The Best Hair Loss Treatment Options, From Pills to Lasers
The earlier you get ahead of hair loss, the better—but you need to build a sustainable, informed routine.
by Adam Hurly
July 19, 2024
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If you want to have your thickest possible hair, then it’s important to know the best hair loss treatment options. And that’s not just for the guys who have lost noticeable amounts of hair; hair loss treatments can also help you get ahead of thinning and recession, so even full-follicled 20-somethings should start sooner than later.
This knowledge can also help separate the real solutions from the hollow promises (like “hair loss shampoo”—that one’s kind of a crock). It’s entirely possible to stop hair loss and see significant regrowth, but it takes patience, dedication, and an awareness of your specific needs. That’s because the best hair loss treatment for you may differ from the next guy.
And remember: While diet and a low-stress life play major roles in your hair’s health, they aren’t enough to stop genetics and Father Time from taking your hairline. So, in addition to making healthy lifestyle choices, consider the following meaningful hair loss solutions as well.
What Causes Male Pattern Hair Loss?
The treatment options below really focus on addressing male-pattern hair loss, or androgenetic alopecia. There are many other types of hair loss out there, so please consult with your dermatologist about the appropriate treatment options available for your specific case, including any male-pattern shedding.
Genetics and Ethnicity
As for the cause of men’s hair loss: It comes for all of us—but how fast and intensely it happens is what boils down to genetics. Plenty of studies exist that prove every guy experiences androgenetic hair loss to some degree. (Here’s one such study.) I find it fascinating that ethnicity is one key factor, as outlined in that study; white men have the earliest odds of going bald, for example. And one study noted that 31% of Australian men were fully bald between ages 40-55 (without intervention), increasing to 53% of men between ages 65-69.
Hormone levels
As for genetics, the speed at which you lose your hair is often tied to your hormone levels, and the rate at which your body produces androgens, such as the testosterone byproduct called dihydrotestosterone, or DHT, which creates an imbalance in your follicles’ growth cycle and ultimately shrivels them up. This is what many hair loss treatments aim to fight—either by countering DHT or by fortifying the follicles and their growth cycle, to get ahead of this imbalancing act. (It really is a lot more nuanced and complicated than explained here, but I am trying to simplify these terms, for everyone’s ease of understanding!)
Lifestyle factors
All of that said, a number of lifestyle factors can also expedite one’s predisposition to hair loss. In general, minimizing all forms of stress on your body and mind is the best way to keep all of your superficials looking their best—from hair health to acne mitigation to general complexion and skin resilience.
But stress isn’t just when we feel anxious or upset about something. It can come from environmental factors, like city pollution, as well as things like alcohol intake, cigarette smoking, and drug abuse. I even consider eating highly processed and sugary foods as part of this—it’s a form of stress put on your system that can disrupt the body’s natural course. And look, you can still pull the occasional all-nighter and down a bottle of wine with your friends while shoving Pizza Hut and Haribo down your throat. But take audit of this stuff, and try to focus on the obvious “wellness pillars” like staying well hydrated, sleeping 7-8 hours nightly, minimizing emotional stress, and letting these factors overwhelmingly outnumber the times you let loose. It would be counterproductive to build a hair loss routine with the below pills and potions, expecting great results, but then halving the potential because you chain smoke or only get 5 hours of sleep every night.
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What to Expect from Hair Loss Treatments (And When to Get Started)
Now let’s touch on the timeline for hair regrowth and what you can expect, largely based on how soon you intervene. Which brings me to the most important bit of advice…
1. The sooner, the better: If you start taking hair loss treatments before you see severe loss (and continue taking them) you may never have to worry about losing your hair.
2. It’s a commitment: If you choose to use hair loss medicines, know that you have to take these forever in order to maintain results. Maybe stem cells or some magic hair-saving vaccine will change that in the future, but this is our reality for now. If you think “forever” feels too unrealistic, you can always try them out for half a year and change your mind later, but at least you made the effort. Give them 3-4 months to show light improvement, since you are resurrecting dormant follicles after all. You should have noticeably impressive results by month 6 or 7.
3. Don’t kid yourself: If you’re trying to recover lost hair, be realistic about what you can revive. Generally, you cannot restore anything lost to recession, but most guys are able to bring back hair lost in the last couple years around the crown, as well as further strengthen the hairs up top there. Any follicles left dormant for more than a couple years are likely shriveled up forever. Sorry.
