1 out of 4. That’s the average number of men who start losing their hair to male pattern baldness before the age of 30.
You are not alone, brother; it’s nothing out of the ordinary. As a matter of fact, it’s quite common. Welcome to our club.
Hair loss is a different experience for each individual, and if you don’t care about losing hair, that’s perfectly fine. It’s not always worth stressing over it.
You have a defined jawline, a strong brow ridge, a nice head shape, have the ability to grow a decent amount of facial hair? If so, hair loss may not be a big deal in your case. You won’t lose much (if any) points in the looks department.
But while this holds true for some men, let’s not forget the other side of the coin: men who just don’t look very attractive when they go bald. If you consider yourself a part of this group, then you might want to consider some sort of treatment. Particularly if you’re younger.
So let’s pretend you take action and seek treatment for hair loss. Do a search on Google or Amazon. What do you find?
Spoiler alert: an ocean of snake oil. All imaginable “natural” ways to treat hair loss. Ways that are only effective at emptying your wallet.
When you just start searching for ways to reverse your hair loss, there is a great possibility you will be misled by companies who want to take advantage of your uninformed state.
To find products that actually work, you have to dig deeper. It’s going to take you a bit of time to distinguish what works from what’s bullcrap.
That’s why I created this guide. I want to help steer you in the right direction. There are many new treatments and possibly even cures on the horizon, but, for now, stick to what is proven to work. After all, the best way to treat hair loss is to start managing it early on. It’s much easier to keep your remaining hair, compared to growing it back. Worst case scenario: you will slow it down to a degree where it may take several years to show any further recession.
I will begin with what I and countless other men use to manage their hair loss, as well as talk about the alternative or complementary options, hair loss transplants, and other procedures (credit to Dr. Alan Bauman from Bauman Medical), plus future treatments for hair loss further down below.
So, without any further ado, let’s being with the hair loss treatments for men that actually work.
- The best hair loss treatment for men: The big three
- Additional compatible hair loss treatments
- Hair transplants and other procedures
- Future hair loss treatments
The best hair loss treatment for men: The big three
Years have passed, and “the big three” still reign supreme. If you start treating your hair loss with these early on, there is a good chance your hairline will remain intact. So, here they are: the best hair loss treatment for men.
Ah, yes. Propecia. The infamous male organ destroyer. If you read the hair loss forums on the internet, you can practically hear the screams of the few who supposedly got affected.
I’m no doctor, and while it’s definitely recommended you get one’s opinion before you go on it, there is a possibility some of those claims might be a little bit exaggerated.
Side effects (like loss of libido and erectile dysfunction) affect only a very small percentage of patients. And more often than not, they are just psychological. The chance of you experiencing real side effects is actually very low.
I’m just presenting you my personal experience and overall impression of the drug after reading a ton of user feedback online and hearing dozens of real-life testimonies.
If you have tried the drug and have experienced real side effects, I’m sorry to hear that. You are the 1%.
If you think you might be having side effects, I would suggest you try NoFap. Don’t masturbate, ejaculate, have sex, or even watch porn for that matter for at least one week. One week. Most of you will feel silly for thinking you might have had side effects.
If the problem persists, consult with your doctor. (You might also be interested in how to alleviate those side effects)
One more thing: be extra careful if you plan on buying finasteride online. Be sure it’s a reputed website. One I would recommend is Baldness Doctor.
- So what exactly is Finasteride?
Finasteride is a type II 5α-reductase inhibitor, an enzyme that converts Testosterone to DHT (dihydrotestosterone).
If your hair follicles are sensitive to DHT, they will begin to shrink, and each time they fall out they will become thinner and thinner, until they become so small that they become virtually invisible. This is how male pattern baldness operates.
Propecia can suppress as much as 70% of DHT and can do any of the following: slow, halt, or even reverse hair loss in some cases. Here you can find a number of before and after photos.
- How do I get it?
You can get it from your regular doctor, dermatologist, or online. Be wary if you plan on buying it online. It’s easy to get scammed, your identity stolen, or get a fake product on dodgy pharmaceuticals websites.
I would recommend you get a prescription from your doctor or an online clinic with a trained, board-certified physician.
- How do I take it?
One 1 mg pill every day is the most common way. Some use it every other day or stick to a Monday, Wednesday, Friday schedule. Some say it has the same effect.
If you want to save money, get a prescription for Proscar (5 mg finasteride) and cut it into four pieces. It will be easier on your wallet.
- When can I see results?
Some users experience regrowth as early as three months, but it may take up to a year. Consider slowing or halting your hair loss a success as well. After all, that’s what Propecia does best, stopping or slowing hair loss. Not regrowing.
