Are you balding? Don’t worry — these days, going bald is optional. It’s really just a matter of finding the right solution for you. People with pattern hair loss can choose from a range of different medications, treatments, supplements, surgeries, and cosmetic solutions.
But if you’re looking for a full on cure for hair loss and balding, scientists aren’t quite there yet. Hair loss treatments are getting better every year, but a true ‘cure’ would mean that we can stop hair loss before it even starts. Doctors can determine the likelihood of you losing hair before you start showing symptoms, but they can’t give you a magic pill or injection to prevent hair loss from occurring.
Why do people lose hair?
Hair loss affects millions of people each year. This problem can be caused by a number of factors, including genetics, stress, diet, hormone imbalances, and immune system issues. Most men struggling with hair loss have androgenic alopecia (male pattern hair loss), a condition caused by a mixture of genetic and hormonal factors.
Androgenic alopecia, which is progressive, is also the most common cause of baldness. According to a study in the Journal of the American Academy of Dermatology, this condition affects 58 percent of men that are over the age of 50, and 73 percent of men over the age of 80.
While pattern hair loss is often associated with older men, young men experience it, too. The American Hair Loss Association says that two-thirds of American men start experiencing hair loss symptoms by the time they’re 35. A quarter of these men start seeing the first signs of androgenic alopecia before they’re 21.
Androgenic alopecia symptoms
Pattern hair loss starts out with easily ignorable symptoms, like hair thinning and excessive hair shedding. People with early-stage hair loss might also notice hair texture changes and hair breakage, or feel like their forehead seems larger.
As androgenic alopecia continues, men start to lose hair around their hairline, temples, and crown. Eventually, hairlines recede, changing their face shape. At the same time, hair stops growing back around the temples and top of the head. Eventually, this condition causes men to lose all the hair along the top of their heads.
Current vs. future hair loss treatments
Hair loss treatments have been around for a few decades. People have been able to counteract hair loss and regrow their hair since 1987. According to Statpearls Publishing, this was when minoxidil solution was approved and became the first androgenic alopecia treatment.
Current treatment options for androgenic alopecia
People struggling with hair loss can choose from a bunch of different options. These include nutraceutical supplements and hair products, prescription-only drugs, hair transplants, and clinic-based treatments. At the moment, there are only three options approved as androgenic alopecia treatments by the US Food and Drug Administration:
- Minoxidil, a topical vasodilator that’s available as a liquid and foam. It’s sold in concentrations of 2 and 5 percent, with the 5 percent concentration thought to be best for men. Minoxidil is meant to be applied twice a day, in the morning and evening.
- Finasteride, an oral dihydrotestosterone (DHT) blocker. This medication targets the hormonal component of androgenic alopecia. Men are meant to take this prescription-only drug in 1 milligram doses each day.
- Low-level laser therapy (LLLT), a biostimulatory light therapy treatment. LLLT devices include combs, brushes, caps, helmets, headbands, and hoods. Each device has its own optimal treatment protocol, but most require between 45 and 105 minutes of use per week. It’s possible to buy your own device to use at home or go into a clinic for light therapy treatments.
But of course, this doesn’t mean that these are the only treatments that work for pattern hair loss. A variety of other solutions are in the research pipeline. And a handful of them are available at clinics or as off-label hair loss treatment options. Realistically, the immediate future of hair loss treatments will likely involve many of the off-label and alternative solutions that have recently been developed for androgenic alopecia.
Clinic-based hair loss treatments
Platelet-rich plasma (PRP) therapy and microneedling are two hair loss treatments that are usually performed by trained professionals at a medical or aesthetics clinic. While microneedling can also be done at home, PRP treatments can only be done by a medical professional.
Microneedling is a procedure that applies a device (usually a dermapen or dermaroller) to the scalp in order to stimulate hair follicles and release beneficial growth factors. When combined with other topical treatments, it can help improve the delivery of the drug or nutrient to the hair follicles, too.
