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Battling Baldness: Shampoos, Drugs, and More

Medically reviewed by Steven N. Gange, MDSusan Kerrigan, MD and Marianne Madsen on January 28, 2023

Most people aren’t happy about hair loss. Sure, some beat nature to the punch with a shaved head but the “chrome-dome” look isn’t for everyone. One out of four men start losing their hair before they turn 21. Adults can lose up to one hundred strands of hair every day, but if you’re starting to notice more forehead than hairline, there are products that promise to supercharge hair growth. However, nothing currently on the market succeeds at arresting the hair-loss process. 


If you’re losing your hair, you aren’t alone. By the time they celebrate their 35th birthday, roughly two-thirds of all men have lost some hair. Around 95% of male hair loss sufferers have androgenic alopecia––commonly called male pattern baldness. Women suffer as well, with around half reporting that they have lost some hair by the time they turn 50. Unfortunately, they face a unique problem since many of the products on the market were created for men and often cause unpleasant side effects in women. However, for those battling baldness, here’s some information about shampoos, drugs, and more. 


Washing Your Way to Better Hair


The notion that you can solve your hair loss problems during a regular morning ritual is an enticing one. Perhaps surprisingly, the consistent advice to those losing their hair is to shampoo less often––no more than every other day. This is especially true for anyone with curly or thick hair. If possible, it’s important not to use anti-dandruff shampoo since this can also dry out thicker hair. Generally speaking, daily shampooing can damage the follicles, accelerating hair loss. 


Further, check your shampoo bottle to make sure it doesn’t contain sulfates. This additive tends to dry out your hair which increases breakage and even hair loss. Yes, it’s ironic that shampoo manufacturers would use an additive that could reduce their customers’ need for the product. However, some medical studies suggest this may be inaccurate. These studies indicate that a mild shampoo can actually counteract hair loss by making it easier to brush or comb. Regardless, regular conditioning is recommended.  


To promote hair growth, there are several natural remedies available.

Shampoos formulated with pumpkin seed oil may reduce production of dihydrotestosterone (DHT) which San Antonio, Texas, dermatologist Dr. Milton R. Moore says can cause miniaturization of hair follicles and even inhibit growth. Plus, pumpkin seed oil contains zinc and Vitamin E––substances that reduce inflammation while accelerating the flow of blood to hair follicles. Another recommended natural additive is saw palmetto, a popular treatment for male pattern baldness that can also inhibit DHT production. 


Of course these products don’t need to be found in shampoo to work. One study in 2014 found that, when taken as a supplement, pumpkin seed oil promotes hair growth. A similar study the next year on the effects of saw palmetto (or Serenoa repens) found the same thing. Keep in mind that just because a product is natural doesn’t imply that it’s safe. Any substance can cause side effects or interact with current medications. Consulting with a healthcare professional is often the best bet before adding supplements to your daily regimen. 


Pills Might Help


You can always tell the drugs that have an outsized impact and widespread popularity. They’re the ones more often referred to by their brand name. Rogaine, the granddaddy of hair loss drugs, is clearly in that camp. Otherwise known as minoxidil, this treatment was released to the public in 1988. It was originally prescribed for high blood pressure, but it’s now marketed as a treatment for male pattern baldness because hair growth is its common side effect. To this day no one is certain exactly how it works, but over 40 percent of people who use it report some hair growth. Today it is available without a prescription and considered safe for women as well as men. 


Once used as a prostate treatment, Finasteride, better known by the brand name Propecia, was released in the early 1990s as a hair growth treatment. Although it is very effective at reducing DHT production (up to 90%) and does promote hair growth, some users experience erectile dysfunction and loss of interest in sexual intercourse. It is also not considered safe for women. Finasteride has several side effects, many of which can be troubling. Some common side effects include chills, cold sweats, dizziness, or confusion. Less common side effects include swelling (including of the breast tissues), hives, usual weight gain or loss, runny nose, congestion, sleepiness, back pain, diarrhea, headache, and stomach pain. Talk to your urologist if you notice any of these, or any other, side effects.

Hair-Raising Options


Although hair transplants have long offered hope to hair loss sufferers, like many medical procedures it has evolved and improved in the 21st century. Today it is considered one of the safest, best options to both men and women with male pattern baldness. However, like all surgery there are risks. It can also be difficult harvesting sufficient donor hair with some subjects. 


No one is certain what causes hair loss. Although there are genetic factors, inheritance is not the only explanation. Diet and environment are also factors. One promising drug may help solve the riddle. Although initially approved as a treatment for osteoporosis, in studies it reduced the activity of the protein SFRP1 which stops follicles from growing hair. Identifying the protein and recognizing how the drug inhibited it is considered a huge step forward. Clinical trials are ongoing but the data is promising. In the meantime, there are plenty of treatments. Or you can take a cue from balding director, Ron Howard, and make a baseball cap a regular part of your wardrobe.


Written by John Bankston

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