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1 in 4 men will start to experience hair loss due to male pattern baldness before the age of 30. By the age of 80, that number jumps to 80 percent! If you are starting to experience male pattern baldness, you are not alone. Most men will experience hair loss in their lifetime. That is why there are so many products on the market that target this condition.

The problem: there is far more snake oil on the market than there are evidence-based treatments.

That is precisely why we have created this primer on the best hair loss treatment for men; we did the tough work of sifting through the evidence to bring you the best-of-the-best when it comes to reversing and slowing the advancement of male pattern baldness.

Not only is this condition widespread, but it is also an age-old problem. The famous Greek philosopher Aristotle, who was balding himself, noted that eunuchs did not lose their hair. That was our first hint that baldness was related to the hormones known as androgens.

However, this observation was forgotten for the next 2,500 years until James B. Hamilton’s landmark study in 1949 that linked baldness to hormones. This link to androgen hormones is why male pattern baldness is also known as androgenetic alopecia (AGA for short).

Hamilton, a researcher at Yale University at the time, also noted that genetic predisposition and age played a significant role. [1]

The good news: researchers have made a lot of advancements since 1949. Not only do we better understand the three contributing factors and an added fourth factor related to inflammation of hair follicles, but several treatments can reverse or slow a receding hairline. Of course, it is easier to preserve than it is to restore…

We have all heard the adage that an ounce of prevention is worth a pound of cure; treating hair loss is no different. While the treatments we are going to review can and likely will help to regrow some hair, they work even better as preventative measures as they can slow down hair loss to the point where it may take years to see any further recession of your hairline.

In this review, we are going to cover the top evidence-based treatments backed by clinical science. We will also explore a few of the alternative and complementary therapies such as hair transplants—a big thanks to Dr. Alan Bauman from Bauman Medical for giving us the lowdown on modern transplants (these aren’t your dad’s transplants).

Finally, we will review what’s in the pipelines as far as the development of new treatments for male pattern baldness and then answer a few frequently asked questions people have about this all-too-common condition.

Without further ado, let’s take a look at the best ways to slow or even reverse the retreat of your hairline!

The 13 best hair loss treatments for men in 2020

There are a lot of treatments out there that target male pattern baldness. In this review, we are going to look at those treatments that are backed by evidence and discuss how they work so that you can make the best choice to treat your receding hairline.

We have organized the list so that the most effective treatments are at the top, working our way down to the alternative or complementary therapies.

Our top-2 (finasteride, aka Propecia and minoxidil, aka Rogaine) are the only treatments that have specific FDA and European Medicines Agency (EMA) approval for treating hair loss due to AGA. However, a new player (dutasteride or Avodart) is emerging on the market and may be even more powerful.

We are placing it at number 4 on the list because more evidence is needed to assess its efficacy, while our top-3 have a longer history of research and use by the public, which all support their effectiveness.

First used for the treatment of benign prostate hyperplasia, the FDA and EMA have now approved it as a treatment for male pattern baldness, and it has since become the best treatment for male hair loss.

Overview:

Finasteride inhibits the types II and III 5-alpha-reductase (5α-reductase) isoenzyme. This, in turn, inhibits the conversion of testosterone to dihydrotestosterone (DHT), which is why it and other similar products are called DHT inhibitors. It is also minimally selective for type I 5α-reductase. Combined, this means that finasteride can block about 70% of serum DHT. [2]

DHT, in those genetically predisposed to AGA, can affect the hair follicle causing it to miniaturize (shrink), leading to thinner hair. AGA is also the result of a shortening of the growth phase of hair—also called the anagen phase—producing shorter, less visible hairs.

As the follicle shrinks and the growth period gets shorter, hairs eventually do not grow past the scalp’s skin.

The result:

The length and width of hair reduce as the follicle shrinks, resulting in hair that eventually becomes so small that it is virtually imperceptible or doesn’t even protrude out of the skin. It becomes vellus-like hair rather than terminal hair.

Vellus hair is the small hairs that grow on our bodies when we are young; they are short, thin, and have little color. Terminal hairs are the hairs that grow on your head, face, and other body parts as we enter puberty. They are thicker, longer, and have more substantial pigmentation.

A meta-analysis (a review of all) of the research that has been done on finasteride shows that it cannot only slow the process of turning terminal hair into vellus hair, but it can also reverse the process. After a year of continued use, patients saw an increase in terminal hair and a reduction in vellus hair on their head.

Likewise, finasteride use over a 48-week period showed a rise in anagen versus telogen hair. Anagen is that hair that is still growing; it is thicker and more pigmented while telogen hair is dormant, thinner, and less pigmented. [3] Thus, finasteride can help improve hair thickness and length.

How to get it:

Talking to your doctor or a dermatologist is the best way as it can interact with other drugs or conditions. However, it is also available online. Be cautious when purchasing online as there are poor imitations and outright fakes on the market. If you want to go the online route, we can recommend Hims as a reliable source.

How to use it:

A once per day 1mg tablet is the standard dose for finasteride.

Note: taking more does not increase its effects but can increase side-effects. [4]

How soon you can expect results:

Some users saw regrowth as early as 3 months, but it can take up to a year. However, the slowing of hair loss should be almost immediate, although some initial shedding may occur (this means the medication is working) as dormant and vellus hairs are replaced with new growth. Remember that in the battle for better hair, a slowing of the process of AGA should be considered a win.

The Good (Pros):

It is the most potent way to treat and prevent hair loss.

Finasteride comes in an easy to swallow tablet, taken once daily.

Things to Consider (Cons):

A minority of users (around 3%) experience serious side effects like loss of libido or erectile dysfunction (ED).

Other common side effects include dizziness, weakness, dyspnea (labored breathing), rhinitis (allergy-like nasal symptoms), and skin rash.