PRP involves taking a small amount of a person’s blood and spinning it down so that the platelet-rich portion is isolated. The platelet-rich blood, which is also rich in various growth factors, is then injected into the scalp to stimulate hair follicles.
Both microneedling and PRP treatments may be performed on their own or combined with FDA-approved treatments. According to a study in the Aesthetic Plastic Surgery journal, microneedling and PRP may even be combined with one another. PRP can also be combined with hair transplantation procedures and fat grafting (an alternative method used to promote hair regrowth).
What awaits us in the future of hair regrowth?
Hair regrowth treatments are an evolving science, just like cancer research, Covid-19 vaccine development, and any other scientific investigation. And like with other medical conditions, countries have researched and approved different treatment options for androgenic alopecia. This means that the ‘future treatments’ we can expect in the USA might already be readily available in other countries, and vice versa.
For example, a DHT blocking medication called dutasteride is approved for the treatment of androgenic alopecia in Japan and South Korea. This drug is also used in the USA and other countries, but at the moment, it’s only approved for the treatment of prostate problems. While it might be prescribed as a hair loss treatment off-label, this drug is likely at the forefront of future hair treatments since it’s already proven to be effective in other countries.
Other novel hair loss treatments we can expect in the next few years include:
- Use of pills, lotions, and creams with powerful nutraceutical ingredients as stand-alone solutions to regrow hair. While these all-natural solutions are generally weaker than medications for hair loss, they have been shown to help regrow hair and may even be free of side effects.
- Use of non-invasive drug delivery systems to enhance topical hair loss treatment’s effectiveness.
- Repurposing and optimizing existing dermatological drugs, like ketoconazole, and cosmetic procedures, like microneedling, to enhance hair regrowth.
- Creating alternative formulations of the same drugs (like finasteride lotion instead of finasteride pills) to reduce side effects and improve effectiveness in stimulating hair regrowth.
- Combining multiple treatments (particularly ones that work in different ways) in order to simultaneously combat various factors that can cause hair loss.
From finasteride lotion to hair loss shampoos, many of these treatments have already been assessed in clinical trials. While more research is needed, studies on these novel solutions have generally reported positive results.
In fact, some of these treatment options are already being manufactured and sold. Just be aware that this doesn’t mean that they are FDA-approved (or considered to be approved hair loss treatments in any other country).
Alternative hair loss treatments
A variety of alternative androgenic alopecia products are readily available. Although they are unapproved as ‘official’ hair loss treatments, they’re usually made for other purposes and are generally considered to be safe. These include options like:
- Saw palmetto and other natural DHT blockers. These nutraceutical ingredients are infused into supplements, shampoos, lotions, and other hair care products.
- Antioxidants, vitamins, and minerals. These are also incorporated into products like multivitamins, shampoos, lotions, oils, and other similar products.
- Medicated shampoos with ingredients like ketoconazole, piroctone olamine, and zinc pyrithione, which are used to help treat scalp issues like dandruff, psoriasis, and fungal infections. A study published in the International Journal of Cosmetic Science reported that these ingredients can help improve the scalp microbiome and support healthier hair growth.
At the moment, the vast majority of these are considered to be adjuvant hair loss treatments. This means that they’re meant to be used alongside minoxidil, finasteride, and LLLT in order to improve hair regrowth results. That being said, some of these options could be approved as stand-alone hair loss treatments in the near future.
Surgical hair loss treatments
The most invasive hair loss treatment you can opt for is a hair transplant. This solution is optimal for people who have allowed their symptoms to progress to later-stage hair loss.
Hair transplants have already evolved quite a lot in the last few decades. The first people who received transplants ended up getting a procedure that’s now referred to as hair plugs. According to the book Hair, An Issue of Dermatologic Clinics, these hair transplants involved transplanting circular punches of skin. Although they grew hair successfully, they were a complete cosmetic failure as the hair ended up looking like the circular tufts dolls have on their heads.
