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.
How to use minoxidil: Be sure that your hair and scalp are dry. Using the dropper or spray pump that's provided with the over-the-counter solution, apply it twice daily to every area where your hair is thinning. Gently massage it into the scalp with your fingers so it can reach the hair follicles. Then air-dry your hair, wash your hands thoroughly, and wash off any solution that has dripped onto your forehead or face. Don't shampoo for at least four hours afterwards.

Kerastem, a company developing an autologous fat-derived stem cell therapy for hair growth, has reported positive data from their phase 2 trial. The results have come from a 6 month clinical trial involving 70 patients. In this study, the patients received a one-time injection of fat-derived stem cells, and purified fat, into their scalp. Kerastem reports an average increase of 29 hairs per cm2 from the treatment, or an increase of 17% from baseline. The press release does mention that the treatment “successfully stimulates hair growth in people with early stage hair loss”, so that is something to take into consideration when evaluating the results. For more info visit Kerastem’s website. 
With those pinned down, it wasn’t hard to determine which don’t actually work. Pretty much all the “active” ingredients listed in ineffective treatments — from biotin and zinc to emu oil and saw palmetto — have never been proven, and are instead marketed based on logical-seeming correlations. It would make sense that biotin, a B vitamin readily found in hair, skin, and nails, could help hair grow more quickly. And caffeine is a stimulant that works in coffee, so rubbing some on your scalp might wake some of those sleepy follicles… right?
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.”
When it comes to a hair growth shampoo, you have two options: prescriptions or over-the-counter treatments. Prescription shampoos like ketoconazole are anti-androgenetic, meaning they prevent testosterone and dihydrotestosterone (DHT), two hormones associated with hair loss by targeting hair growth at the site of the follicle and helping to interrupt the hormone cycle locally that causes thinning,” explains Dr. Schweiger. “Over-the-counter growth shampoos typically contain amino acids and antioxidants to provide the components to rebuild hair as well as reduce damage and inflammation.”
Hair loss is often distressing and can have a significant effect on the patient's quality of life. Patients may present to their family physician first with diffuse or patchy hair loss. Scarring alopecia is best evaluated by a dermatologist. Nonscarring alopecias can be readily diagnosed and treated in the family physician's office. Androgenetic alopecia can be diagnosed clinically and treated with minoxidil. Alopecia areata is diagnosed by typical patches of hair loss and is self-limited. Tinea capitis causes patches of alopecia that may be erythematous and scaly and must be treated systemically. Telogen effluvium is a nonscarring, noninflammatory alopecia of relatively sudden onset caused by physiologic or emotional stress. Once the precipitating cause is removed, the hair typically will regrow. Trichotillomania is an impulse-control disorder; treatment is aimed at controlling the underlying psychiatric condition. Trichorrhexis nodosa occurs when hairs break secondary to trauma and is often a result of hair styling or overuse of hair products. Anagen effluvium is the abnormal diffuse loss of hair during the growth phase caused by an event that impairs the mitotic activity of the hair follicle, most commonly chemotherapy. Physician support is especially important for patients in this situation.
The most permanent solution for those who have lost or are losing their hair is hair transplants. Follicles are harvested from the back of the head and seeded into bald areas. Techniques have vastly improved and no longer do these look like fake “plugs”. Skilled surgeons can provide the patient we a very natural looking head of hair. A recent technological innovation is robotic assisted hair transplantation which help the surgeon be more precise and keep scalp scarring minimal. The limitations?
Farrell makes what he calls “hair systems.” They’re not quite wigs or toupees—you can keep them on for weeks at a time. They cost more than a thousand dollars. Farrell was in New York for a week, holding meetings with clients in his hotel room. Now his rolling suitcases were packed. Malaysia, Singapore, South Africa, Russia: he’s almost always on the road, satiating international demand for high-end hair pieces.
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?
Indian gooseberry. Also known as amla, Indian gooseberry is one of the most popular natural ingredients that can induce fast hair growth. It is also a known antibacterial that can help maintain a healthy scalp. Mix a tablespoon of Indian gooseberry pulp and lemon juice. Use it to massage your scalp, and cover with a shower cap after. Leave on for the night and wash with shampoo in the morning.
Farrell makes what he calls “hair systems.” They’re not quite wigs or toupees—you can keep them on for weeks at a time. They cost more than a thousand dollars. Farrell was in New York for a week, holding meetings with clients in his hotel room. Now his rolling suitcases were packed. Malaysia, Singapore, South Africa, Russia: he’s almost always on the road, satiating international demand for high-end hair pieces.
While thinning generally worsens after menopause, doctors said hormone treatments typically do not improve hair growth. Minoxidil lotion or foam, which can be purchased over the counter, is the first line of treatment. About half of women who use it have not lost more hair a year later, Cotsarelis said. Spironolactone, a blood-pressure drug, can also help, doctors said. Some may also try finasteride — approved to treat baldness in men — off-label. The evidence that it works in women is weak, Patel said. 