Bottom Line:

This is the best hair loss treatment for men that is approved by the FDA. [5] While there are some side effects, they are usually minimal, and many of them fade with prolonged use. In the case of libido and ED, these effects were seen in a small segment of the population and may be mainly psychological and can sometimes be treated without stopping treatment.

If you experience any side effects, you should talk to your doctor and discuss your options.

Minoxidil is another medication that started as a treatment for another condition (high blood pressure) and was found to have the side effect of slowing hair loss and promoting hair growth.

Overview:

As we discussed above, miniaturization of the hair follicles and the premature termination of the anagen (growth) phase of hair are the primary factors in AGA. Treatments that are effective at halting or reversing male pattern baldness are going to have some effect on one or both of these factors.

While the mechanisms of minoxidil are not fully understood, because our understanding of hair growth and follicles is still limited, its effects are well documented.

The growth of hair is thought to be supported by some cell growth factors, including proteins and hormones such as VEGF, FGF-5S, IGF-1, and KGF, as well as the dermal papilla cells and dermal papillary vascular system.

On the flip side, negative factors bring an end to the anagen phase and put hair into the dormant phase or recessive phase. In AGA, the presence of androgen hormones causes a shift and stops the anagen process prematurely.[6]

Minoxidil appears to recruit follicles that are in the dormant phase and pushes them into the anagen phase, keeping them there for an extended period leading to longer, thicker hair.

The mechanisms of action are believed to be three-fold. First, it helps to boost the aforementioned growth factors. Second, it may also inhibit the effects of negative factors. Finally, it helps to dilate hair follicle arteries increasing the blood flow to the follicle, which improves oxygen and nutrient delivery. [7]

The result:

Hair that grows longer and thicker wherever you apply minoxidil. It has similar effects to finasteride but works via a different mechanism of action. Minoxidil can help to counteract the effects of DHT but does not prevent it from shrinking hair follicles. This is why they are often used in combination, as finasteride helps to avoid damage from DHT, while minoxidil helps to reverse the effects.

Remember:

Always consult with a physician or pharmacist before mixing treatments of any kind.

How to get it:

Minoxidil is available over the counter. You can stick to the original, more expensive brand name Rogaine (Regaine in the EU), or you can go for one of the other brands like Lipogaine, Kirkland Minoxidil, Regenepure, Foligain, etc.

Rogaine has been around for longer, and thus, the manufacturer has had a more extended amount of time to hone their formula to deliver maximum results with fewer side effects. If you are concerned about side effects, stick to the original brand.

How to use it:

It comes in two forms, a topical solution, and a topical aerosol foam. Both are equally effective, but the aerosol is easier and quicker to apply and may have reduced side effects—however, it is also a bit more expensive.

Apply a 1ml amount (or 1 pump of foam aerosol) all over your scalp twice per day with at least 8 hours between applications. Some users only use one application per day as minoxidil has a half-life of 22 hours, but this leaves a gap of 2 hours if you are applying it once per 24 hours, which Pfizer says leads to a reduction in results.

We recommend sticking to twice per day as it is the most effective and safe way to use minoxidil to stimulate hair growth for men.

How soon you can expect results:

You should start to see positive changes within 2 to 6 months of regular use, but you should give it 12 months to see the maximum benefit as far as hair regrowth goes.

The Good (Pros):

This is the most effective way to regrow hair; paired with finasteride, they make a powerful combo.

It can now be found in less expensive varieties as the patent has expired.

There is no risk of sexual side effects like decreased libido or ED.

The newer foam aerosols cause less irritation than the hydroalcoholic formula that uses propylene glycol.

Things to Consider (Cons):

Generic brands may have more side effects like itchy scalp and redness.

Minoxidil does not stop the damage caused by DHT; instead, it reverses it.

Bottom Line:

You can think of finasteride as a preventive treatment, while minoxidil reverses some of the damage. Used together, they are more powerful than used separately. They are generally well-tolerated as a combo, but you should still consult a doctor or pharmacist before mixing medications.

Similar to minoxidil, but current research suggests it may be more effective as it works through multiple mechanisms and is better absorbed by the skin. This effect is further enhanced by the nanosome delivery method developed by DS Laboratories.

Overview:

Nanoxidil has a similar chemical structure to minoxidil but with a lower molecular weight. Compounds with a lower molecular weight are generally better absorbed by skin and hair, which make them more effective at delivering their active compounds to the hair follicle. [8]

Nanoxidil has similar effects to minoxidil but has fewer side effects. The only side effects noted in studies were mild redness and some itching on the scalp, which was reported by a minimal number of participants. Furthermore, Spectral.DNC-N has other active compounds that not only promote hair growth but help to alleviate inflammation of the scalp.

A few of the other key ingredients in Spectral.DNC-N include myristoyl pentapeptide-17, adenosine, piroctone olamine, retinol (vitamin A), and caffeine. The last two help to stimulate growth but also improve the skin’s ability to absorb other active ingredients.

Myristol Pentapeptide-17, Adenosine, and Piroctone olamine have also shown to be effective at stimulating hair growth and promoting the effects of topical hair loss treatments. [9]

This relative newbie to the field is making a strong showing. It opens ion channels within cells, which helps activate cellular mechanisms that enhance hair growth while reducing the negative growth factors associated with AGA.

The delivery system in this product is also novel but backed by solid research. DS Laboratories has developed nanosomes, which are based on the liposome delivery system. Liposomes have proven a more effective way to deliver higher concentrations of active compounds to hair follicles—essentially, they help active ingredients cross the skin barrier. [10] Nanosomes work using similar technology and have been shown to have the same effectiveness but are more stable, providing a longer shelf-life for more reliable delivery. [11]

The result:

This formula not only works to regrow longer and thicker hair like minoxidil, but it helps to inhibit the conversion of testosterone to DHT like finasteride, albeit with less efficacy. It provides a multilateral approach to treating hair loss in one leave-on treatment. Unlike minoxidil, it doesn’t use propylene glycol, which can cause contact dermatitis, irritation, and greasy hair.

