Comprehensive Treatment Guide for Male Hair Loss

The vast majority of hair loss treatments offered over the internet are ineffective. They are nothing more than commercial nonsense aimed solely at increasing the revenue of the company selling them.

With brand names like Regenepure DR and Neofollics , ordinary products are transformed into “the latest innovation”. Phrases such as This shampoo contains a variety of proven active ingredients that may improve hair growth and inhibit hair loss make it seem like the effectiveness of this product is undisputed.

The reality however is that it’s not. The company obviously knows this and are therefore using terms that suggest efficacy, but don’t mean anything without specific data.

The health claims that are thrown around here and there make it difficult to distinguish between sense and nonsense. In addition, they also get on our nerves.

Purpose

The purpose of this guide is to provide an overview of all treatments that work and those that do not. Readers may consider this guide to be all-inclusive and treatments not included in this guide to be ineffective .

To assess each treatment, we have collected and analyzed multiple scientific studies. A treatment assessed as ineffective, actually is ineffective. This also applies vice versa.

To keep the guide compact and readable, we’ve summarized the analysis for each treatment in just a few sentences. For a complete overview of the research results, you can refer to the attached articles and scientific references.

Medical treatments

Finasteride

A large number of studies are available, 16 of which are placebo-controlled. The quality of the studies is high.

The primary function of finasteride is the prevention of disease progression (stopping hair loss) by reducing the amount of DHT. A dose of 1mg/d provides a DHT reduction of approximately 70%.

In two long-term studies of 10 years, finasteride stopped hair loss in 86% and 99.1% of men. Long-term effectiveness is thus confirmed.

Dutasteride

A large number of studies are available. Quality is high.

The effect of dutasteride is similar to that of finasteride. It reduces the amount of DHT by about 84% at a dosage of 0.5mg/d. Dutasteride is slightly more effective, but the risk of getting side effects is also slightly higher.

Long-term studies are limited. Studies of 1 and 3 years seem to confirm safety and efficacy, but follow-up studies are needed.

Despite its effectiveness, dutasteride is not yet approved as a treatment for hair loss. No argumentation is available as to why .

Minoxidil

Includes a large number of studies, 25 of which are placebo-controlled. Quality of the studies is medium-high.

According to the studies, minoxidil caused an increase in hair growth and hair thickness. The effectiveness was >60%. Peak efficacy was reached after 12 months.

Long term studies show a decrease in effectiveness after 2 to 3 years after which the hair loss process continues, but at a slower rate.

The primary function of minoxidil seems to slow down the hair loss process. Not to stop it. The achieved stabilization during the first 2 years is temporary.

Herbal extracts and preparations

The studies that researched the effectiveness of herbal extracts for treating hair loss are scarce and generally of low quality. Our findings are discussed below.

Saw palmetto

Limited number of studies. A single high quality study dates back to 1996 and examined the effect of Saw Palmetto on BPH (enlarged prostate). Effectiveness as a treatment for hair loss is thus not proven. Quality of other studies is low. Studies with a high risk of bias, small study group, etc.

The ability of Saw Palmetto to reduce scalp-DHT has not been proven. Data does not exist. Saw Palmetto as a treatment for hair loss is unlikely.

Caffeine

Limited number of studies available. Effectiveness of caffeine on the hair follicle studied in laboratory settings only. In vivo studies measured the effectiveness of caffeine using the hair pull test . A non-standardized method that says nothing about the effect on hair loss.

Moreover, the way caffeine is applied in the studies does not correspond to real-life conditions. Penetration and effect of caffeine in the hair follicle has not been measured in vivo ; i.e. living human subjects.

The efficacy of caffeine shampoo as a treatment for hair loss has not been proven.

Ginseng

Limited number of studies. Most studies were done in laboratory settings that do not correspond to real-life conditions. In vivo studies are scarce and have a high degree of subjectivity. Large placebo-controlled studies are lacking. Results are unreliable.

Ginkgo biloboa

Very limited number of studies. Relationship between Ginkgo Biloboa and DHT not investigated. Ginkgo Biloboa as a means to stop hair loss seems thus excluded.

Studies that have examined the effect of Ginko Biloboa for promoting hair growth are of low quality. Objective measuring instruments are lacking. Furthermore, there is no data available on how large the effect is (if any).

Marine extract and silicea component

Very limited number of studies. The study that noted a positive result dates back to 1992. Study has a high risk of bias: small control group and no randomized setting.

Relationship with DHT not investigated. Stopping hair loss seems thus excluded.

Vitamins

Vitamin A

A limited number of studies are available. Relationship with DHT has not been studied. Vitamin A as a means to stop hair loss is unlikely.

The effectiveness of Vitamin A in promoting hair growth has not been proven. High doses of Vitamin A can cause hair loss and thinning. Vitamin A supplementation is not recommended.

Vitamin B

The vitamin B complex includes eight water-soluble vitamins-thiamine (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), vitamin B6, biotin (B7), folate, and vitamin B12.

Vitamin B7 - Biotin

Studies are limited. Biotin is effective for treating hair loss if caused by an inherited enzyme deficiency in biotinidase or holocarboxylase synthetase. A rare genetic disorder occurring in 1:60.000 humans.

Biotin deficiency in the healthy population has never been reported.Reason: about 50% of the required amount of biotin is produced by intestinal bacteria. Therefore, to become biotin deficient is highly unlikely.

Supplementing biotin is not recommended. it’s benefit is limited to those with a rare genetic disorder.

Warning: Supplementing biotin may cause false-low troponin levels, a biomarker for the diagnosis of heart attacks causing such diagnoses to be missed.

Vitamin C

There is no data available on the efficacy of Vitamin C as a treatment for hair loss.

Vitamin D

Some studies are available. Supplementation of vitamin D for the treatment of hair loss was found to be ineffective.

Some studies have measured lower Vit D levels in patients with Alopecia Areata (AA). The relationship is possible, but uncertain. An abnormality in the Vitamin D receptor is speculated.

Alopecia Areata is an autoimmune disease. The low vitamin D levels are probably a consequence of and not a cause.

Vitamin E

Very limited number of studies available. Effectiveness of Vitamin E for the treatment of Androgenetic Alopecia not investigated. Focus of the studies was on the treatment of Alopecia Areata (AA).

Higher values of oxidative stress biomarkers and lower concentration of antioxidants are measured in patients with AA. The possible role of Vitamin E for the treatment for AA is suspected because of its antioxidant properties.

There is no data available showing Vitamin E to be effective for genetic hair loss or Alopecia Areata.

Minerals

Zinc

Only a handful of studies are available. Quality of the studies is low. Small control group, high risk of bias etc.

Severe zinc deficiency can cause hair loss, but is rare. The effectiveness of zinc in the healthy population has not been proven. Data is lacking.

Iron

The number of studies is limited. Iron supplementation in healthy population not investigated. Focus was on iron deficiency.

Iron supplementation in men with AGA had no effect. Iron supplementation in women yields contradictory results. Effectiveness is unclear.

Surgery and laser therapy

Hair transplants

In a hair transplant hair follicles are taken from the donor area and used to create new hairline. The hair follicles are DHT resistant and the new hairline permanent.

The result depends on the expertise of the surgeon. Patient satisfaction is higher in FUE than FUT. For treating hair loss, hair transplantation is useless. It is a repair technique, not a prevention technique.

A hair transplant is therefore ineffective as a treatment for hair loss.

Laser therapy

Studies are limited. The quality of the studies was weak. The manufacturer was sponsor of the study in some studies. Results are therefore unreliable.

The efficacy of low-light laser therapy has not been demonstrated.