I know you read a lot of my observations and opinions on this blog. This time, I decided to take a different approach.
Everyone has questions about the different hair loss products you read about online. I thought it was time you got some answers to your questions.
In the following sections, you will see I have prepared summaries of independent studies/reviews of the most common prescription and non-prescription options for hair loss treatment.
Most of the data was collected by US and EU federal organizations or their authorized third-party libraries. These organizations examined countless studies on each product and shared their analysis which I am sharing with you.
I tried to remain as unbiased as the resources themselves. However, there were times when it was hard to bite my tongue. Either way, I encourage you to read the data and decide for yourself.
Primarily used as a prostate medicine (the organ most susceptible to real danger from DHT), Finasteride is now used as a prescription DHT blocker.
It works by inhibiting the production of 5AR, the enzyme responsible for turning regular testosterone into the more toxic DHT.
Here are some of the pros for Finasteride. The US National Institute of Health states that it is recommended for use in men suffering from a receding hairline or balding at the crown.
In a 5 year study, 2 out of 3 men regrew some hair according to hair counting using 1mg daily. An independent panel stated 48% of those men seemed to visually grow hair and 42% seemed to not lose more hair.
Here are the cons. It cannot be used for women’s hair loss.
If a woman even touches a broken or crushed Finasteride tablet (meaning the Finasteride ingredients itself) she should wash her hands thoroughly and immediately call the doctor as it can cause significant harm to a fetus, and possibly to a woman’s ovaries. Children should not touch Finasteride for the same reason.
The next most significant con is the warning that Finasteride does put a man at risk for a highly aggressive form of prostate cancer.
While this process is unclear, it is possible that the lack of concentrated DHT (which should represent about 3-5% of a healthy man’s total testosterone levels) leads to an extreme excess of both testosterone and estrogen leading to this hormonal based cancer.
(Incidentally, if you play a professional sport you will not be able to take Finasteride because it is known as a steroid masking drug which blocks the hormonal signature of performance enhancing drugs.)
Finasteride blocks almost all DHT, including the DHT a healthy man needs. This can lead to decreased sex drive, depression, and lumps in breast tissue. There is no way to balance the DHT blocked, it is either all or nothing.
Finasteride will not treat hair loss at the temples. If hair regrowth is not noticed within the first 12 months of use, it should not be considered effective. If you stop taking Finasteride, you will lose all of the hair you regained.
Finasteride will not stop hair loss, only slow the process- the root cause of the hormonal imbalance must be addressed to stop the process. Furthermore, hair loss will seem to accelerate once you stop taking Finasteride as you lose hair you would have normally lost and the hair you regrew.
Finally, Finasteride is not covered by many domestic insurance plans. This means the cost will be totally out of pocket. Generic Finasteride is more than half the price of the name brands, but it also does not guarantee consistent dosage which is very important when manipulating hormones.
This is also a 5AR inhibitor which blocks the conversion of testosterone into DHT.
Like Finasteride, it Dutasteride was developed to treat benign prostate issues. In the late 1990’s, the manufacturer began to explore its viability versus other hair growth products for men.
In 2002, the manufacturer called off their Phase 2 testing. It was never explained why. However, during testing it was revealed the .5mg/day and 2.5mg/day doses generated a greater hair count than 5mg of Finasteride within 12 to 24 weeks.
An expert, but notably not unbiased, panel observed a 1” circle on each test scalp.
After 24 weeks the placebo had lost an average of 32 hairs, the Finasteride subjects had grown an average of 75 hairs. The .5mg dose of Dutasteride had grown an average of 94 hairs and the 2.5mg had averaged 109 additional hair.
The manufacturer began more advanced trials to test the safety of the pill if used as an androgenic (DHT) hair loss. The results of this study has not been published.
As of yet, the manufacturer has not continued the filing process for US or EU certification as a hair loss product. However, many doctors will prescribe it as such.
Here are some of the cons of Dutasteride. It will cause birth defects in male fetuses, not female fetuses, causing physiological defects.
Once again, a woman who is pregnant, could get pregnant, or is of child bearing age should not handle Dutasteride. The same is true of small male children, as it can inhibit the DHT they need to develop juvenile masculine traits and future masculine traits. Obviously, this will never be used in women’s hair loss products.