How to get it:

You can buy Spectral.DNC-N directly from the manufacturer.

Pro tip: because hair loss is best treated with consistent application of any treatment, check out the 3-month supply at a reduced rate. Go the subscription route for an added 10% off.

How to use it:

Apply 6 sprays, twice daily on clean, dry, compromised hair. This is a leave-in treatment, don’t rinse it out after application and wash your hands with soap and water immediately afterward. You can add the Spectral.F7 Efficacy Booster, which reduces hair loss caused by stress to enhance the effects of DNC-N.

How soon you can expect results:

Participants started to see results after 3 to 6 months.

The Good (Pros):

DNC-N works to regrow hair by promoting growth factors and inhibiting negative factors on hair growth, and it reduces hair loss by limiting the conversion of testosterone to DHT.

It has fewer side effects than minoxidil and finasteride.

Things to Consider (Cons):

Nanoxidil hasn’t been around as long as our top-2, but the evidence for its efficacy is growing.

It may not be as effective as a minoxidil and finasteride combo, but the research is ongoing in this case.

Bottom Line:

Nanoxidil is a robust third-place competitor as the newest topical treatment for hair loss from DS Laboratories. It is potent, backed by science, and has fewer side effects than its competitors. This one is definitely worth a shot, especially if minoxidil or finasteride had too many side effects for you.

4. Dutasteride (Brand name: Avodart)

While this may actually be the most potent product on the list, the research is still ongoing, which is why we are putting it in the number 4 spot instead of at the top. It’s a DHT inhibitor like finasteride, but it may be even more effective.

Overview:

Dutasteride works on the same mechanisms as finasteride with one slight but very important difference. Finasteride inhibits the types II and III 5-alpha-reductase (5α-reductase) isoenzyme. In this case, inhibiting type II is what helps to limit the conversion of testosterone to DHT in hair follicles.

There is, as you may have deduced, a type I 5-alpha-reductase, and it also turns testosterone into DHT in hair follicles. Dutasteride works on both types I and II 5α-reductase. This dual-action boosts its efficacy significantly from finasteride’s 70% reduction in DHT to a whopping 99% reduction for dutasteride. That’s a big bump in DHT-blocking power! [12]

The increased effectiveness does not appear to come with increased risk for side effects, either. [13] In fact, a meta-analysis that looked at several studies found that dutasteride may have a decreased risk for sexual dysfunction side effects. [14]

The result:

The same effects you can get with finasteride but with potentially greater efficacy and perhaps even reduced side effects.

How to get it:

You’re going to need to talk to your doctor for this one, as it is strictly prescription only.

How to use it:

A tablet is taken once daily; the standard starting dose is 0.5mg (500 micrograms).

How soon you can expect results:

This one is going to take a year to see results. In the first six months, you may even see what appears to be thinning of hair, but this a sign that it is triggering hair renewal and should begin to show positive effects after this phase.

The Good (Pros):

It is potentially more potent than the current leader in treating hair loss.

Dutasteride may also have a slightly reduced risk for side effects.

Things to Consider (Cons):

This is still a new product, and research is ongoing.

Bottom Line:

We expect that if we were writing this article a few years from now, this treatment would be in the number one spot, at least as far as ranking the products already on this list currently. It’s potent and can reduce serum DHT levels even more than finasteride (99% and 70%, respectively).

New research is also indicating that it may have a reduced risk for adverse sexual side effects.

5. Topical Finasteride (Brand name: Formula 82F)

Treatments that work systemically (often by taking a pill orally) don’t always work topically. While the topical application of finasteride is not currently an FDA or EMA approved treatment for AGA, the evidence is growing for this type of topical application.

The brand name we have provided here is a combination topical treatment that uses the standard 5% concentration of minoxidil in conjunction with 0.25% concentration of finasteride. However, because the benefits of minoxidil are well established, we will look at the potential benefits and risks of adding topical finasteride to the mix.

Overview:

Our first clue that topical finasteride may be successful was the fact that Dr. Bauman talks about the topical finasteride treatment Formula 82F on his website—and that man knows his research when it comes to AGA and the potential treatments.

When we started looking into the studies, we were not surprised to see that there is a growing body of evidence to support the uses of this compound in a topical delivery method.

Minoxidil and retinoic acid are present in this formula, both are well established for hair loss treatment, and retinoic acid also helps the skin absorb other topical applications.

The real question here is, how well does finasteride work when applied topically? Two meta-analyses were conducted, one in 2018 and one in 2020. They looked at 7 and 28 articles, respectively, that tested finasteride as a topical treatment for hair loss.

They concluded that topical application could indeed reduce DHT levels in the scalp, and some studies even indicated that the systemic effects decreased, i.e., participants reported less sexual dysfunction than oral finasteride use. [15] [16]

The result:

Topical application can indeed reduce DHT levels in the scalp while limiting exposure to the rest of the body; this could mean a reduction, but not the elimination of side effects. As such, it is now possible to get the DHT reducing effects of finasteride while limiting its potential to cause sexual dysfunction.

Researchers note that further studies are required to determine the ideal topical concentration, application frequency, and side effects. But this is promising news, especially for those who want to combine the results of finasteride and minoxidil in a single treatment for ease of application.

As an added benefit, this topical formula is also free of propylene glycol (PG), you get none of the skin irritation that comes from a lot of the other minoxidil treatments that use PG as a delivery method.

