Updated: Dec 11, 2020
How much do you really know about hair loss and treatments for it?
There are, unfortunately, many people who are experiencing hair loss that know little-to-none about it. Just like most things in life, knowledge is key, and in order to achieve success in overcoming hair loss you need to first understand how it works so that you can determine which treatments are going to be effective for you. But getting a grasp of hair loss is no easy feat.
Unfortunately, there is a lot of misinformation about hair loss, and especially in regards to the treatments. With hair loss being one of the world’s most common conditions, it can be hard to navigate through the immense amount of information surrounding it, and even harder to determine which information is trustworthy or not.
The best benchmark we have for legit information is the scientific evidence that it has to back it. Research that is published through accredited sources is pretty much the only way to determine the validity of information and claims.
The purpose of this article is going to be to compile a list, based solely on research, of hair loss treatments and their effectiveness. The list is going to be divided by category (i.e. DHT blockers, blood flow enhancers, etc.) and treatments will be ranked based on how effective scientifically published research has shown them to be. The threshold that I will be using is that the treatment must have at least three studies conducted on it, both of which show similar results.
Any treatment without three studies is likely either relatively new (meaning it’s also unproven) or there wasn’t enough evidence in the preliminary study to warrant a second/third. The purpose of the threshold is to ensure that the list only contains relatively consistent and proven treatments.
Pretty self-explanatory, this category includes any treatment that works to block dihydrotestosterone: the most important aspect of overcoming hair loss.
Dutasteride is a 5-alpha reductase (5-AR) inhibitor. By blocking the enzyme 5-AR (both type 1 and type 2) dutasteride suppresses the number of conversions of testosterone into DHT. Studies have shown that dutasteride blocks upwards of 90+% of DHT, making it the most powerful DHT blocking agent we have available.
Finasteride is also a 5-AR inhibitor, although it only blocks type 2. Finasteride is also quite effective at blocking conversions of testosterone into DHT, but not quite as effective as dutasteride which is why it is at number two. Studies show that finasteride is capable of blocking about 70% of DHT (when taken at the standard 5mg dose).
Most people believe that saw palmetto is the most well-studied plant for hair loss, but it is actually nettle leaf (saw palmetto has hardly been researched). It has been shown in studies to potentially block 5-AR. As to how effective it is scientists have not yet determined and exact number, but nonetheless it is likely beneficial for blocking DHT.
Last on the DHT list is pumpkin seed oil. Studies have shown that it can reduce DHT, possibly by inhibiting 5-AR, although that is only speculative up to this point.
Blood flow enhancers
A close second in importance for overcoming hair loss is improving blood flow. DHT blockers work to stop hair loss from progressing, while blood flow enhancers work to regrow hair that has been lost. Blood contains vital oxygen and nutrients that hair uses to grow.
Minoxidil is a vasodilator, meaning it helps open (dilate) blood vessels, therefore improving blood flow. It is the top of the line in terms of effectiveness at re-growing hair. Studies have shown it to increase density and terminal hair count in about 62% of men that use it.
Scalp massages work differently than minoxidil. Instead of dilating your blood vessels through medication, you are instead dilating them through mechanical stimulation. Studies have shown scalp massages to effectively increase hair thickness and growth rate, but there are not enough solid numbers to put it above minoxidil.
Scientists have still not confirmed the exact mechanism by which LLLT regrows hair, but it is one of only three FDA approved treatments. It is third on the list due to the mechanism of action being unknown, although one of the popular theories is that it increases blood flow via. nitric oxide release.
Rosemary has had multiple studies conducted for its hair loss benefits. In fact, in one study it was tested directly against minoxidil and outperformed it. This is why many people refer to it as a natural vasodilator, but researchers have yet to confirm exactly how it helps hair loss. Nonetheless it has been shown to benefit it.
DHT blocking and blood flow are the two most important factors to consider when overcoming hair loss. But, there are a couple of treatments that have been proven to help hair loss, albeit they don’t fall under any specific category of mechanism of action.
Ketoconazole has several benefits for the scalp that can help improve hair loss. Studies have shown that it can help control dandruff by killing harmful microbes, reduce inflammation, and balance scalp sebum (oil) levels, all of which can help create a healthy environment for improving hair density.
RU58841 helps to reduce the effects of DHT, but not by blocking it. When using RU, the DHT levels in the body are going to likely remain the same. Studies have shown that RU instead blocks the DHT receptors in the hair, thus preventing DHT from binding to the hair. RU is second on the list because the rights to it were shelved meaning no studies have been conducted for a long time.
As far as available research goes, these treatments are the cream of the crop. Any treatment that has sufficient research to back it is much more trustworthy than those without. If you want the best chance of overcoming hair loss your best bet is to pick from this list, ideally in descending order from most proven to least proven.