief dalliance, Stormy Daniels confronted him about his hair. “I was like, ‘Dude, what’s up with that?’ ” she said, to In Touch, in 2011. Trump laughed. Then he told her that he worried that “if he cut his hair or changed it, that he would lose his power and his wealth.” Recently, Trump’s physician admitted that the President takes the anti-baldness medicine Propecia.
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.)

Aclaris Therapeutics has announced on March 9, 2018 that the US Patent and Trademark Office has issued their company U.S. Patent No. 9,895,301, for methods related to  the use and administration of a certain janus kinase (JAK) inhibitor for treating hair loss disorders. This patent covers the treatment of both alopecia areata as well as androgenic alopecia.
I asked Joseph what it might feel like to get his hands on an actual, proven hair-growth product. The question gave him pause. “It’s hard to put into words,” he said. “This would be the biggest, freeing, liberating thing for so many people. I mean, there would be smiles from coast to coast. That’s the best way I can respond to that question. I think people would be smiling from coast to coast.”
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!

Patients with hair loss will often consult their family physician first. Hair loss is not life threatening, but it is distressing and significantly affects the patient's quality of life. The pattern of hair loss may be obvious, such as the bald patches that occur in alopecia areata, or more subtle, such as the diffuse hair loss that occurs in telogen effluvium. As with most conditions, the physician should begin the evaluation with a detailed history and physical examination. It is helpful to determine whether the hair loss is nonscarring (also called noncicatricial), which is reversible, or scarring (also called cicatricial), which is permanent. Scarring alopecia is rare and has various etiologies, including autoimmune diseases such as discoid lupus erythematosus. If the follicular orifices are absent, the alopecia is probably scarring; these patients should be referred to a dermatologist. This article will discuss approaches to nonscarring causes of alopecia.
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 patient, a small, vaguely European man in his late forties, had rings on his fingers and a bloody, rectangular gash on the back of his head. It looked like a chunk of missing carpet. Bernstein pointed at the white opening of exposed scalp, and explained how easy it would be to stitch skin together over the gap. This was a traditional process for follicular-unit transplantation. Then Bernstein led me into a second room, where another patient was seated with his face in a massage-table-like padded hole. A portion of the back of his head was marked off. To his right was a boxy gray machine, roughly four feet by four feet, with a jutting mechanical arm. This was the ARTAS Robotic Hair Transplant.

Baldness is not caused by excess testosterone as is commonly thought; nor is it inherited from your maternal grandfather. It’s caused by sensitivity to testosterone: an enzyme converts testosterone into a substance called dihydrotestosterone – which then causes the follicle to shrink and fall out. Male pattern baldness is inherited, but from both or either side of your genetic line. Why men go bald, we’re not sure – though there is a hypothesis that baldness was once a genetic advantage. People tend to associate baldness with virility and wisdom. The bald hunter-gatherer would have been a natural choice for a chieftain back when life expectancies were shorter and bald heads rarer. In our age of appearances not so much. Of 17 male members of Cabinet, two are bald (Chris Grayling and Sajid Javid). Studies correlate baldness with depression; the term “psycho-trichological” is used to describe the feelings of disfigurement, social avoidance and anxiety disorders that often arrive with premature baldness.

In Michael Wolff’s “Fire and Fury,” Kuntzman’s theory is bolstered. Wolff writes that Ivanka Trump “often described the mechanics behind it to friends: an absolutely clean pate—a contained island after scalp-reduction ­surgery—surrounded by a furry circle of hair around the sides and front, from which all ends are drawn up to meet in the center and then swept back and secured by a stiffening spray.”
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.
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.
Anagen effluvium is abnormal diffuse hair loss (usually abrupt) during the anagen phase due to an event that impairs the mitotic or metabolic activity of the hair follicle. The incidence of anagen effluvium after chemotherapy is approximately 65%24; it is most commonly associated with cyclophosphamide, nitrosoureas, and doxorubicin (Adriamycin). Other causative medications include tamoxifen, allopurinol, levodopa, bromocriptine (Parlodel), and toxins such as bismuth, arsenic, and gold. Other medical and inflammatory conditions, such as mycosis fungoides or pemphigus vulgaris, can lead to anagen effluvium.25

The dermatologist also will carefully look at your scalp and hair. During an exam, the dermatologist may pull on your hair. Sometimes a dermatologist needs to pull out a hair to get the necessary evidence. And sometimes a dermatologist needs to look at the hair on the rest of your body to see whether there is too little or too much hair in other areas.
You’ll find ketoconazole in Nizoral anti-dandruff shampoo, and preliminary research indicates that it may be effective in treating hair loss. Researchers found that both 2% ketoconazole and minoxidil regimens improved hair density, size, and proportion of anagen follicles. Ketoconazole also is effective in treating a fungus called Pityriasis that often inhabits the scalp.
Some factors that are thought to play a role in female hair loss include high androgen birth control pills, menopause, pregnancy, ovarian cysts, and other factors tied to the actions of hormones. The American Hair Loss Association said it’s important that women who have a history of hair loss in their family to be made aware of the potential effects of birth control pills on normal hair growth.
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.
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.
Coconut milk / coconut oil. Coconut milk/oil, like aloe vera, is one of the oldest and most common natural ingredients for promoting hair growth and growing healthy, shiny hair. Coconut is rich in protein, iron and other minerals that promote healthy hair and prevent breakage. Apply the coconut milk/oil on your bald spots or all over the scalp, and leave it on overnight. Rinse the next day with cool water. You can do this every time you wash your hair.
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.
This particular research which was published in the Nature journal showed that a synthetic version of sandalwood, called Sandalore, binds to the OR2AT4 receptor in hair folliles and prolongs their anagen (growth) phase. The hair follicles studied were treated in a petri dish. Paus has subsequently announced that a completed clinical trial of 20 female volunteers using a topical version of Sandalore showed a reduction of daily hair loss. There is also another larger clinical trial ongoing now which hopes to confirm the effect and announce results in early 2019. Paus has gone as far to say “there is even a chance that this might be able to bring the hair back.” We’ll keep our fingers crossed.
During this procedure, surgeons remove a narrow strip of scalp and divide it into hundreds of tiny grafts, each containing just a few hairs. Each graft is planted in a slit in the scalp created by a blade or needle in the area of missing hair. Hair grows naturally this way, in small clusters of one to four follicles, called follicular units. As a result, the graft looks better than the larger "plugs" associated with hair transplants of yesteryear.
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