How to get it:

Talk to your doctor because this one is another prescription-only option.

How to use it:

Use the dropper to apply 30 drops twice daily and spread it evenly over the at-risk or affected areas with weakened hair growth. It needs 3 hours to set, so no showering, bathing, swimming, or sweating for 3 hours after application. Basically, keep your head dry for 3 hours after you apply it.

How soon you can expect results:

It starts to work in as little as ten weeks, but to see the effects in the mirror, it will take 6 to 12 months.

The Good (Pros):

It has the benefits of oral finasteride with a decreased risk for sexual dysfunction.

Formula 82F combines the benefits of minoxidil and finasteride in a single topical formula.

Things to Consider (Cons):

For women, this one is no-go if you are of childbearing age, finasteride (topical or oral) can lead to significant birth defects.

There is still a risk of sexual dysfunction, so talk to your doctor if you experience these or any other side effects.

Bottom Line:

Topical finasteride shows promise as a treatment for AGA, but more research is necessary to home in on the best concentration and frequency of use. You can go with other brands, but Formula 82F has minoxidil and finasteride, so if you can, why not go for the combo of the two best treatments in one bottle.

We are squarely in the complementary treatments now, meaning this is best paired with another treatment to see the best results. Unless you are using this strictly as a preventative measure, we would recommend pairing it with Spectral.DNC-N, minoxidil, or finasteride.

DS Laboratories also notes that it can help transplanted follicles thrive. If you have or are going to have a hair transplant procedure, talk to your specialist about using this shampoo post-transplant.

Overview:

Ketoconazole shampoos were first used to treat dry, itchy scalp, dandruff, and the more severe form of these, seborrheic dermatitis. Then, people started noticing it also made their hair thicker and even stimulated regrowth in balding areas.

The reasons for this were believed to be related to its anti-inflammatory properties, remember inflammation is a fourth significant contributor to androgenetic alopecia. As researchers begun to investigate the mechanisms of action behind ketoconazole on male pattern baldness, they discovered that it also had anti-androgenic (DHT blocking) properties, a previously unknown effect. [17] [18]

The anti-inflammatory properties are also why this shampoo makes for a great add-on to an existing treatment plan (also called adjuvant therapy). It can not only stimulate hair growth, but research shows that it can also counteract some of the side effects of popular treatments, especially minoxidil. [19]

DS Laboratories did not stop there with this formula though, they have also included caffeine, which research shows has anti-androgen properties by blocking DHT and promoting significant, healthy follicle growth. [20] Further research has also indicated that a topical shampoo is one of the best delivery methods for this type of treatment. [21]

Finally, DS Laboratories has included biotin in this formula. While biotin treatment is only helpful in reversing hair loss that is due to a deficiency in this nutrient, it is an essential compound in healthy follicles. It is a welcome addition to the formula as it can help support the healthy function of follicles, giving your hair the best chance for regrowth. [22]

This shampoo can help extended the anagen phase while shortening the telogen phase.

The result:

You see longer, thicker hair growth with healthier looking and feeling hair. You should also see a reduction in redness, itchiness, and skin flaking if that was an issue for you.

How to get it:

Buy it directly from DS Laboratories.

How to use it:

Use 5 times per week, apply to wet hair and scalp, massage it in, and leave it for two minutes, then rinse. Follow it up with the Revita conditioner to further boost the effects.

How soon you can expect results:

Give this shampoo at least 3 months (90 days) to see results. Consistent use is vital, as with most other treatments.

The Good (Pros):

This is an excellent adjuvant therapy for those already experiencing hair loss, especially if you are using minoxidil.

It is a useful preventative measure for those at risk or concerned about hair loss.

This ketoconazole shampoo can reduce the side effects of other treatments that may cause redness, itchiness, and dandruff.

The added compounds support the health of hair and their follicles.

Things to Consider (Cons):

If you have medium to advanced hair loss, you are going to need another more potent treatment as well as the shampoo.

Bottom Line:

Perfect for those who are concerned about or are at risk of hair loss, this shampoo can also make a great addition to other treatments and can even help to reduce their side effects. This shampoo is excellent for any stage of hair loss, but those with more advanced loss should use this as an add-on to other treatment options.

DS Laboratories is not the only option for a ketoconazole shampoo. Nizoral is another brand that offers a similar product but without the added healthy-hair compounds. This shampoo is marketed for anti-dandruff but contains enough ketoconazole (1%), to help alleviate the symptoms of other treatments and offer a boost in blocking DHT.

Overview:

Nizoral is similar to the DS Laboratories shampoo, but it does not have the added caffeine or biotin.

It can block the formation of DHT and help reduce inflammation, both of which are factors that contribute to male pattern hair loss. This means that it also offers the same ability to counteract the side effects of other treatments such as minoxidil.

The result:

You see longer, thicker hair growth with healthier looking and feeling hair. You should also see a reduction in redness, itchiness, and skin flaking if that is something with which you struggle.

How to get it:

You can purchase this one straight off of Amazon.

How to use it:

Use it instead of your regular shampoo twice per week, apply to wet scalp and hair, massage it in, leave it for two to three minutes, and then rinse.

How soon you can expect results:

Again, give this one 3 months (90 days) to begin to see results.

The Good (Pros):

This is a good adjuvant therapy for those already experiencing hair loss, especially if you are using minoxidil.

It is a great preventative measure for those at risk or concerned about hair loss.

This ketoconazole shampoo can reduce the side effects of other treatments.

Things to Consider (Cons):

If you have medium to advanced hair loss, you are going to need another more potent treatment as well as the shampoo.

This one does not have the added components that the DS Labs shampoo has, meaning it does not boast the same level of DHT blocking and does not provided add nutrients for hair and follicle health.

