NOTE: This article discusses low-level laser therapy (LLLT) as an option for treating male pattern baldness. This treatment is included because several scientific studies have shown that it is effective, which are referenced. However, in my personal experience, I have only received benefit from using a 272-diode laser cap in conjunction with minoxidil. I tried the Theradome laser cap (which contains 80 diodes) on its own for six months, and it did not stop the progression of my hair loss. This suggests that either it is not powerful enough, it is a poor device, or my hair does not respond to low-level laser therapy.
There are two ways to address the root cause of hair loss in men: inhibit (block) the production of DHT, the chemical that causes hair loss, and/or stimulate hair growth to offset the effects of DHT. Either method will slow down or stop the process of hair loss, but it won’t create new hair on completely bald spots. To replace hair where it has been lost, you need to get a hair transplant or hair replacement system.
In general, it is a good idea to use at least one inhibitor in combination with at least one “stimulator” in your regimen for countering hair loss, as that will increase the effectiveness of your treatment. A study showed that men who used both minoxidil (a stimulator) and finasteride (a DHT inhibitor) in combination experienced more benefit for their hair than men who used only one or the other on its own.
Inhibitors
One way to halt the process of hair loss is to slow down or block the production of DHT, the root cause of hair loss.
1. Topical Ketoconazole. As of now, the cheapest way to slow down and possibly stop hair loss is to use 2% ketoconazole shampoo 2-4 times per week. As the link I just posted discusses, scientific studies have demonstrated that it blocks the activity of DHT on hair loss. Those studies also show that it had a positive effect on hair growth in men experiencing male pattern baldness after six months of use.
There are two other well-tested “blockers” (inhibitors) of DHT out there on the market.
2. Finasteride (generic or Propecia) and dutasteride (generic or Avodart). Finasteride is a FDA-approved prescription drug that is taken orally. Finasteride has been found to slow DHT production and hair loss, in multiple scientific studies:
Finasteride in the treatment of men with frontal male pattern hair loss
Efficacy and tolerability of finasteride 1 mg in men aged 41 to 60 years with male pattern hair loss
Finasteride in the treatment of men with androgenetic alopecia
Because there is so much research backing up the effectiveness of finasteride, this product is a good example of something that is science-based rather than hype-based. Thus, it will most likely not be a waste of money in your plan to deal with hair loss.
Note: Finasteride/Propecia may have side-effects of erectile dysfunction or decreased sexual drive. It is up to you whether or not you want to take that risk in order to control hair loss. You can opt to skip finasteride and try other strategies if you want to avoid that risk.*
To obtain Propecia or generic finasteride, simply go to your doctor or to a hair restoration clinic and ask for a prescription.
Dutasteride (generic or Avodart) is another prescription drug that significantly reduces the production of DHT. However, you should be aware of possible side effects, just as with finasteride. You should also not take both dutasteride and finasteride over the same period of time; only one of the two should be taken at a time.
Stimulators
Another way to halt the process of hair loss is to over-stimulate growth in the hair follicles in order to overcome the weakening effects of DHT on hair. Using a stimulator in combination with an inhibitor will provide an even stronger effect than using only one of the two (as the study I mentioned above suggests). There are a few stimulators currently available on the market that seem to be supported by scientific studies:
1. Rogaine (or generic minoxidil). This is an FDA-approved over-the-counter topical solution that has been shown to usually enhance hair growth in men with progressive hair loss. It has been shown to effectively regrow hair on the crown of the head, and it may also help a receding hairline.
It has also been shown that the use of Rogaine and finasteride (Propecia) together produces better results than using either one on its own. (However, be aware that finasteride has the possible side effects of erectile dysfunction and/or low libido in some men.)
If you are experiencing a receding hairline, minoxidil may or may not work very well on its own. I recommend adding finasteride and/or laser treatment to deliver a stronger punch.*
2. Low-Level Laser Therapy (LLLT). This involves immersing your scalp in low-energy (safe) lasers that are supposed to increase blood flow and stimulate hair growth. You can obtain laser treatment via a home laser device (the most powerful of which is the Capillus Laser Cap) or at a hair restoration clinic. There are several scientific studies that demonstrate that low-level lasers can increase hair growth:
Low Level Laser Therapy and Hair Regrowth: An Evidence-Based Review
Low-level laser (light) therapy (LLLT) for treatment of hair loss.
In addition, Laser Therapy (such as that done via the home device Laser Cap) seems to show some results in hair growth aesthetically (although you should always be skeptical of pictures):
A good comparison of many of the in-home laser devices can be found here.
The idea is that the stimulation of hair growth resulting from laser treatment may offset the weakening of the hair follicles caused by DHT. If that is the case, then hair loss will be slowed down or halted and you can maintain the hair you currently have. However, some lasers on the market are less effective than others, so make sure that the laser you invest in has a high number of lasers. The more aggressive your hair loss is, the more powerful of a laser you may need. The laser devices I am aware of in order of increasing power are the Laser Comb ($295 – $545), the iGrow laser ($695), Theradome ($895), and the Capillus Laser Cap ($799 – $3000, depending on which device you buy). (Note: I purchased the Theradome and tried it for 6 months, and did not notice any significant positive effect on my hair growth. See below.)
In my experience, the 80-laser diode Theradome did not help my hair loss. This might mean that either my particular type of hair loss is too aggressive to be affected by a device with only 80 lasers, or that the device itself is of low quality. The 272-diode Capillus Laser Cap did seem to have positive effects on my hair growth, although I also used minoxidil at the same time, so it is not possible to draw any definite conclusions for myself.
There are no known harmful side effects of laser therapy, since the laser is not thought to penetrate through the scalp. Always ask a doctor before trying any laser treatment, however.
So there you have it. If you want to slow down or halt the cause of hair loss at its “roots,” use at least one product that blocks DHT production and at least one product that stimulates hair growth. Finasteride and dutasteride block DHT, but they sometimes give side effects in some men that you need to be aware of. 2% ketoconazole shampoo also seems to reduce the effects of DHT on the hair, but not quite as effectively as the oral medications. Products that seem to stimulate hair growth include minoxidil and low-level laser therapy (LLLT).
If your hair loss is especially aggressive and you want to keep all of your hair, you may want to try a synergistic approach and use all three treatments: finasteride (or dutasteride), minoxidil, and laser therapy.* See My Experience and Recommendation for more suggestions.
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*I am not a doctor. You should always consult a board-certified hair restoration doctor before making any decisions about hair loss treatments. The opinions on this blog are solely those of myself. However, I try my best to develop informed opinions by basing them on the results of clinical studies that I reference here on my website.
Maintaining Hair For Men 