Oral and Topical Hair Loss Treatments
Currently the only real and affordable way to lock in your hair as it is now—and to revive recently lost hair—is the pair of hair loss medicines, minoxidil and finasteride. You can take them both or choose one. They take different approaches to help restore hair and prevent loss, though.
Minoxidil as a Hair Loss Treatment
Minoxidil works by improving circulation and nutrient delivery to your hairs, and is better for overall hair density. Topical minoxidil is the generic for Rogaine. Oral minoxidil is the generic for Loniten, which in larger doses is a treatment for high blood pressure.
You can get topical minoxidil over the counter (men should take 5% for hair thinning, as opposed to 2% for female pattern hair loss unless advised otherwise). Oral minoxidil is usually just obtained through your doctor (and monitored by them), because of its other prescriptive uses.
Oral minoxidil can also increase hair growth all over the body—personally, I think it’s probably one of your best odds for improving facial hair density as a side bonus, too, but only if you are predestined for it. Still, most doctors I’m interviewing lately tend to agree that oral minoxidil is the gold standard hair loss treatment for alopecia areata (male pattern hair loss); while its results are mostly congruent with topical options, it’s less messy and won’t impact your hair style, given that the serum and foam options with topical solutions can be a pain.
Finasteride as a Hair Loss Treatment
Finasteride counters the hormonal byproducts that shrink hair follicles, and while it works for general thinning, it is best for anyone who is experiencing or preventing hairline recession. Oral finasteride is the generic for Propecia.
Topical finasteride is increasing in popularity lately, given that oral finasteride can cause some sexual side effects (like loss of libido or difficulty getting hard in 1-2% of cases; this is usually reversible but a fraction of men have permanent side effects). So it’s no shock as to why the topical option is increasingly preferred, since it doesn’t circulate the drug throughout the body like the oral option. (Here’s one study that proves its efficacy and lowered risks.)
Still, you’ll need a prescription for either form of finasteride. Also, watch the market for more and more instances of dutasteride, which is seemingly more effective alternative to finasteride (albeit with similar risks).
Best Brands for Minoxidil and Finasteride
The below telemedicine sites can prescribe topical and oral solutions for hair loss after you first schedule a consultation with their on-staff dermatologists. They’ll deliver directly to your door, too.
Ro | Hims | XYON | Keeps | Happy Head
You can also get medicines direct from your dermatologist, if you have a good cadence with him/her and can get regular refills. I do find that the automation from the above brands is often worth not having to navigate the overbooked dermo office (not to mention, co-pay fees).
I’ll do a deeper dive on these brands later on; I think each one offers something that the others don’t. I appreciate how easy it is to get oral minoxidil from both Ro and Hims right now, but I also enjoy that most of these brands make a hybrid topical option that allows you to get both drugs at once, with a single application each day.
Before Taking Hair Loss Drugs…
Please don’t start using minoxidil or finasteride without reading more about both drugs. (Links above and below to my overview on each.) Remember, finasteride is originally a drug to treat enlarged prostates, and minoxidil is a blood pressure drug. So, while they are dosed low and carefully for cosmetic reasons, you still need to be informed about what you’re taking, and potential risks.
Also, please have a board-certified dermatologist supervise any oral finasteride use because, as I mentioned, a small percentage of users will experience sexual side effects (usually these go away once you discontinue use, but not always).
Hair Growth Supplements
I think of hair loss supplements as exactly that: Supplements. These should be the secondary effort in your hair growth plan, behind the medicinal efforts outlined above. I know a lot of guys who prefer not to incorporate finasteride into their routine, so a supplement is a great way to get some of those same DHT-reducing benefits from targeted ingredients, while pinning much of the lifting on minoxidil.
A majority of supplements that promise to help you grow your hair are probably just going to overdose you on biotin and let you think that the hairs are growing thicker and staying anchored longer. I’m fairly skeptical about most supplements that promise actual hair loss reversal or hair retention, with a few key exceptions.
There is one brand whose supplements I trust far above the others—Nutrafol—because they have the muscle to do research, source quality ingredients, and pack it all into this potent little pill. But Nutrafol is also quite expensive—like $80ish a month.
