Analysis of Hair Loss Treatments: The Verdicts

As I discuss in a previous post, it is important to be skeptical of the numerous “treatments” for male pattern hair loss that are available on the market, and to only invest in treatments that are supported by science.  Otherwise, you will be wasting your money and will experience no positive results.  In this post, I will examine a number of products and treatments and assign a “verdict” to each one, indicating whether they have been demonstrated to be effective or not.  This list continues to grow, as I become aware of new products on the market.  If there are any you don’t see here, feel free to suggest one.

Image from www.stacaravansgids.nl.
Image from http://www.stacaravansgids.nl.

A good philosophy to have when evaluating hair growth products is “guilty until proven innocent.”  In other words, unless and until sufficient studies and clinical trials demonstrate the effectiveness of a treatment on male pattern baldness specifically, one should remain skeptical of that treatment.  So without further ado, here are some of the treatments for hair loss out there and whether or not they are effective for male pattern baldness:

The Good: Backed by Science

For the scientific papers supporting these treatments, see this post.

Finasteride (includes Propecia and Proscar)
Minoxidil (includes Rogaine)
Ketoconazole 2% Shampoo
Low-level laser therapy (LLLT)
Dutasteride (includes Avodart)
Topical Finasteride (see this study.)


The (Probably) Effective: Backed by Some Promising Scientific Studies So Far

Viviscal (Supplements).  Studies have shown that Viviscal improved hair growth in both women and men who were experiencing thinning hair (also see here).  Thus, it does seem to have some effectiveness, but more testing needs to be done, in my opinion.

Plasma-Rich Platelet (PRP) Therapy.  This is a surgical treatment that must be done at a hair restoration clinic.  While it is still in the early stages of testing, some studies have shown that it has an effect on hair growth in men experiencing male pattern hair loss (see here and here, for example).  This procedure is expensive (on the order of $1000 per injection), however, and requires multiple injections over time (every 1 -2 years).

The Possible: May Have a Mild Positive Effect, but Still Largely Untested

Alpecin Caffeine Shampoo.  Some studies have shown that it has a positive effect on hair growth, but its overall effectiveness and ability to slow or stop male pattern baldness is unknown and probably insufficient.  See this post for more information.

Cimetidine (Oral Medication).  A study has shown that it is effective against female pattern baldness (see here), but it has not been tested on male pattern baldness.

Flutamide (Oral Medication).  Studies have shown that this antiandrogen can mildly improve hair loss in women (see here), but it has not been tested for its effectiveness against male pattern baldness.

Niacin.  Definitely helps promote hair growth in females experiencing androgenetic hair loss, but no studies have been done showing that it helps male pattern baldness.

Spironolactone (Oral Medication).  Studies have shown that this antiandrogen can stop or reverse hair loss in women (see here, for example), but it has not been tested for its effectiveness against male pattern baldness.


The Ineffective: May Help Hair in Other Ways, but Won’t Stop Male Pattern Baldness
(In Alphabetical Order)

Biotin.  May help with general hair growth, but no clinical trials have been conducted that show it can effectively counter male pattern baldness (as this study points out).  Biotin deficiency could be a cause of hair loss in some cases (paper), but if the cause of hair loss in a specific case is male pattern baldness, there is no established evidence biotin can help.  Biotin does seem to have some good reviews by users on WebMD, however.

Castor Oil.  Untested on male pattern baldness, but may have anti-inflammatory properties.

“DHT-Blocking” Shampoos or Topical Formulas.  May contain some good ingredients that combat DHT, but no studies have shown specifically that the shampoos can effectively and consistently lower DHT levels to the extent that would slow or stop male pattern baldness (in contrast to ketoconazole, which blocks DHT and has been shown to counter male pattern baldness.  See above).

Folicure.  Does not appear to contain ingredients that block DHT.  Even if it did contain such ingredients, it would fall under the same category as DHT-Blocking Shampoos: its ability to reduce DHT to the extent that male pattern baldness is slowed or stopped has not been tested.

Hairomega (Supplements).  Contains some ingredients such as niacin and saw palmetto, neither of which have been proven to significantly counteract hair loss in men (see above and below).

Nanogen Hair Growth Factor (or Serum).  Does not contain ingredients that counter DHT, the cause of hair loss in men.  More importantly, it has not been tested independently for effectiveness against male pattern baldness.  It may help thicken hair in other ways.

Nizoral 1%.  Contains 1% ketoconazole, similar to Regenepure.  While Nizoral 1% has been shown to reduce shedding, it does not increase hair density in those experiencing male pattern baldness.  The concentration that helps with male pattern baldness is 2%.

Regenepure. Contains 1% ketoconazole, which slightly reduces DHT and is good for shedding, but does not increase hair density in men with male pattern baldness.

Revivogen Scalp Therapy & Shampoo.  Falls under the category of DHT-Blocking Shampoos & Formulas: hasn’t been tested enough.  In addition, the reviews on Amazon.com are mixed.

Saw Palmetto.  A study showed that 320 mg/day of saw palmetto reduced prostate DHT levels by 32% after six months.  (Finasteride reduced DHT by 80% in the study.)  However, saw palmetto did not reduce blood levels of DHT.   Thus, it is questionable whether or not it would have any effect on male pattern baldness.