Finasteride is FDA approved and arguably the best anti-hair loss mechanism available.
The second member of “the big three” and another extremely effective FDA-approved hair loss treatment is minoxidil. Minoxidil was originally an oral medication for high blood pressure. But after a while, patients started reporting hair growth — all over their bodies. And not much longer after, the minoxidil topical solution for treating hair loss was born.
Minoxidil stimulates your hair follicles to grow anywhere you apply it. It works by widening blood vessels, allowing more oxygen, nutrients, and blood to the follicle. Do note, however, it does nothing to prevent the DHT from shrinking your hair follicles.
- Ok, when can I start seeing results?
Results should begin to show anywhere between 2 to 6 months.
- How do I use it?
Apply 1 ml of minoxidil liquid (or 1 foam squeeze, if you are using the foam version) all over the top of your scalp twice per day (with at least an 8-hour window in between). It takes only a few minutes to apply (even less with the foam version). It’s faster than brushing your teeth.
Some use it only once per day since minoxidil has a half-life of 22 hours. However, Pfizer (the manufacturer of Rogaine) warns it can be less effective this way.
- Where can I get it?
Anywhere. It’s a medicine available over the counter. You can check it out on Amazon in the links below.
- Liquid or foam minoxidil?
Both are equally effective. The topical solution is cheaper, but the foam is easier and faster to apply.
- The box says it works only on the back of the scalp (vertex). Will it work in the front (temples) as well?
You bet. But the test was conducted only on the vertex, that’s why it can only be advertised to work on your crown.
- What are some minoxidil brands?
There are plenty of minoxidil brands: Rogaine (know as Regaine in Europe), Lipogaine, Kirkland Minoxidil, Regenepure, Foligain, etc.
- What are some of the best minoxidil products?
In the 1980s, Rogaine was the first brand to patent topical minoxidil as a hair regrowth treatment. After their patent expired in the 90s, many new generic minoxidil brands began appearing on the market, finally plummeting the price down. Rogaine is a ‘well-tried’ and trusted minoxidil brand.
Both, the liquid and foam versions of Rogaine work equally well. Many prefer the topical aerosol, as it’s faster and easier to apply.
Pros: Known and trustworthy brand, quality ingredients (lower chance of experiencing side effects)
Cons: Higher prices compared to other “regular” minoxidil products
Since the FDA pulled every 10-15% minoxidil and anything containing azelaic acid, the golden days of minoxidil products with added DHT blocking substances are over, and a lot of people went back to using regular 5% minoxidil.
They just are not as effective anymore, but supposedly they are now safer.
Lipogaine used to have 5% azelaic acid. It later switched to a natural alternative Azetinol to minimize the possible scalp itchiness caused by azelaic acid.
Besides Azetinol, it also contains other ingredients that are proven to prevent hair follicle shrinkage by DHT, such as saw palmetto extract, oleic acid, linolenic acid, beta-sitosterol, etc.
Lipogaine is pricier compared to regular 5% minoxidil brands. If you can afford the increased price tag, it’s probably a good idea. The added DHT-blocking ingredients will give you a boost, but they can’t compare to finasteride.
Pros: Additional DHT-blocking ingredients
Cons: More expensive compared to “regular” minoxidil products, available only in liquid form
Same as Rogaine, but at a lower price.
Why would anyone buy Rogaine if generic brands like Kirkland Minoxidil cost less?
Rogaine supposedly uses better quality ingredients. People report less itchiness, redness, and flakiness when using Rogaine, compared to generic brands.
Kirkland minoxidil is cheap. A 6-month supply goes for around $25. This is probably your best budget option.
Pros: Cheap, just as good as other “regular” minoxidil products in terms of effectiveness
Cons: Higher possibility you might experience side effects
Minoxidil is FDA approved, has no chances of sexual side effects, and, regarding potency, only second to finasteride.
Nizoral, or rather, ketoconazole, is the third anti-hair loss component of “the big three.”
Nizoral is an anti-dandruff and anti-fungal shampoo, but several studies have confirmed that the active ingredient ketoconazole can help treat hair loss in men with male pattern baldness, due to its anti-inflammatory, sebum reduction, and anti-androgen qualities.
While not as powerful as finasteride and minoxidil, it’s still an excellent addition to your anti-hair loss arsenal. To win this “war”, don’t shy away from any powerful “weapon” — articularly one that’s safe to use.
Nizoral is available in two versions: 1% and 2% ketoconazole, and it’s likely you are going to need a prescription for the 2%.
- How do I use it?