Bottom Line:

Another good option for an add-on therapy. Not as potent as the DS Laboratories shampoo but still effective.

I know it sounds like we are getting into crazy science fiction territory here but stick with us. This was discovered when some laser treatments used to remove hair had the opposite effect, a phenomenon known as “Paradoxical Hypertrichosis.”

Similar therapies are also used by physiotherapists to treat musculoskeletal conditions. Although it sounds like sci-fi, LLLT does have therapeutic effects. Now the question is, how well does it treat AGA? Let’s take a look.

Overview:

Used in the treatment of other conditions, LLLT research and use have shown that laser therapies can indeed have a significant impact on the functioning and health of our bodies. The evidence for LLLT therapy is growing, and numerous studies have been conducted, all of which show significant positive effects.

Two recent meta-analyses of the research studies that have been conducted indicate this and conclude that the evidence in support of LLLT is of high-quality. [23] [24]

As this is a new treatment, certain parameters for its effective use are being determined. Still, the two devices we are going to review here both operate in the optimal ranges specified by preliminary research and have undergone clinical trials which support their efficacy in treating male and female pattern hair loss. [25]

The iRestore system uses 650 nm red light—this refers to the wavelength of light they used and falls within the optimal range specified by several studies.

The methods by which LLLT stimulates follicles and promotes hair regrowth are not entirely known. Current theories from the research above cite improved circulation, improved cellular metabolism, heat that triggers follicles to grow hairs by stimulation of epidermal stem cells, and sub-therapeutic skin disruption that triggers follicles to regenerate and regrow hair—the disruption here is exceptionally minimal and just enough to trigger the healing process.

These appear to trigger follicles to switch from the telogen phase to the anagen phase, which is supported by findings that show post-treatment participants had more terminal hairs than they did during pre-treatment observations. [26] [27] [28]

The results:

You will see a regrowth of hair in areas affected by AGA, resulting in thicker, longer, and more pigmented terminal hairs. This gives your hair a fuller look.

How to get it:

You can get iRestore’s Hair Growth System laser-filled helmet from Amazon.

How to use it:

Use it every other day for 25 minutes.

How soon you can expect results:

iRestore recommends allowing 3 to 6 months to see results. Whether you purchase from Amazon or somewhere else, you can return this product at the 6-month mark for a full refund. Make sure you contact Freedom Laser Therapy directly to process the refund as Amazon only offers a 30-day refund policy.

The Good (Pros):

Can be combined with finasteride, minoxidil and other therapies to enhance the effects (be careful not to combine it with treatments that increase photosensitivity as this is a photo-based treatment, this includes products that contain vitamin A in any form such as retinol or retinoic acid)

It is a non-invasive, painless treatment with no known side effects.

It improves hair strength as well.

There is no fatigue from the application; as a helmet, this device requires no active combing or brushing action, which can become tiring.

Things to Consider (Cons):

Like all LLLT, it cannot be combined with therapies that use vitamin A or other photosensitizing products

It can be time-consuming.

It is expensive.

It has only been shown to be effective in some people, while others are non-responsive (thankfully, they offer a full money-back guarantee on the iRestore system).

Bottom Line:

Backed by solid science and having undergone its own clinical trials, the iRestore Hair Growth System is a reliable LLLT device that can function as an add-on treatment or as an alternative treatment for those who do not respond well to traditional therapies.

Another LLLT treatment, this one is going to offer the same results as the iRestore Hair Growth System.

Overview:

The science here is the same as with the iRestore system. We couldn’t find any mention of the parameters for the lasers used in the HairMax combs directly on their website. But when we looked at the clinical trials, we found that their products are within the same range as the iRestore system operating in the 635 to 655 nm range.

The LaserComb is another product not only backed by solid science in LLLT but also by clinical trials of their specific devices. [29]

There are a few key differences here. First, the HairMax combs use lasers instead of LED light, which may contribute to the shorter treatment time and may make it more effective. Second, the comb teeth part the hair allowing the light to reach the follicles unobstructed, which can also contribute to a shorter and more effective treatment.

The downside is that you have to comb it through your hair for 8 or 11 minutes (the classic Ultima 9 is 11 minutes while the Ultima 12 is 8 minutes).

The results:

You will see regrowth of hair in areas affected by AGA, resulting in thicker, longer, and more pigmented terminal hairs. This gives your hair a fuller look.

How to get it:

Another set of products that you can purchase from Amazon: Ultima 9 Classic LaserComb. Ultima 12 LaserComb.

How to use it:

Start at the hairline and turn the device on, after four seconds, the unit will beep, at which point you move it back a half-inch and then leave it for another 4 seconds, then move the comb another half-inch back, repeat until you hit the back of your head.

Do this again over the same area, then jump to the next section, repeating the process until you’ve covered the entire head.

How soon you can expect results:

Give this one the same 6 to 12 months to see results.

The Good (Pros):

Can be combined with finasteride, minoxidil and other therapies to enhance the effects (be careful not to combine it with treatments that increase photosensitivity as this is a photo-based treatment, this includes products that contain vitamin A in any form such as retinol or retinoic acid)

It is a non-invasive, painless treatment with no known side effects.

It improves hair strength as well.

The use of lasers and comb teeth to part hair makes for a shorter and more effective treatment.

This laser comb is cheaper than the iRestore Hair Growth System.

The combs are more portable than helmet or hat systems.

Things to Consider (Cons):

It cannot be combined with therapies that use vitamin A or other photosensitizing products

It can be time-consuming.

Although cheaper than the iRestore helmet, it is still expensive at $200 & $400.

You must comb your hair for 8 to 11 minutes in a row, which can become tiring for some.

Bottom Line:

Less expensive and possibly more effective than the iRestore, this is an excellent option for those who don’t mind giving their hair a comb for 11 minutes at a time, 3 times per week.