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.
Disruptions in the normal length of each phase, which can cause hair loss and hair thinning, may be the result of a number of internal and external stimuli. These are also what we call the triggers and causes of your hair loss. As a quick example, dieting can leave the body stressed and in need of important nutrients. Because of this stress, hair growth may be cut shorter than usual and there is an early onset of telogen or shedding of hair.

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.
Over the past year, the Hair Restoration Laboratories’ Professional Strength DHT Blocking Hair Loss Shampoo (and accompanying DHT Blocking Hair Loss Conditioner) has been a top seller on Amazon and many other sites. Combined, the daily use Shampoo and Conditioner has more DHT blockers than any shampoo/conditioner set presently available. Among the key DHT Blockers in this set are: Caffeine, Saw Palmetto, Black Cumin Seed Oil, Cayenne Fruit Extract, Rosemary Leaf Oil, Pumpkin Seed Oil, Green Tea Leaf Extract, Pea Extract and many more. By helping to block DHT, they should be a great asset in helping to halt the miniaturization of the hair follicles and regrow healthier and thicker hair.

I started combining two of them right away – because they both had different ingredients that I really wanted. I combine the Hair Surge for the caffeine, ketoconazole, and saw palmetto, along with the Regenepure DR for the Emu oil. I use a bit of both every day – and though I haven’t noticed a lot of hair coming back in – I HAVE noticed that a whole lot less is falling out. I used to see lots of hair in the tub or in my hand after drying. Hopefully some baby hairs will start so show themselves soon.


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It wasn’t quite the “accident” it was portrayed to be. He worked out that the drug targeted a protein called SFRP1, which affects follicle growth. He looked into the literature and discovered there was a pre-existing osteoporosis drug, WAY-316606, designed to target this protein with much more precision. So he applied that to leftover slabs of scalp donated by hair transplant clinics. “We usually do experiments for over a week. We put the hair follicles in a dish and this drug enhanced hair shaft elongation within two days. But it also kept the hairs healthier. When you look at them, they’re larger, thicker hair follicles. So, it’s quite promising.”

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.


Treatment is based on patient preference. Topical minoxidil (2% or 5% solution) is approved for the treatment of androgenetic alopecia in men. Hair regrowth is more robust at the vertex than in the frontal area, and will take six to 12 months to improve.5 Treatment should continue indefinitely because hair loss reoccurs when treatment is discontinued. Minoxidil 2% solution is recommended for the treatment of androgenetic alopecia in women.6 Adverse effects include irritant and contact dermatitis.
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.

One is how much emphasis the company places on compliance, the major stumbling block in the efficacy of any treatment, said Dr. Senna, an author of studies on the subject. Prospective users are questioned about their ability to stick to a regimen because the extract must be applied every day, and they are told that the more conscientious they are, the better. Users are also reminded and encouraged with regular check-ins.
The Holy Grail remains a drug that will promote regrowth, but this might not be so far away. Earlier this year, Manchester University announced that an osteoporosis drug had been found to have “dramatic results” promoting hair growth when applied to tissue samples in pre-clinical trials. The resultant frenzy left the PhD student responsible, Dr Nathan Hawkshaw, a little dazed. “Every other week, something comes out about hair loss and it doesn’t generate as much media coverage as what I experienced,” he grumbles. He’s in this for the science – there aren’t many fields where you get to mess around with real human tissue – but such is the distress caused by hair loss and such is the potential customer base that interest is always high.
McElwee is an associate professor in the Department of Dermatology and Skin Health at the University of British Columbia (UBC) in British Columbia, Canada and director of the Hair Research Laboratory in the Vancouver Coastal Health Research Institute (VCHI) at Vancouver General Hospital (VGH). A hair research scientist, McElwee is one of only a small group of research scientists worldwide who studies hair biology and associated diseases.
3. Hair fibers. The best (and easiest) way to hide a widening part or sparse patch is with hair fibers. They’re tiny, charged fibers that adhere to your scalp (until your next shampoo). Toppik Hair Building Fibers ($25) come in a range of colors so you can easily find one that matches your own hair. (In a pinch, you can also brush a powdered eye shadow that matches your hair color along your part.)
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

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.
“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.
To do the exercise, simply rub the fingernails of both hands - except the thumbs - against each other as hard as possible. Make sure not to let the surface of the nails rub against each other - just the tips. In acupressure therapy, it is believed that the hair follicles on the scalp are connected to the fingernails and by doing the exercise, it will stimulate blood circulation and nutrients into the follicles, therefore promoting hair growth.
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