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We hate to break it to you: If your hair is thinning or receding, it’s probably male pattern baldness (MPB) and left unchecked, it’s likely to continue. 95% of cases of hair loss in men are MPB. That means your hair loss (also known as androgenetic alopecia) most likely isn’t caused by stress, or a vitamin deficiency, or not getting enough protein. (Although those do happen, they’re rare.) The overwhelming culprit is genetics—specifically, your scalp’s genetic susceptibility to the male hormone DHT.
DHT is an androgen, derived from testosterone, that attacks hair follicles on the head. Over time, DHT causes the follicles to shrink (a process called follicular miniaturization) and grow shorter, and thinner hairs called vellus hairs. Once a follicle is “dead,” it’s difficult to revive it. So if you’re bothered by balding, the sooner you take action, the more likely you’ll be successful at reversing baldness and regrowing some hair. The best time to start was a while back. The second best time is now.
The good news: There have never been more things you can do to stem hair loss and encourage regrowth. It’s not guaranteed, but many men have seen good results from the science-backed solutions below; some are more effective than others.
- Most cases of thinning hair are caused by male pattern baldness.
- There are three science-backed therapies that are considered effective to stop hair loss and encourage regrowth.
- There’s insufficient evidence that taking vitamins can reverse hair loss—with two big exceptions.
- Finasteride and minoxidil, used in combination, are considered more effective at reversing certain kinds of balding than either one alone.
1. Take finasteride
Finasteride (brand name Propecia) is an oral medication known as a 5-alpha-reductase inhibitor. 5-alpha-reductase is the baldness enabler: It converts testosterone into DHT. But when 5-alpha-reductase is inhibited, so is the production of DHT, and hair loss can stop or reverse.
The American Hair Loss Association says finasteride stopped hair-loss progression in 86% of men who took the drug in clinical trials, and 65% of them experienced increased hair growth. Side effects are minimal, but they have been reported (AHLA, n.d.).
2. Use minoxidil
Minoxidil (brand name Rogaine) is an over-the-counter liquid or foam that is applied to the scalp twice a day. Minoxidil doesn’t have a direct effect on DHT. It’s known as a peripheral vasodilator, which means it helps to widen and loosen blood vessels, increasing blood flow. Experts believe that action may help minoxidil regrow hair.
Minoxidil hasn’t been shown to be effective on a receding hairline, just at the crown (top) of the head. It also tends to work best on younger men who’ve been experiencing hair loss for less than five years (Scow, 1999). Side effects are minimal.
Studies show that using minoxidil and finasteride together is more effective than using either one alone for certain types of baldness (Chandrashekar, 2015). (Minoxidil will be effective whether it’s the pricey brand preparation, Rogaine, or the inexpensive version sold online for a few dollars a bottle, as long as the version you buy isn’t counterfeit.) Keep in mind that it’s necessary to use minoxidil continuously — if you discontinue it, any new hair growth may reverse, and your male pattern hair loss will pick up where it left off.
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3. Use an LLLT device
Holding a laser wand to your head to regrow hair might seem like science fiction, but actual scientists are pretty cool with it: Low-level laser therapy (LLLT) is an FDA-cleared way to treat hair loss. These devices, which emit a constant red LED light, come in the form of a wand you point at the scalp or a cap you can wear. The red light is believed to reduce inflammation and increase blood flow to the hair follicles.
According to a 2017 meta-analysis of studies published in the Journal of the American Academy of Dermatology, all three of the solutions above—minoxidil, finasteride, and LLLT—were found to be superior to placebo in regrowing hair. The researchers concluded they’re all effective for promoting hair growth in men with male pattern hair loss (Adil, 2017).
4. Get enough of these vitamins and minerals
There are a lot of vitamin and nutritional supplements on the market that claim to regrow hair or make it thicker or shinier. But there’s actually little evidence that vitamins and supplements can help with hair loss — with two notable 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, studies show supplementing your diet with vitamin D or iron—if you are deficient in them—can improve symptoms of androgenetic alopecia and telogen effluvium (TE), a temporary condition in which hair loss is caused by shock, stress or trauma.
Vitamin D is naturally produced by the body when the skin is exposed to sunlight. We also get it in food like milk and eggs. But a lot of Americans, pasty people that we tend to be, are vitamin D deficient. If you have thinning hair, you might want to get your vitamin D level checked by a healthcare provider. It’s not a magic bullet, but there are other benefits to vitamin D: It may play a role in protection against many forms of cancer (NCI, 2013).
Iron is a mineral that people get in their diet, in things like red meat or spinach. Iron deficiency is also common—even more so in women. Being deficient in iron can make you anemic (when you have low blood cell counts). You can get this level checked by a healthcare provider, too.
5. Try 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 (Hugo Perez, 2004).
6. Get PRP treatment
Also known as “platelet-rich plasma,” this procedure is offered by a number of dermatologists and hair-replacement specialists. A patient’s blood is drawn and placed in a centrifuge to extract the plasma, which is then injected into the scalp. The theory is that the growth factors in platelets can spur hair growth. A 2017 study published in the International Journal of Molecular Sciences found that PRP treatment increased the number of hairs and overall hair density versus areas treated with a placebo (Gentile, 2017).