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The Best Men’s Hair-Loss Treatments, According to Doctors

Photo: NBC

If you’re a gentleman who has been noticing a receding hairline or is worried about balding, the first step is to schedule a visit (or phone consultation, for the time being) with a doctor or dermatologist and make sure your hair loss isn’t a sign of a more serious health issue. “Not all hair loss is male-pattern hair loss,” explains Dr. Marc Glashofer, a board-certified dermatologist specializing in hair loss who practices in northern New Jersey. A thyroid disorder, an autoimmune disease, or even a scalp issue could be the cause of a hairline resembling Bruce Willis’s in Die Hard 2. But most hair loss is androgenetic alopecia, also known as male-pattern baldness, and fortunately (or not, depending on your perspective), it’s just a symptom of getting older.

Once male-pattern baldness starts, it’s not going to stop, though the rate at which this happens differs from person to person and depends on genetics. And since the grind of hair loss is unending, it’s important to start treatment as soon as your hairline starts bothering you. If you’re looking for a more quantitative metric, Dr. Paul McAndrews, a clinical professor of dermatology at the USC School of Medicine and member of the International Society of Hair Restoration Surgery, told us that “you have to lose half your hair before the human eye can tell.”

We spoke to McAndrews and 11 other doctors and dermatologists about the most effective products to treat hair loss, including topical foam, oral medication, and even a laser comb. (Of course, if you don’t care about losing your hair and are fine with going full Prince William and shaving your head, go for it. We’ve got some recommendations for razors and hair trimmers to help you out on that front.) If some of the following items look familiar, that’s because, since we last updated this article, the best-in-class over-the-counter hair-loss treatments really haven’t changed, according to all of our experts. (Medical procedures for fighting hair loss may be getting more advanced, but Dr. Corey Hartman of Skin Wellness Dermatology explains that there “have not been breakthroughs in terms of topical and oral products, in part because the ones we have work in a pretty decent way.”) That said, we’ve restructured the list to reflect the fact that many of our experts say there are two products you should really take in tandem if you seek the most effective treatment (one is for preventing loss, the other for promoting growth, and we’ve deemed both “best overall.”)

Before we dive in, a note about hair-growth shampoos and vitamins: There is less evidence supporting the efficacy of any hair-growth shampoos that claim to block DHT (dihydrotestosterone), a hormone responsible for shrinking hair follicles, which ultimately leads to hair loss and eventually baldness. Dr. Evan Rieder, a dermatologist in the Ronald O. Perelman Department of Dermatology at NYU Langone Health, is skeptical that you’re going to see any tangible benefits by rubbing DHT blockers into your scalp. “I find it very difficult to believe that something that’s applied to the scalp and rinsed off is going to have any appreciable effect,” he says. Four experts also say not to put much faith (or money) into hair-growth supplements or vitamins that promise to help promote hair growth or stop hair loss — though a couple hypothesized that vitamins or supplements could lead to hair regrowth if your hair loss was a result of a nutritional deficiency. Otherwise, says Dr. Amy McMichael, a professor and the chair of Wake Forest Baptist Medical Center’s dermatology department, “there is no such thing as a ‘hair vitamin’” for male-pattern baldness.

Best overall product to prevent hair loss

If you decide to start treatment to save your hair, a good place to start is with minoxidil, most commonly sold as Rogaine, which came recommended as the first line of defense by every expert we spoke to. Don’t expect this hair-loss treatment to create luscious locks; minoxidil is better at slowing down or preventing more loss rather than promoting hair growth. But, according to McMichael, it is effective “if used as recommended, with evidence of improvement seen around six to nine months” — a sentiment echoed by hair-loss specialist Dr. Marc Avram, who recommends giving it at least eight months to judge efficacy. Simply massage the foam or solution into your scalp once or twice daily, and for best results, use a formula like Rogaine’s with a 5 percent concentration. Dr. Oma Agbai, the director of multicultural dermatology at UC Davis, warns that “some people will experience an increase in hair shedding during the first few weeks of treatment,” but promises this is temporary and “a sign that the treatment is working.” (She adds: “As long as there is no itching or burning of the scalp associated with applying minoxidil, the treatment can be continued safely.”)

Three of our experts specifically recommend this Rogaine foam, which Avram says has “been around forever” and which Dr. Douglas D. Altchek, the founder of Altchek Dermatology, says is “very reliable and remains the mainstay of topical treatments for male-pattern baldness.” Avram also has this tip: “Clinically, it works in the front and back,” so feel free to apply the foam to the crown of the head as well as the hairline.