There are no clear guidelines on what’s the best way to use Nizoral. A good rule of thumb would be to use it every other day or, at the very least, once per week. Apply it like you would any kind of shampoo, leave it on for 5 – 10 minutes, and then thoroughly wash it off. Don’t let it get into your eyes, trust me — speaking from experience.
Don’t go overboard with Nizoral. If you see your hair becoming brittle over time, cut back.
- 1% or 2% — which one should I use?
Either, as they both are effective. The 2% is more potent and may require a prescription. The Nizoral 1% is readily available over the counter.
- Are there any side effects?
- How long does it take to see results?
Nizoral should be used in conjunction with finasteride and minoxidil. Don’t use it on its own and expect to see immense results. In the “Nizoral studies”, men with MPB who were using Nizoral lost significantly fewer hairs over the months compared to those who weren’t. Don’t expect to regrow hair using it, but rest assured you hair loss progression is slowed down.
- Are there any other ketoconazole shampoo brands?
You bet. If you are having trouble finding this shampoo in your country, here is a complete list of ketoconazole shampoo brands.
- Are there any others shampoos that are designed to combat hair loss?
An army of them. These also do not contain sodium laureth sulfate, a cheap foaming agent which can cause irritation and inflammation. However, most of them don’t do much. Here’s our guide to hair loss shampoos that actually work.
Additional compatible hair loss treatments
1. Dutasteride (
Dutasteride is a dual 5-α reductase inhibitor manufactured by GlaxoSmithKline under the name “Avodart.” Its primary use is to treat BHP (benign prostatic hyperplasia).
Avodart is essentially a much stronger Propecia. It reduces significantly more serum DHT, and, accompanying that, has a higher chance of side effects. Dutasteride inhibits both Type 1 and Type 2 5-α reductase, while finasteride inhibits only Type 2.
To get Avodart, you will have to convince your doctor to give you a prescription. Personally, I’ve been on it for the last 6 months and have absolutely no side effects. (Your experience may differ).
I would suggest you try finasteride first, and, if that does not work, start considering Avodart.
Since the drug is applied topically, it shouldn’t have systemic effects like oral treatments.
How RU58841 works is, instead of suppressing DHT (like finasteride, dutasteride, and ketoconazole), it prevents it from attaching to hair follicles.
For now, the drug is only intended as a research chemical, but you still can buy it online on several websites for “research purposes.”
3. Derma Roller
The Derma Roller is a small plastic roller with numerous small needles, designed to improve skin and help treat hair loss by rolling it on the affected area.
Originally, the Derma Roller was just a tool for skin care, but a later study confirmed that, if used on the scalp in conjunction with minoxidil, it can help regrow hair better compared to just using minoxidil alone.
Dermarolling will cause small incisions on your skin, which shouldn’t hurt or cause bleeding. It can leave your skin reddish after use.
The way it is supposed to work is by causing minor damage to your skin, so it will start to heal and regenerate. This will increase collagen production and better absorb nutrients.
While there is some evidence the Derma Roller works, its efficacy is still widely debatable and has sparked controversy.
There are people online who claim it does wonders for them, as well as an equal amount of those who believe it doesn’t do jack, and may even be harmful.
If you want to try the Derma Roller, I would go easy — don’t use it more than once a week, and don’t apply minoxidil on the day you do.
You can find a lot more information and read real user experiences (with pictures) in this massive thread.
SpironolactoneAldactone is primarily used to treat fluid build-up due to heart failure, kidney disease, or liver scarring. It’s also used for treating high blood pressure, low blood potassium, excessive hair growth in women, and transgender hormone therapy.
While that is not our goal, when applied topically, spironolactone has some evidence it blocks DHT from binding to your hair follicle receptors without going systemic and causing side effects.
Topical spironolactone is a weak topical DHT blocker. Some users swear by it, but the general tone is that spironolactone is not as effective as finasteride. If you are concerned about the side effects of finasteride, it may be worth giving topical spironolactone a try.
Hair Transplants and other procedures
(This section was provided by Dr. Alan Bauman, an ABHRS-board certified and IAHRS-accepted medical and surgical hair restoration specialist).
The best option for many patients with significant hair loss is hair transplantation. Not your father’s “hair plugs” anymore, advances in artistry and minimally-invasive surgical techniques can comfortably, undetectably restore hairlines and coverage. Hair transplants are used to permanently restore living and growing hair to an area of the scalp that is depleted of hair follicles.