Spironolactone is another DHT blocker that appears to have few systemic side effects (i.e., sexual dysfunction) when applied topically. However, it does not appear to be as effective as finasteride.

It is primarily used to treat fluid build-up due to heart failure, kidney disease, liver scarring, high blood pressure, low blood potassium, excessive hair growth in women (hirsutism) and female pattern hair loss. It is also used for transgender hormone therapy

Overview:

For men, this has to be applied topically only; oral use is restricted to women as the systemic effects of oral use result in feminization (i.e., they cause the appearance of female characteristics), which is why it is used in transgender hormone therapy. Applied topically, it does not appear to cause systemic effects in men. [30]

Topical use does appear to have some DHT-blocking effects. However, they are less effective than finasteride. [31] There are plenty of men out there who swear by topical application. It is worth a try if you’ve tried finasteride and did not like the side effects or did not see results, but we recommend pairing it with other DHT blockers for improved outcomes.

The result:

A reduction in the speed with which your hairline recedes and some potential regrowth of hair.

How to get it:

You can purchase the Maxogen-S topical cream from MinoxidilMax.

How to use it:

Apply a small amount to the base of hairs (trying not to get it on your hair) twice daily. Do not apply too much. Check the website for a picture guide, but they are using a dollop about the size of a few rice grains.

How soon you can expect results:

MinoxidilMax does not cite a specific time frame, but as it works similarly to finasteride, you should expect results to show after about 3 months, but significant effects could take a year to begin to show.

The Good (Pros):

This is a suitable alternative treatment for those who tried finasteride and saw no results or were unhappy with its side effects.

Topical use does not appear to have systemic effects.

Things to Consider (Cons):

It is not as potent as finasteride.

Oral use is only approved for women as the systemic effects on men may lead to feminization.

Bottom Line:

Spironolactone is a suitable alternative to finasteride, especially if paired with other DHT blockers. Men should avoid oral administration of spironolactone due to hormone-related side effects.

Dr. Alan Bauman provided this section. Dr. Bauman is an ABHRS-board-certified and IAHRS-accepted medical and surgical hair restoration specialist. We have adapted this review from the information he provided to BaldingBeards.com.

Dr. Bauman is a leader in hair restoration with a wide breadth of knowledge on the subject, visit his clinic’s website for more information on hair loss and treatment options available at his clinic.

Overview:

If you have advanced hair loss, transplantation is the best hair loss treatment to recover a full head of hair. New advances in technology provide the precision of robotics with the artistry of a hair loss specialist to offer a minimally-invasive procedure that can comfortably and undetectably restore your hairline and hair coverage over your scalp.

SmartGraft is a new technology that helps surgeons and their specialized team of experts perform a Follicular Unit Extraction (FUE) hair transplant. SmartGraft is a precision instrument that allows surgeons to extract as few as a single follicle.

This cutting-edge piece of kit allows more accurate and realistic looking placement of follicles to mimic the natural hairline. SmartGraft allows for non-linear harvesting, which means you do not end up with the zipper-like scars that are common with other techniques.

For you, this means less pain, less scarring, and a quicker recovery that allows you to get back to your normal life in less time.

This state-of-the-art tech helps surgeons extract and store follicles during the transplant procedure leading to a faster process with less handling of the harvested follicles.

What that means for you is a reduced risk of graft failure, a reduced risk of poor growth quality post-transplant, and improved comfort.

One part science and one part artistry, Dr. Bauman advises that you choose your surgeon carefully as the look of the final result ultimately comes down to the experience of the person doing the transplant.

Think of it likes this:

You can buy yourself the best paints, paintbrushes, and canvas in the world but that doesn’t mean you can paint like Rembrandt. That requires practice and expertise.

While Fue SmartGraft represents the best of transplant technology and improves the patient experience, recovery time, and gives surgeons unparalleled precision, how natural your hairline appears post-procedure depends on the knowledge and artistry of the surgeon controlling this follicle plucking and planting robot.

The result:

You will see the recovery of your hairline that looks natural, even for those with significant hair loss.

How to get it:

Find a respected surgeon in your area who specializes in FUE SmartGraft transplants. The cost ranges from $8,000 to $20,000 per procedure.

How to use it:

Hopefully, a trained hair recovery expert is doing this part.

How soon you can expect results:

Immediately, that is the best part of a transplant. There is, of course, some healing time, but the hair is there! It can take 7 to 10 days to recover from the procedure and about 2 weeks for the areas of harvested follicles to grow back. Compare that to the six weeks or more for “your dad’s hair plugs.”

The Good (Pros):

This is the best option for those with significant hair loss.

It has minimal recovery time when compared to traditional linear transplants.

Improved comfort and reduced scarring compared to linear transplants.

Things to Consider (Cons):

There is a short healing period.

You might experience the occasional sharp pain for several weeks after the treatment.

It is the most expensive option available, but it is also the most effective.

Bottom Line:

This advanced technology in the hands of a trained specialist is the best option for those with advanced hair loss. Recovery time is down to 7 to 10 days, allowing you to return to your normal activities in a much shorter amount of time than traditional linear transplant techniques.

12. Platelet Rich Plasma (PRP)

Another medical procedure used to treat a multitude of conditions, now being used to treat AGA as well.

Overview:

PRP involves extracting blood from the patient and refining it to remove red blood cells, concentrating the patient’s own platelets and growth factors in the plasma that is to be injected into the treatment area, thus stimulating the healing process.

Sort of like hacking your healing system to promote the regeneration of healthy follicles that grow terminal hairs.

While the method is slightly different, it appears to have some similar effects to LLLT. It stimulates stem cells in the follicle, which promotes healing and the growth of longer, thicker terminal hairs.

