There’s no cure for baldness, but there are ways to hold on to what you’ve got. The six dermatologists and the clinical studies point to three methods: minoxidil, laser treatments, and prescription finasteride. The key is finding the combination and hair loss regimen that works for you. A doctor is your best bet for that kind of guidance — but we found a few trustworthy products that will work for most people.
Our top pick is Men’s Rogaine Unscented Foam. It contains five percent minoxidil which has been clinically proven to slow hair loss and even regrow some hair. It’s also FDA-approved and non-prescription, which means it’s not only effective and safe for use but widely available. You can easily find a three-month supply on Amazon for about $35.
There’s also a women’s version (Women’s Rogaine Foam) — but a three-month supply costs $22 more online. The only difference between the two products are the instructions; women are instructed to apply once a day instead of twice. If you’re a woman who doesn’t feel like paying extra for marketing, the men’s product will suffice. A cheaper generic version is Kirkland Signature Minoxidil Foam, but with a longer history on the market and more customer testimonials, Rogaine is our first choice.
Our other recommendation is the HairMax Ultima 12 LaserComb. The comb uses low-level lasers to stimulate hair follicles and modulate dihydrotestosterone (DHT) — a hormone that causes the most common type of hair loss. While it sounds like something from a sci-fi movie, the treatment works, and the dermatologists we consulted reported that their patients saw thicker and longer hair when combined with our top pick. The only catch: The comb isn’t as effective as minoxidil treatments, and at nearly $400, it’s a much bigger investment. Still, it’s the best option if you’re looking for a non-invasive, non-chemical treatment.
How We Found the Best Hair Loss Treatment
“The most common cause of hair loss in both men and women is androgenetic alopecia, which is genetic pattern hair loss,” explains Dr. Michael B. Wolfeld, a board-certified plastic surgeon and an assistant clinical professor of plastic surgery at the Icahn School of Medicine at Mount Sinai Hospital in New York. The root cause of this type of hair loss is dihydrotestosterone (DHT), a byproduct of testosterone that shrinks certain hair follicles until they eventually stop producing hair.
Other medical conditions — most commonly telogen effluvium and seborrheic dermatitis — can also cause hair loss, but most people can trace their follicular woes back to androgenetic alopecia, so we focused our search there. We started with more than 200 products, including all-natural solutions and high-tech gadgets, while skipping treatments that focus only on volumizing or thickening hair. We also limited our scope to the scalp, and left out specialty products designed only for eyebrows or beards.
We dug into clinical studies and talked to experts in the field, who helped identify specific ingredients that have proven effective in combating hair loss and aren’t just snake oil.
The ugly truth: The vast majority of hair loss treatments boast exaggerated claims, and a startling number have absolutely no scientific backing whatsoever.
Our first step: eliminating those snake oils.
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.
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?
Not so fast. Dr. Alex Khadavi, a board-certified dermatologist and associate professor of dermatology at the University of Southern California, says that it’s a good idea to approach all of these products with a skeptical eye.
“There’s people selling pills and creams and lotions and whatever else, and sometimes you can’t even trust what ingredients they have in there,” he warned us when we spoke to him over the phone. Key takeaway: The hair loss industry is crazy dishonest, so we eliminated any treatments (especially homeopathic methods) that aren’t based in concrete, peer-reviewed science.
We favored minoxidil over laser treatments.
Laser treatments are the latest frontier in staving off hair loss, and they’ll be the first choice for fans of sci-fi. As silly as they may sound, these treatments do work — the American Journal of Clinical Dermatology in 2014 reported a “statistically significant difference” in hair density with no “serious adverse events” or side effects.The bad news: Laser treatments tend to be expensive, progress is slow, and they don’t always produce stellar results.
Dr. Cheri Ong, dermatologist for American Dermatology Associates, Inc., confirmed and explained “Low-level laser treatments (LLLT) are popular non-invasive and non-chemical options for hair loss that work by activating energy production in the hair follicle and modulating DHT.”
“I think their effectiveness is not as significant as finasteride or minoxidil,” says Dr. Wolfeld, “however, it’s something that can be used quite easily by patients at home. If they use it two or three times a week, I tell them it can help to thicken their hair.” Results can take up to 18 months to show up, so Dr. Wolfeld stresses that patience is a virtue.
And then ditched 2 percent minoxidil treatments for 5 percent.
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.
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.
We cut anything including propylene glycol.
While there are no overtly harmful ingredients in over-the-counter minoxidil, liquid solutions contain propylene glycol, which may cause itching, redness, and irritation. The topic is a contentious one — researchers point out documented cases of irritation while others point to studies that show small amounts are harmless and even safe to eat.
The truth is, the amount of propylene glycol in hair loss treatments is not likely to cause any real harm and the FDA has given the chemical approval for many uses. But even though it is safe, we wanted to ensure that our top picks would be as comfortable to use as possible. So when Dr. Khadavi told us that “a third of my patients get irritated from minoxidil products because of propylene glycol,” we decided to cut any treatments with it. In any case, it’s the minoxidil that helps curb hair loss and not the propylene glycol.
Fortunately, most minoxidil foams don’t use propylene glycol and thus stand a much lower chance of irritating your scalp than their liquid counterparts — all our top picks are foams.
This Article First Published On reviews.com