Fortunately, the hair plugs style of hair transplant is no longer performed. Hair transplant surgeons generally offer one of two procedures: FUE (follicular unit extraction) or FUT (follicular unit transplantation).
FUE is the newer and more challenging type of hair transplant. It involves the extraction and transplantation of individual follicular units. FUT involves the surgical extraction of a strip of skin, from which follicles are then removed and transplanted. While FUT has a high success rate, the procedure can be somewhat unappealing as it leaves a huge scar.
It’s also not unusual for FUE and FUT to be done simultaneously. This can be a particularly good option for people with extensive hair loss. A study from the journal Hair Transplant Forum International also reported that performing both of these procedures might be the best way to counteract hair loss.
This study reported that hair transplants were most effective when people first had FUT, then had FUE. If this is the case, future surgical hair loss treatments will ideally allow for these optimized results but reduce the post-procedure scarring FUT currently involves.
Keep in mind that while FUE and FUT can help counteract the effects of pattern hair loss, they aren’t really treatments or cures. If you get one or both of these surgeries in your 20s or 30s, you’ll likely need another later on in life.
Stem cell-based hair loss treatments
In the near future, hair loss transplants could also be combined with other types of transplants. Rather than just transplanting hair follicles, surgeons might also transplant stem cells to help regenerate hair follicles. A review in the journal CellR4 Repair Replace Regen Reprogram also mentioned the potential of transplanting stem cell-derived conditioned medium and stem cell-derived exosomes.
Stem cell-derived conditioned medium focuses on growth factors and other bioactive molecules that can help regulate the hair growth cycle and stimulate hair regrowth. While studies so far are promising and seem safe, creating solutions with the same levels of growth factors and other molecules can be challenging to replicate.
Exosomes are the tiniest extracellular vesicles found in stem cells. They are thought to act as messengers for bioactive molecules. Studies on stem cell-derived exosomes have shown great promise during pre-clinical testing, but have yet to reach clinical testing for hair growth.
Historically, stem cell research has been somewhat limited. Stem cell-derived conditioned medium and stem cell-derived exosomes are both interesting alternatives to stem cell transplantation because they don’t actually involve whole cells. Because of this, they could be considered cheaper, less restricted procedures and cause fewer side effects.
So far, both the transplantation of stem cells and stem cell-derived conditioned medium seem successful at enhancing hair growth. Although the research on these transplant procedures is still in the early stages, this review reported findings like:
- Faster hair growth
- Increased hair density
- Thicker hair diameter
- Improvements to scalp skin
Unfortunately, for now, stem cell transplantation remains experimental and fairly costly. And while using stem cell-derived conditioned medium and stem cell-derived exosomes might be cheaper and safer, the procedures used to isolate them haven’t yet been optimized. All three of these procedures (transplantation of stem cells, stem cell-derived conditioned medium, and stem cell-derived exosomes) will need to undergo more clinical trials before they can be combined with existing hair transplant procedures.
In the future of hair loss, is a cure in sight?
Androgenic alopecia is caused by a mixture of hormonal and genetic factors. In order to stop this type of hair loss before it starts causing symptoms, the truth is that you’d have to hack your genes.
Before you go saying that’s impossible, gene editing has already existed for a few decades. And in fact, a study published in the Biomaterials journal has already been looking into using CRISPR (a gene editing technology) to counteract androgenic alopecia.
However, there are two problems: Right now, CRISPR is still a fairly new technology. Because of this, it’s generally reserved for life threatening diseases. The other issue is that while it almost certainly can work for androgenic alopecia, the Biomaterials study only showed proof of concept… and that was in mice. It’s still not really known how well this treatment would work, what side effects it could cause, and if it could truly be considered a ‘cure’.
Unfortunately, this means that in the future (at least, the near future), baldness will still exist. With any luck, a cure might not be too far off. But for the moment, it’s likely best to hedge your bets on combining FDA-approved treatment, like minoxidil, with a doctor-recommended adjuvant product or procedure, like platelet-rich plasma therapy.