It also encourages the formation of new blood vessels around follicles, increasing blood flow and, subsequently, oxygen and nutrient delivery. [32]

Treatment with PPT results in an increase of healthy follicles in the treatment area as well as improved hair thickness and improved results on the hair pull test. Moreover, it appears to have no major side effects in the majority of patients. [33] [34] [35]

PRP can also be combined with a transplant procedure to strengthen non-transplanted hair, reduce donor scarring, and accelerate the healing process. Furthermore, researchers report that PRP can improve graft survival rate and accelerate the growth of transplanted hair. [36]

Dr. Bauman informed us that PRP enhanced with extracellular matrix (ECM), stem cells/signaling cells is even more effective than PRP alone. They not only boost the effectiveness of the treatment, but they prolong the results leading to fewer treatments. [37]

The result:

You should see regrowth of thicker, healthier hair in the affected areas.

PRP also leads to improved recovery and regrowth of both transplanted and non-transplanted hair after a FUE SmartGraft procedure.

How to get it:

Consult a hair loss specialist train in PRP treatment, especially those familiar with the enhanced PRP treatments. The cost is in the range of $2600 to $5900.

How to use it:

Another one that is up to the trained specialist, you just have to show up and follow directions!

How soon you can expect results:

Research indicates that you should see results in 3 to 6 months.

The Good (Pros):

There is no recovery time as it is a series of minimally-invasive injections.

These are short treatments that are about an hour long.

You can get treated during your lunch hour and return to normal activities the same day.

Things to Consider (Cons):

The procedure requires a local anesthetic.

All injections come with a risk of infection and scar tissue, but a trained expert minimizes these risks.

Cost is a significant factor as we are in the thousands of dollars range.

Bottom Line:

A relatively safe and effective treatment that is further enhanced by added compounds makes this a good stand-alone treatment and a great add-no to hair transplant treatments.

A bit pricey, but if you are already going the transplant route, you might as well give the grafts the best chance of success.

13. Scalp Micropigmentation (SMP)

SMP comes last on the list because it is not really a treatment for AGA, rather it is a cosmetic procedure that involves a process similar to tattooing on the scalp to give the appearance of fuller hair.

Overview:

Does anyone remember the Ron Popeil infomercial for “hair in a can” formally dubbed Ronco GLH #9 Spray-on Hair? Well, we are in that realm now. SMP is a similar procedure in that it uses color to give the visual illusion of thicker hair, but Ron’s spray is temporary.

In contrast, scalp micropigmentation is permanent or at least semi-permanent—you may be required to go back for touch-ups after about 8 years.

Scalp micropigmentation is a form of cosmetic tattooing, similar to permanent makeup or cosmetics. It utilizes injected pigment on the scalp to give the visual appearance of thicker hair. It reduces the contrast between your hair color and scalp color to make your hair appear fuller.

This is done by placing small dots in different hues of black to simulate the look of shadow, giving depth and definition—basically, pointillism but on your scalp. The ink is not injected as deep into the skin as a tattoo is, and the procedure utilizes smaller needles.

However, it does not at all treat the underlying causes of androgenetic alopecia. Because it is similar to a tattoo, there are no follow-up treatments, get it and forget it! Ok, we’ll stop with the Ron Popeil jokes now.

Some people are combining it with FUE transplants to improve the final look of hair, which has proven effective. [38]

Of course, if you choose to put a permanent tattoo on your scalp, you are going to have to commit to fighting hair loss for the duration of your life, or you will be left with an exposed tattooed scalp.

How to get it:

Visit a trained SMP professional for a consultation. Single sessions can run anywhere from $400 to $1000, but you will likely need more than one session with an SMP practitioner.

How to use it:

Receive the treatment, follow the post-procedure guidelines, and keep up with hair loss prevention.

How soon you can expect results:

The results are pretty immediate. Just like tattoos, they fade over time, and you may need to have touch-ups around the 8-year mark.

The Good (Pros):

There is no downtime with scalp micropigmentation.

As a semi-permanent ink injection, it has long-lasting results.

Things to Consider (Cons):

It is not a regulated procedure, so the onus is on you to find a suitable practitioner.

Some people have an allergic reaction to the ink.

There is always a risk of infection with any ink injection procedure.

Bottom Line:

SMP is a purely cosmetic procedure, but it can help to give the appearance of a fuller head of hair.

How we chose these products

Science is our guide here. Because androgenetic alopecia is so common, there is a bevy of options on the market. Of course, they don’t all work, not at reducing hair loss anyways, many of them are incredibly effective at emptying your wallet!

We looked at the research and chose only those treatments that are based on solid evidence and have been tested clinically to assess both their efficacy at treating hair loss and the side effects they may cause.

When we mentioned a brand name for a particular product or treatment, we have ensured that the concentrations or parameters that a brand uses adhere to the guidelines that are backed by research.

When looking at newer treatments with fewer studies, we still checked to ensure that they were conducted with proper research designs.

When compared to a control group (usually a placebo treatment or sham device), actual hair loss treatments should show a reduction in follicle miniaturization or even a reversal of the process.

Researchers should use clinical photography or other methods to count the number of terminal hairs versus vellus hairs and to assess the number of hairs in the anagen versus telogen phase. They should also use other proven methods to evaluate hair shedding, thickness, and health.

We have only included treatments that are backed by research and have received positive assessments from study participants.

The only exception to this is scalp micropigmentation, that is because this is a purely cosmetic treatment that does not address the underlying causes of AGA. As such, there aren’t any scientific studies on its effectiveness.

Products in the pipeline (Potential future treatments)

HairLossTalk.com has put together an illuminating infographic on the progress of new treatments for hair loss that are coming down the R&D pipeline.