Like Finasteride, there is an increased chance of suffering from an aggressive prostate cancer. It is not clear whether or not the Dutasteride causes the prostate cancer or accelerates the growth of existing malignant cells. It is also speculated that Dutasteride itself will mask signs of early prostate cancer.
Once again, you cannot control how much DHT is blocked when taking Dutasteride. It is very possible a man will lose the necessary amount of DHT he needs to maintain his masculine sexual traits.
While impotence side affects do typically reduce after 6 months, approximately 1% of men continue to have trouble after 24 months. After the first year, there is a greater incidence of breast tissue problems, but those also decrease after 24 months.
As you may have guessed, because Dutasteride works better it costs more. In some cases it costs more than twice the amount of Finasteride. Also, use for hair loss is frequently not covered by the average domestic insurance plan.
As of yet, no data has been published regarding what happens when you stop taking Dutasteride. In cases of prostate issues, the symptoms quickly returned.
It is probably safe to assume if you stop taking Dutasteride, and have not corrected the root cause of the hormone imbalance, the hair loss will return at an accelerated rate.
DHT related hair loss is not the only type of hair loss out there. Some people suffer from forms of alopecia where all of their hair, including all of their body hair, sometimes falls out. It is believed that the body forms a sort of allergic reaction to its own hair follicles and sebum.
The reaction can be almost like eczema while it is flaring up and normally settles down once the hair is gone. Hair can fall out in patches or completely. Many times, the hair never grows back.
Like any other allergic reaction, steroids are often used to stop the flare up. They remove swelling within the deeper layers of the skin and they stop blood vessel constriction which allows more nourishment to reach the impacted skin.
Corticosteroids can be taken orally, but are typically considered more effective when applied topically in a cream. A doctor must prescribe Corticosteroids; they cannot be bough over the counter.
Any product claiming to be available over the counter will not be potent enough to actually help you. There are only a few different corticosteroids, but they all work in the same way.
Corticosteroids will work if you are losing your hair due to an allergic reaction. They will reduce swelling and prevent immediate hair loss. However, they will not fix the root allergy or immune system malfunction.
The next time you are exposed to the allergen or when your immune system acts up, the problem will start all over again. Because you can only use Corticosteroids once you have a clear allergy outbreak, there will be some damage done before the medicine kicks in.
Each time the reaction will cause more damage and possibly leave scarring which will affect future hair growth.
While cons may not be a suitable word, it is important to note some cautions with this method. Corticosteroids can only be used for a maximum of 2 weeks at a time because they area a very potent drug.
They thin the skin. This also tends to leave a slight discoloring which may be permanent. This topical version must also be left on for several hours, at least twice a day, to be effective which can put stress on the hair shafts and may require additional care.
Doctors and experts are very divided on the viability of Corticosteroids for permanent alopecia prevention. Some doctors believe long-term hair loss with this type of alopecia is unpreventable and using steroids is a waste of time, money, and risk.
However, others believe that Corticosteroids may be effective if used to treat symptoms and then major lifestyle changes regarding nutrition and fitness are made to overcome immune system malfunction. (Not to brag, but that’s what The Hair Loss Black Book is all about.)
Over The Counter Options
This is a topical solution which is typically applied at a 5% potency for men and 2% for women. Commercially it is frequently included in shampoos, styling products, and sprays.
However, the inactive ingredients of these products can inhibit the effectiveness and potency of the solution.
It is most effective in a direct solution applied to the scalp after it is cleaned and when it can be left on for several hours. It can also be applied up to twice a day without any known adverse effects.
The Cochrane Library, an independent organization dedicated to reviewing scientific studies and analyzing the quality of the results, has examined over 20 Minoxidil studies.
While most of the studies did not list qualified results because their results were considered at risk for “bias”, Cochrane noted in 7 studies examined, there was an average increase of 13 hairs per cm2.
However, the studies did not clarify whether or not this increase was from currently functioning hair follicles or dormant/diseased hair follicles.
In other words, in some of the studies it was noted that women began to grow multiple hairs from the same follicle (which is common) and other studies claimed to reactivate diseased follicles.
Additionally, there was no evidence as to how long the hair follicles had been dormant. In other words, if the Minoxidil was capable of saving long dormant or dying follicles or just recently sickened ones.
