Broadly, hair loss treatments come in two forms: oral and topical. Oral hair loss treatments include natural dietary supplements such as saw palmetto and biotin as well as prescription pills like finasteride. Topical treatments are applied to the scalp directly. In this article, we take a look at the best topical hair loss treatments.
Spironolactone is usually prescribed in pill form for its anti-androgenic properties. And while these effects are too strong to make the oral form a practical hair loss treatment, the topical version is much less likely to cause side effects.
As you may know, male pattern hair loss – androgenetic alopecia – is primarily caused by the hormone dihydrotestosterone (DHT).
DHT binds to hormone receptors in the hair follicle. Over time, this causes the follicle to shrink until it stops producing hair.
But spironolactone prevents DHT from binding to the hormone receptors. In theory, this would stop hair loss from progressing.
However, there is limited evidence to support the efficacy of topical spironolactone for hair loss.
It has been shown to be moderately effective for acne – a related condition – but there have been no trials of its effects on hair loss. Some users online have reported improvements in their hair with topical spironolactone but there are more effective topical anti-androgens out there.
4. Azelaic acid
Azelaic acid is an organic compound found in wheat, rye, and several types of grass. It’s also present in small amounts in human skin.
It has anti-inflammatory effects. And inflammation is commonly associated with many types of hair loss.
But that’s not the best part. Studies suggest azelaic acid is a potent 5 alpha-reductase inhibitor.
5-alpha reductase is what converts testosterone to the far more potent – and damaging for hair – DHT. So as an inhibitor of this enzyme, azelaic acid effectively reduces DHT levels in the area where it is applied. In theory, this could stop – or even reverse – male pattern hair loss.
However, it’s important to point out that these effects have only been observed in vitro – i.e. not on live human hair follicles.
Even so, it’s a promising finding. What’s more, many hair loss sufferers online report improvements in hair growth from using azelaic acid. For more information, check out this article for more info on azelaic acid for hair loss.
RU58841 is a research chemical that has been trialled for a number of androgen related conditions – among them, male pattern hair loss.
And it’s been shown to be very effective.
This study – admittedly conducted on macaques and not humans – “revealed a potent increase in density, thickening, and length of hair in the macaque model of androgenetic alopecia, whereas no systemic effects were detected.”
It’s not just the one study either. RU58841 has been shown to be a very powerful anti-androgen when applied topically. Not only that, plenty of hair loss sufferers online have experienced hair regrowth with this compound – and posted results photos too!
Sounds great, right? Well, there are a few downsides.
First off, a number of RU58841 users report side effects, suggesting the drug can be absorbed systemically. This means RU58841 could have effects elsewhere in the body besides the scalp.
Second, not everyone experiences the same kind of regrowth seen in the photos above.
But possibly the biggest drawback is that it is not approved to treat any medical conditions – including hair loss. You can’t just get a prescription from your doctor or pick it up at your local pharmacy.
And while it is still possible to acquire RU58841, it is classified as a research chemical. This means you have to buy the powder separately and create your own RU58841 solution. But this means little guarantee of safety, quality, or dosage – unless you know what you’re doing.
Still interested? Find out more about RU58841.
2. Ketoconazole shampoo
Without doubt the best shampoo for male pattern hair loss.
Ketoconazole – an ingredient used in shampoo brands such as Nizoral – is touted for its ability to improve dandruff.
But it’s also an effective treatment for androgenetic alopecia.
First off, it has antifungal properties. Ketoconazole tackles the Malassezia fungus, reducing inflammation along with the itchy feeling that commonly accompanies male pattern hair loss.
But most importantly, ketoconazole has been shown to improve hair count and thickness in a number of controlled medical studies. Furthermore, there is some evidence to suggest that it also disrupts the DHT pathways in the scalp too.
By itself, though, ketoconazole is unlikely to be strong enough to stop hair loss completely.
The only topical treatment approved by the FDA to treat hair loss.
You may know it as Rogaine, but minoxidil is the active ingredient that is clinically proven to regrow hair.
First approved by the FDA in 1988, the patent for minoxidil expired in 1996, allowing other manufacturers to produce their own minoxidil-based hair loss treatments.
Unlike the other products on this list, though, minoxidil doesn’t work by reducing DHT. The exact mechanism of action is unknown, but minoxidil has been proven to be effective. In fact, its so effective that it can even grow hair elsewhere on the body – for example the beard area.
And while drugs that reduce DHT levels – such as finasteride and dutasteride – are effective at maintaining hair, minoxidil is the most effective for regrowth.
However, it is important to stay on top of the underlying hormonal – DHT – or hair loss will continue.
When used together, though, this multi-angle approach – minoxidil for regrowth and finasteride for maintenance – is highly effective.