However, don’t wait for these new treatments to come out to start treating AGA. If there is one thing we know about hair loss, it is that it is easier to prevent than it is to reverse, and these treatments are all a ways off of being released for the public.

The majority of them are in stage 2 of research or earlier.

You can check out the infographic for yourself, but we will discuss the three that are farthest along the research and development track: RHC-01(s), Hair Stimulating Complex, and Follica.

RHC-01(s) & (r)

RHC-01(s) and RHC-01(r) are similar treatments, but the former is being tested in Asia by Shiseido, who acquired the exclusive license to this RepliCel Life Sciences technology for the whole Asia region.

They are conducting the same type of research, but they are farther along in the timeline and are running separate trials to RepliCel.

The basics of this treatment involve taking cells from the unaffected hairs on the head of someone afflicted with AGA and transplanting them to the affected areas.

The hope is that the healthy functioning cells will bring with them their cellular and genetic traits that make them immune to the effects of androgen-related hair loss to the affected areas of the scalp.

We don’t know if this research is going to pan out, but we are excited to see how things develop!

Hair Stimulating Complex

Histogen’s Hair Stimulating Complex is a stem cell treatment that uses neonatal cells grown in a simulated embryonic condition (hypoxia, an environment with a 3-5% concentration of oxygen).

This causes them to become multipotent, which just means that they can both divide and develop into any specialized cell. This complex also contains a mix of several of the growth factors we mentioned in our review above, including KGF, VEGF, and follistatin.

These growth factors are essential for signaling stem cells to differentiate into hair follicle cells and in triggering hair growth, especially follistatin.

Again, we are going to have to wait and see how the research develops, but this injectable treatment looks promising.

Follica

If you looked at the infographic, you might have noticed one entry that read “Wound Device,” it’s an unexpected bit of text to see on a list of treatments for hair loss, but there is some fascinating science behind this one.

Researcher Dr. George Cotsarelis discovered that “skin disruption” or creating small wounds on the skin, applied in a controlled manner, can lead to follicle neogenesis, or the generation of new follicles.

Essentially, carefully wounding the skin causes re-epithelialization (skin regrowth), which leads to the formation of new follicles in the area. This research aims to see if minoxidil is more effective when applied at a very particular point after wounding the skin.

Not only is the process being tested, but Dr. Cotsarelis and his team are developing a device to apply it in a controlled and safe manner.

Crazy but true, let’s see how this one turns out when the final verdict is reached.

Frequently asked questions (FAQ)

Do Hair Loss Treatments Actually Work?

Yes. In case you skipped our review to check out the FAQ, we have linked to several studies conducted by independent researchers backing some of the most common ingredients or devices in hair loss treatments.

These therapies do work to reduce hair loss, and in some cases, help hair grow back. That is not to say there aren’t a lot of bogus treatments out there, but there are also proven methods for fighting hair loss. You do not have to live with a receding hairline; you can fight back!

Can Hair Grow Back After It’s Started Thinning?

Again, yes. You may see hair regrowth after starting treatments for hair loss. If you have advanced hair loss, they aren’t likely to take you back to that full head of hair.

However, if you are starting at the first signs of a receding hairline, you can stop the recession and potentially grow back the small amount of lost hair.

As most treatments take about a year to reach their full potential, you should stick with it for the year and then assess where you are at. If you are still unhappy with the amount of hair you have, then you can seek more aggressive treatments like transplants.

Who Should I See About My Hair Loss?

If you are looking to try minoxidil, you don’t have to visit any doctors as it is available over the counter. However, if you are taking any other medications or have any other underlying conditions, it is wise to consult a physician before starting any kind of treatment for anything, prescription or over the counter.

If you are looking for prescription treatments, your regular doctor will usually suffice to get a prescription. If you need to go further, like transplants, or if you have been unhappy with your doctor’s advice, seek the help of a hair loss specialist.

In the US, this would be a board-certified hair restoration physician. Dermatologists are skin specialists who can also be very helpful when seeking help for treating AGA.

Can I Take Minoxidil and Finasteride Together?

For most people, this is, in fact, the best way to treat hair loss. Twice daily application of 5% minoxidil and once-daily, oral finasteride appears to be the most effective way to treat hair loss. It tackles both the prevention of hair follicle damage and stimulating hair growth by healing follicular damage. [39]

I Am in My Thirties; Do I Need to Worry About Hair Loss Now?

Worry might be a strong term, but definitely keep an eye on that hairline and jump on it if you start to see it receding. You’ll have a lot more luck at stopping it early than you will have at trying to reverse the effects of advanced hair loss.

Can I Use the Same Products on My Beard?

It depends on the treatment. As an example, DHT has the exact opposite effect on beard hair than it does on the hair on your head. DHT helps beard hair to grow, so trying to use finasteride or other DHT-blockers can thin your beard.

Minoxidil, on the other hand, is effective at helping people to grow a thicker beard. If you are unhappy with your beard growth, check out our article on the proven ways to grow a thicker beard.

Spoiler alert: minoxidil is on that list. But, there are several other promising methods you should check out.

Conclusion

Hair loss starts as early as our 3rd decade of life, if your hairline is beginning to recede, now is the time to start treatments. There are several proven treatments on the market, and we have done the work of sorting the actual from the scams and only give you treatments that are backed by quality research.

Don’t wait to start the battle against thinning or balding hair; the sooner you begin, the more effective the treatments will be.

Have you tried any of these treatments? If so, what were your experiences? What has worked for you? What didn’t work? What side effects have you experienced? By sharing our expertise, we can all be better informed.

If you have any lingering questions, leave them in the comments so we can address them. Don’t forget to share this with others who are experiencing androgenetic alopecia and lets band together in fighting male pattern baldness as we strut off into the sunset with thicker, fuller-looking hair.

References