There are adverse affects reported with Minoxidil based hair growth products.
The most important being that hair loss resumes within 30 to 60 days after you stop using Minoxidil, meaning you would have to use it the rest of your life if you make no other changes.
If Minoxidil is going to work, it will cause a brief period of accelerated hair shedding as the healthy follicles experience an accelerated growth cycle. However, it frequently causes drying, dandruff, and rashes. It is also highly toxic to cats.
2. Glyco-Proteins And Amino Acids
These products do not stop hair loss. They are designed to assist hair loss products by increasing the thickness of existing hair. Essentially, the proteins penetrate the hair shaft and saturate the material inside.
The soaked hair then “swells” with the proteins. Then, the amino acids smooth any damage on the outside of the cuticle to prevent delicate hairs from breaking. The tiny fine hairs from the follicles in the process of dying can only swell so much.
As the hair growing will be significantly thinner and weaker than the “plumped” hair along the length of the shaft. You will need to use these treatments regularly or risk the hair breaking at the root from the weight.
There are no real adverse affects with these products, unless you happen to have a specific allergy to the product.
It is just important to note that it will not stop the hair from dying or falling out. The hair will remain thin as long as the cause of the hair loss is not addressed.
3. Herbal Options
It is hard to examine any one specific herbal, but over-the-counter, product for thinning hair. There are literally thousands of different pills, ointments, and treatments out there.
Each has a “secret” formula of certain herbal ingredients, prepared a certain way, with different strength, and administered in their own unique way.
To give you the same review of herbal hair loss products as I have done with the other solutions here I would have to review each individually.
Given the selection on the market, that would be quite a lengthy blog post. Instead, let me tell you some general facts about commercial herbal treatments.
All-in-one herbal supplements are a lot easier than the do-it-yourself alternatives. There is no preparation necessary, normally the products are ready to use. Typically, there is less of an upfront cost than buying the ingredients individually.
(Although, it is important to note that the small amount you are taking of the individual ingredients will average out to a better price comparison among hair thinning products.)
One of the biggest drawbacks to a commercial herbal solution is that you lack control over the ingredients within the solution and their potency.
You may find one product has the amount of Tribulus you need for your anti-DHT plan, but lacks the right amount of Biotin needed to actually make hair grow.
You may also discover the anti-DHT components of the supplement are too strong and “burn” the scalp overwhelming the restorative ingredients.
Another drawback to a commercial herbal solution is how much the ingredients must be processed before they are molded into an easy to use form with a long shelf life. Many are overcooked. Some are saturated with water.
Others are simply prepared in a manner which makes them difficult for the body to absorb properly. Furthermore many commercial products are still filled with dyes and fragrance which inhibit the effectiveness of the herbs.
I studied herbs rather thoroughly when writing The Hair Loss Black Book and in previous blog posts. In the book, I listed the herbs (and the supporting statistics) which are proven to best nurture your scalp and body back into an anti-DHT environment.
I also wrote a previous review of recent herbal discoveries and how they will impact hair loss and regrowth.
I really encourage you to check out both of those resources. In addition to telling you about the herbs, I listed the dosage and preparation instructions to get the most benefit.
I wholeheartedly felt this is a better way to go versus a commercial alternative.
Total Body Options
I encourage you to make this decision for yourself, but if it was me I wouldn’t want to shell out hundreds of dollars each month for the rest of my life just to take a pill that may, in the long run, cause more harm than good.
Unfortunately, that is exactly what you’ll have to do if you don’t fix the true source of your hair loss. A total body option is really the only true defense against hair loss.
Even if you have another form of alopecia other than DHT related, most treatable forms of hair loss will be better controlled or prevented if you include fitness, lifestyle, nutrition, and supplementation as a fundamental part of your hair loss regime.
Furthermore, ANY prescription or non prescription option you use will have better results if you are working to correct the root cause. In fact, these options will only be needed temporarily instead of being take for life drugs for those who do nothing about the root problem.
Obviously, Hair Loss Black Book is the total body option I recommend.
If you decide it isn’t for you, I still encourage you to find a hair loss treatment which will restore balance within your body and on your scalp not one that tries to use a pill to mask symptoms.
You can run from your symptoms with a pill or you can solve your problem with a little bit of hard work.