SmartGraft is a new, breakthrough device that helps surgeons and their specialized teams perform FUE or Follicular Unit Extraction hair transplantation. Less invasive than traditional linear “strip” harvesting, Follicular Unit Extraction uses no scalpel, no stitches, no staples in the donor area–allowing for faster healing, less discomfort after transplantation, quicker return to athletic activity and leaving absolutely NO tell-tale linear scar. It yields only grafts which contain as little as a single hair follicle, which — when used artistically — can result in a 100% natural appearance.
Working just like a precise microsurgical extension of the human hand, SmartGraft’s all-in-one ergonomic handpiece and storage system was designed to help accurately separate, extract and store FUE grafts during hair transplantation. Fewer steps, less handling, and manual transferring of grafts allows the FUE procedure to be accomplished at a faster speed, reduced risks of graft failure and poor growth quality as well as with improved patient comfort.
FUE grafts are fragile and can still result in an unnatural appearance if careful planning and artistry are not used, so choose an experienced, credentialed FUE hair transplant expert.
COST: The cost of an FUE SmartGraft hair transplant will vary by patient, but ranges from $8,000 to $20,000 per procedure.
The first robot designed to help surgeons perform a portion of the hair transplant procedure recently became FDA approved. Called the ARTAS Robotic-Assisted FUE System by Restoration Robotics, it’s an image-guided robot with micron-level precision that harvests up to 1,000 hair grafts per hour – which has made hair transplant surgery even more accurate and efficient.
As with any new technology, there is still a lot of educating that needs to happen, at both the physician and consumer level, when talking about robotic hair transplants. Some people have the misconception that the ARTAS robot is operating on it own when, in reality, the robot is simply an extension of the operator, working within parameters programmed by the surgeon. Its effectiveness, therefore, is tied directly to the expertise of the surgeon and the end result — as with any hair transplant — is only as natural as the artistic skills of the surgeon behind the machine.
COST: The cost of an ARTAS-assisted FUE hair transplant will vary by patient, but typically ranges from $8,000 to $20,000 per procedure.
PRP – Platelet Rich Plasma
“Vampire PRP Hair Growth” or Platelet-Rich Plasma is one of the hottest new non-invasive treatments to become available for hair loss sufferers.
Here’s how it works: Using special equipment and a centrifuge, a patient’s own blood is separated and concentrated to enhance the number of platelets and key growth factors. That Platelet-Rich Plasma is then comfortably applied into the scalp, where it revives dying follicles and regrows weak hair.
PRP for Hair Growth has become one of the most exciting recent breakthroughs in hair restoration and is not only showing positive results as a stand-alone treatment, it has proved to be a valuable tool during hair transplantation as well. During the transplant process, PRP has been shown to strengthen non-transplanted hair, minimize donor scarring and accelerate wound healing. In addition, PRP has also been reported to improve graft survival and accelerate the growth of the transplanted hair.
In addition to its effectiveness in treating certain types of hair loss, a growing number of patients are drawn to PRP because of its comfortable, quick, and non-invasive nature. This outpatient procedure takes about one hour and requires no downtime for patients, which means you could literally have it performed during your lunch hour and return to your activities of daily life immediately.
The use of PRP “enhancements,” such as Extracellular Matrix (ECMs) as well as Stem Cells/Signaling Cells can be added to the PRP to enhance its hair growth properties and prolong its effects. When PRP is performed without these enhancements, multiple repeat treatments are needed as often as every other month. Research has shown that the use of ECMs like ACell–derived from porcine/pig bladder, BioD–derived from donated healthy human placenta, Adipose-Derived Stem/Signalling Cells–harvested and separated from the patient’s own fat, and even special exosome preparations can help strengthen the effectiveness and lengthen the duration of the results from a single PRP treatment.
COST: PRP with ECMs, adipose-derived stem cells or other “enhancements” for hair regrowth may range from $2600 to $5900
Future hair loss treatments
There is a great deal of future hair loss treatments and possible cures in development. Unfortunately, these won’t be available anytime soon. And when they will finally hit the market, they likely won’t come cheap.
HairLossTalk.com has created a great looking visual “pipeline” of the upcoming treatments from plenty of different companies, institutions, and research facilities:
The big three are still the best anti-hair loss regime for most men who just started losing their hair. They are safe, inexpensive, take little time to apply, and, best of all, they work. However, if your hair is beyond the Norwood 3 scale, you might want to be looking into other solutions, like a hair transplant. The big three are much more effective at keeping your hair, not regrowing it.
If you have a friend who is experiencing hair loss and is bothered by it, have him read this article. Friends don’t let friends buy snake oil.
For any questions, constructive criticism, experiences, thoughts or ideas, leave a comment below. I would be happy to make any changes if any of my facts are wrong and update the article with new information.
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