I’m in the habit of curating my own hair growth supplements based on the research suggesting follicle fortification (and mimicking what it is I like about Nutrafol). I think the best three supplements to consider include saw palmetto and pumpkin seed oil (which prevent that hormonal byproduct DHT from shrinking your follicles) as well as the adaptogen ashwagandha (to help the body resist stress and inflammation).
Read more about the best hair growth supplements for men, where I also recommend options for the above three ingredients (saw palmetto, pumpkin seed oil, and ashwagandha). However, while it’s still a cost-effective approach to supplementation, it’s also common to get subpar supplements, and becomes tedious as you manage three separate supplements for each day’s intake. By that point, maybe it does just make more sense to go with the ol’ reliable Nutrafol.
Laser Hair Loss Treatments and Plasma Injections
There are also lasers (LLLT, or low-level laser therapy), and plasma injections (PRP, or platelet-rich plasma), which I often group together because they started as clinical treatments. These are both next-level options for guys who need more muscle behind their efforts (and have the money to burn). I have done both as part of my work, and while I can vouch for both in terms of efficacy, I can also vouch for their high prices. So for most people, I think it’s smart to stay dedicated to oral and topical solutions.
LLLT / Low-Level Laser Therapy
With laser therapy for hair loss, the lasers stimulate cell growth in the follicles. Lately, it’s becoming more common to find at-home LLLT alternatives in the form of laser and LED caps. These can be anywhere from a few hundred bucks to $6000 (LED options are usually less expensive and less effective than laser ones), but considering in-clinic LLLT treatments can cost hundreds or more, it can be a money-saving measure if you use them daily. They won’t be as powerful as clinical options, but the daily use and accessibility goes a long way.
Learn more about low-level laser therapy for hair loss, and the best at-home laser and LED methods.
PRP / Platelet-Rich Plasma
With plasma treatments for hair loss, the doctor will draw your blood and then put it into a centrifuge to separate out the plasma. Your plasma has growth factors that, when injected into your scalp, give your follicles this insane kick to boost that cellular growth. PRP is used for other cosmetic treatments, since it can significantly improve collagen production when injected into skin.
Consider Hair Transplants
Hey, hair transplants look great these days, too—that’s another thing I can vouch for firsthand. And my partner too; we both went to Dr. Serkan Aygin Clinic in Istanbul, Turkey, if you were wondering. (They were nice to give me a referral link; if you go to them and use that link to initiate the process—with no commitment—they give me a nice little referral bonus, which I’d be grateful for! And if you want to see our hair results, check out the GQ article I wrote about our experiences, with before and after images.)
The hair transplant is one of my favorite grooming topics to discuss too, because it can be life changing in terms of the confidence boost. But don’t count on them as a last resort, because the less hair you have to work with, the less optimal the results. Remember: The sooner you act, the more hair you save. And, if you do choose to get a hair transplant, you need to be well-invested in a hair retention routine already, and plan to stick with it in perpetuity. Otherwise, you’ll be looking like a Franciscan monk in about 5 years’ time.
Going Bald Ain’t Bad
Lastly: Let’s not act like it’s a bad thing to go bald. You’d be in good company. All my bald relatives and friends tell me that it’s a freeing experience, too, and one that builds a lot of confidence (plus, maybe you’ll be hot without hair—there’s one way to find out).
I’m too deep in the hair retention game to ever experience this, but I do envy bald guys for these aspects. Maybe the envy goes both ways—at least I’ll tell myself that with each day’s finasteride and minoxidil dose.
So, Which Hair Loss Treatment Is Best?
If I had to pinpoint one best hair loss treatment universally, I would say oral minoxidil—echoing most dermatologists I work with. That’s because oral minoxidil provides high efficacy with a lowered level of risks. (Not to mention, its affordability, if you can get your dermatologist to prescribe some.) Still, many docs would vote for topical finasteride or a compound topical treatment of both drugs—and I’d agree with them, that this is a perfect approach for most men. Again, you can schedule a telemedicine appointment with any of the below sites, and their on-staff dermatologists can prescribe the best treatments for you.
Ro | Hims | XYON | Keeps | Happy Head
Still, what’s best for one guy isn’t necessarily going to be best for the next guy—particularly in terms of how we all react differently to medicines, or just because your unique genetics and hair loss patterns are different from everyone else’s. So, my advice is to visit your board-certified dermatologist and discuss those hair loss patterns, as well as the best potential solutions.
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