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There is no shortage of lotions, potions, vitamins, and supplements that manufacturers claim will make your hair thicker and your scalp less spare. But only three therapies are FDA cleared— multiple studies showing them to be effective—to treat male pattern baldness. And one of them is the gold standard, demonstrably more effective than the others: Finasteride.
Finasteride (brand name Propecia) is an oral medication known as a 5-alpha-reductase inhibitor. It works by blocking the formation of an androgen (or sex hormone) known as DHT, which can attack hair follicles, causing them to shrink and produce smaller, thinner hairs. 5-alpha-reductase converts testosterone into DHT; when 5-alpha-reductase is inhibited, so is the production of DHT, and hair loss may slow, stop, or reverse.
The American Hair Loss Association says finasteride stopped hair-loss progression in 86% of men who took finasteride in clinical trials, and 65% of them experienced increased hair growth. Finasteride takes three to four months to show any benefit, and it can take up to a year to see maximum results. Side effects are rare, but they can occur.
Read more about finasteride here.
To get the biggest bang for your buck, there are some things you can do while taking finasteride to increase its effectiveness.
- Finasteride, an oral medication that blocks the formation of DHT, has been found to be the most effective therapy for male pattern baldness.
- But there are things you can do in combination with taking finasteride to maximize results.
- Studies have found that using finasteride and minoxidil together is more effective than using either one alone.
- Some studies have found that scalp massage might be effective for increasing hair growth.
Combine finasteride with minoxidil
Minoxidil (brand name Rogaine) is a foam or liquid rubbed onto the scalp twice a day. Scientists believe it helps stem or slow hair loss by increasing the flow of blood and nutrients to hair follicles. About 40% of men experience hair regrowth when using minoxidil, and studies have found that using finasteride and minoxidil together is more effective for hair preservation that using either one alone.
It’s necessary to use minoxidil continuously—if you discontinue it, new hair growth will likely reverse, and male pattern hair loss will proceed. There’s no difference in effectiveness between brand-name Rogaine and less expensive generic minoxidil sold for a few dollars a bottle online.
Read more about minoxidil here.
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Use an LLLT device
In addition to taking finasteride and using minoxidil, you can incorporate low-level laser therapy (LLLT), the third FDA-cleared method of treating hair loss. These devices come in the form of a wand you point at the scalp or a cap you can wear. They emit a constant red LED light, which is believed to reduce inflammation and increase blood flow to hair follicles.
According to a 2017 meta-analysis of studies published in the Journal of the American Academy of Dermatology, LLLT was found to be superior to placebo in regrowing hair (Adil, 2017). The researchers concluded that LLLT, finasteride, and minoxidil are all effective for promoting hair regrowth in men with male pattern hair loss.
Do a scalp massage
Could massaging your scalp actually improve baldness? A recent study suggests it might. According to research published in the journal Dermatological Therapies, 327 men with male pattern baldness watched a video on standardized scalp massage and tried it on themselves for a median time of 11 to 20 minutes a day. Ultimately, nearly 69 percent of them reported “hair loss stabilization or regrowth.” It took over 36 hours of total massage time to see results, on average (English, 2019).
Try a DHT-blocking shampoo
Several varieties of shampoo claim to block DHT’s effects on hair follicles. They’re considered less effective than finasteride, but some men see good results from them in combination. Some of these shampoos contain minoxidil or ketoconazole (the active ingredient in the dandruff shampoo Nizoral). It is hypothesized that ketoconazole, in combination with finasteride, can disrupt DHT’s damaging effects on hair follicles (Perez, 2010).
Take a vitamin D supplement
In researching how to deal with male pattern baldness and keep more of your hair, you’ve probably run across a lot of ads for “hair vitamins” and recommendations that you take supplements like biotin, zinc, and vitamin B. There’s actually very little scientific evidence that vitamins and supplements can help with hair loss—with two exceptions.
In a 2019 review of studies published in the journal Dermatology and Therapy, researchers said there was “insufficient data to recommend” many of the vitamins and minerals touted to help with hair growth, including zinc, riboflavin, folic acid, vitamin B12, vitamin E, and biotin (Almohanna, 2019).
But, the researchers noted, supplementing your diet with low levels of vitamin D can improve symptoms of androgenetic alopecia—a.k.a. male pattern baldness—and telogen effluvium (TE), which is temporary hair loss caused by stress or trauma.
Vitamin D, known as “the sunshine vitamin,” is naturally produced by the body when the skin is exposed to the sun. We also get it via food like milk and eggs. But many Americans are vitamin D deficient. If you have thinning hair, you might want to get your vitamin D level checked by a healthcare provider. Increasing your level of vitamin D isn’t a magic bullet for hair loss, but there are other benefits to making sure you’re getting enough: Vitamin D is believed to be protective against several forms of cancer.
In studies, taking iron supplementation was also effective for hair loss in individuals who had low iron.