Best overall product to promote hair growth

The other main hair-loss treatment recommended by seven of the dermatologists we interviewed is finasteride, which is taken orally and often called by its brand name, Propecia. The FDA-approved brand-name medication is available only with a prescription, but these days, finasteride is easily found as a generic and can be ordered online after a virtual consultation through start-ups like Hims, Keeps, and Lemonaid. Finasteride restrains an enzyme that converts testosterone to DHT, the hormone that causes hair loss in men, and unlike minoxidil, this drug can actually help hair grow back as well as prevent further loss. All you have to do is take one pill a day, according to Rieder, who says that two-thirds of men taking this treatment will see improvement in hair density over time.

Six of the experts we spoke to recommend combining finasteride with Rogaine for the maximum effect. While Rogaine remains his first recommendation, Altchek told us that adding finasteride “may potentiate the effect,” seeing as finasteride will help more hair to grow at the same time that Rogaine is helping prevent additional loss. McAndrews calls the combination of orally administered finasteride and topically applied minoxidil a “full-court press” against hair loss. “That’s doing the most you can for preventative medicine.” Rieder also notes that taking both drugs together is more effective, as does Hartman, who says that the combination “seems to have a better result than taking any one alone.”

Best liquid product to prevent hair loss

Hartman says that for people with dry or color-treated hair, the alcohol in Rogaine’s foaming formula “can cause breakage.” For that reason, he explains, some people may prefer to use a liquid solution. Dermatologist Dr. Michele Green told us she likes the alcohol-free Lipogaine because, on top of containing 5 percent minoxidil like Rogaine, it has 5 percent azelaic acid, which “acts as a DHT blocker that inhibits the production of DHT.”

Best product to prevent hair loss on sensitive scalps

“Nanoxidil is very similar to minoxidil, without the side effects of an irritated scalp that some Rogaine users report,” explains Green, making nanoxidil a good bet for patients who have experienced scalp sensitivity or dry skin from Rogaine. She suggests this nanoxidil product from DS Laboratories, which is also formulated with retinol to promote scalp health and azelaic acid to block DHT. While nanoxidil in general is a fairly new product, Green tells us it has proven very effective in treating hair loss because nanoxidil “has a smaller molecular weight, which allows it to penetrate the scalp faster, resulting in a better absorption rate,” she says. Like finasteride, Green says it has also been shown to increase hair density as well as hair growth.

Best kit for treating and preventing hair loss

For the same price as buying a 30-day supply of finasteride from Hims on its own, you can get the company’s hair-loss kit, which comes with both its 5-percent liquid minoxidil treatment and a 30-day supply of finasteride. Keeps has one as well, and according to Dr. Amanda Doyle of Russak Dermatology Clinic, “both are great options for a lot of men to address hair loss.” Like the dermatologists above, Doyle adds that while it might seem like overkill to take different hair-loss treatments at once, this is one of those rare instances in which more is actually better.

But you must start these medical therapies before you lose all your hair. McAndrews likens it to brushing your teeth in that both are preventative measures. “The sooner you start doing it, the better at slowing down this aging process,” he explains. “Is toothpaste perfect? No, you’re still getting tooth decay with toothpaste, but you’re slowing down tooth decay.”

Best laser comb for treating hair loss

Although this treatment appears to be safe and somewhat effective, according to research, it’s hard to tell who will react well to this low-level light therapy, which is why the doctors we spoke with were hesitant to fully endorse it. “The laser comb works by emitting red light [which enhances circulation to the follicles] to the scalp as you brush through your hair,” Dr. Joshua Zeichner, the director of cosmetic and clinical Research at Mount Sinai Hospital, told us. This increased circulation, he explains, can help make products like Rogaine and finasteride more effective. But Zeichner cautions that “the issue with the combs is that their effectiveness is user dependent: You need to brush your hair slowly and repeatedly in order to get optimal exposure to the light.”

Rieder adds: “We’re not sure what the optimal power is, what the optimal wavelength is; we don’t even really know the mechanism of action of how this is working.” Plus, it doesn’t work on everyone. “There are subpopulations of patients who do respond to low-level laser light, but this is not easily predictable,” explains McMichael, though she adds that the risk of using the LaserComb is low.