If you have been noticing a receding hairline or are worried about balding, the first step is to schedule a visit 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. 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 doesn’t stop, though the rate at which it happens differs from person to person and depends on genetics. No matter how fast it happens, because it 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, tells us that “you have to lose half your hair before the human eye can tell.”
We spoke to Glashofer, McAndrews, and nine other doctors and dermatologists about the most effective products to treat hair loss, from topical and oral medications like minoxidil (Rogaine) and finasteride (Propecia) to more “natural” methods like scalp serums and laser wands.
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What we’re looking for:
Doctor-recommended ingredients: As Dr. Douglas D. Altchek, founder of Altchek Dermatology, puts it, “There are 1,001 products out there purporting to grow hair,” but there’s no definitive cure for baldness. Dr. Corey L. Hartman of Skin Wellness Dermatology adds that there have not been any major recent breakthroughs in this category, and notes that “the hair-loss space is one where you want to proceed with some caution, because there’s a bit of snake oil to the claims that some of these companies make.”
For emerging hair-loss treatments like platelet-rich plasma injections, stem-cell activation, and micro-needling, you’ll need to consult with a specialized dermatologist. But before it comes to that, all of our experts say it’s worth leaning on reliable doctor-recommended standbys like minoxidil and finasteride — a.k.a. Rogaine and Propecia, respectively — ideally in tandem. The former is helpful for preventing hair loss, the latter for promoting growth. Because of their long and trusted track record as well as the unanimous recommendation from our experts, we’ve deemed both of them our “best overall” products for tackling male hair loss.
As for hair-loss treatment red flags, you’ll want to be especially wary of hair-growth shampoos and vitamins: There is little 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. “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,” says Dr. Evan Rieder, a dermatologist in the Ronald O. Perelman Department of Dermatology at NYU Langone Health. Several of our 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 is a result of a nutritional deficiency or stress. 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.
Type of treatment: In addition to the sheer number of hair-loss treatments on the market today, there are a bunch of different formulations to choose from. Topical treatments usually come as a liquid, serum, or foam that is applied to the scalp on a daily basis. Light-therapy treatments use lasers to increase circulation in your scalp and stimulate hair follicles. Then there are treatments that come in the form of pills or gummies. As with most health and beauty products, what works for you is not necessarily what will work for all people. To help you find the best fit, we’ve included a range of treatment types and noted what form they take, as well as who might benefit from each.
Price: Everyone we spoke to emphasized that hair-loss treatments are not a cure for hair loss, but a long-term daily commitment. Once you stop using them, you will start losing hair again. This means they’re also a long-term financial investment that will cost you around a dollar a day for topical or oral treatments. Laser devices will cost more up front, but after continued use over time, the cost per day will start to go way down. We’ve noted the price per day for the first month of use in the details section for each product below.
Side effects: We’ve heard from our experts that some people experience dry scalp, hair breakage, or even initial increased shedding from certain minoxidil products. Others may not like the greasy feel of a certain liquid or serum. To make sure you know what to expect before buying anything, we’ve listed the most common side effects, if any, for each product.
Best overall product to prevent hair loss
Minoxidil | Foam | 90 cents/day | Possible side effects: Temporary increase in hair shedding, dry or irritated scalp, hair breakage
If you decide to try a hair-loss treatment, 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. (Minoxidil is also available as a generic from several other brands, including Hims, Keeps, and Kirkland Signature.) Don’t expect it 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 using it for at least eight months before judging efficacy. Dermatologist Dr. Michele Green agrees, adding that because it takes four months for hair to even grow, “you can’t possibly know before that.” Simply massage it into your scalp once or twice daily, and for best results, use a formula like Rogaine’s with a 5 percent concentration of minoxidil. 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 Altchek 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 you can apply it to the crown of the head as well as the hairline.
Best overall product to promote hair growth
Finasteride | Pill | 90 cents/day | Possible side effects: Dizziness, cold sweats
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 minoxidil (Rogaine) for the maximum effect. While minoxidil 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 minoxidil 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,” he says. Rieder also notes that taking both drugs together is more effective, as does Hartman, who recommends attacking hair loss from as many angles as you can: “Different treatments have different mechanisms of action, so as long as there are no adverse side effects when you employ them individually, you shouldn’t have any issues putting them on top of each other for maximum benefit.”
Best liquid formula to prevent hair loss
Minoxidil | Liquid | Possible side effects: Greasy-looking hair, scalp irritation
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. Green told us she likes the alcohol-free Lipogaine because, on top of containing 5 percent minoxidil like Rogaine, it contains 5 percent azelaic acid, which “acts as a DHT blocker that inhibits the production of DHT.”
Best formula to prevent hair loss on sensitive scalps
Nanoxidil | Liquid | 1.33 dollars/day | No reported adverse reactions as of yet
“Nanoxidil is very similar to minoxidil, without the side effects of an irritated scalp that some Rogaine users report,” explains Green, making formulas with the ingredient 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 fairly new to the hair-loss-treatment market, Green tells us it has proven very effective 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 promote hair growth and density.