Everyday Health Q&A: Hair Loss Treatments
Keith Kantor, PhD, ND, Trichologist
Prepared for Everyday Health
Hair loss is one of those issues where people often wait too long because they hope it will fix itself.
Sometimes shedding is temporary, but true pattern thinning usually needs a plan. My approach is to first
determine why the hair is thinning, then build a treatment plan that protects the follicles that are still alive
and supports healthier new growth. Hair restoration is not about one product. The best outcomes come
from finding the reason the hair is thinning, treating that cause early, and supporting the follicle before it
is too far gone.
What are the most effective hair loss treatments on the market today (types, not brand names)?
The most effective treatments are usually the ones that match the cause of the hair loss. For hereditary or
hormonal hair thinning, the main categories are topical growth stimulators, oral medications that reduce
the hormonal attack on the follicle, regenerative treatments such as platelet-rich plasma or stem-
cell/exosome-based therapies, low-level light therapy, and hair transplantation when the follicle is no
longer active. I do not look at this as one magic product. In my opinion, the best results usually come
from a multi-phase approach: slow or block the cause of miniaturization, wake up weaker follicles where
possible, support the scalp environment, and correct nutritional or stress-related issues that may be
making the shedding worse.
Can hair loss really be reversed?
Sometimes, yes — but it depends on the type and how long it has been going on. If the follicle is still alive
but weakened or miniaturized, improvement is very possible. If someone has temporary shedding from
stress, illness, medication changes, postpartum shifts, poor nutrition, or rapid weight loss, that can often
improve once the trigger is corrected. But if the follicle is completely gone and the scalp is smooth and
shiny, that area is much harder to reverse without transplant surgery. That is why early treatment matters.
My biggest message to patients is: do not wait until the follicle is dead before you take hair loss seriously.
Can hair loss really be reversed?
Sometimes, yes — but it depends on the type and how long it has been going on. If the follicle is still alive
but weakened or miniaturized, improvement is very possible. If someone has temporary shedding from
stress, illness, medication changes, postpartum shifts, poor nutrition, or rapid weight loss, that can often
improve once the trigger is corrected. But if the follicle is completely gone and the scalp is smooth and
shiny, that area is much harder to reverse without transplant surgery. That is why early treatment matters.
My biggest message to patients is: do not wait until the follicle is dead before you take hair loss seriously.
How long do treatments like minoxidil take to start working?
Most people should think in months, not weeks. With minoxidil, I usually tell patients they may start
noticing less shedding or early signs of improvement around three to four months, but the more
meaningful cosmetic improvement is often closer to six months and sometimes up to a year. Hair grows
slowly, so taking pictures under the same lighting every month is more useful than checking the mirror
every day. Some people also notice a temporary increase in shedding early on, which can happen as
older hairs cycle out and follicles move into a new growth phase. The minoxidil I am speaking about here
is the prescription strength (10%). I use the 5% just to stimulate blood flow and assist the stem cells.
What happens when you stop using hair loss treatments like minoxidil?
When you stop minoxidil, you usually lose the benefit it was providing. The hairs that were being
supported by the treatment can gradually shed over the next several months, and the hair may return to
where it would have been without treatment. That does not mean minoxidil is addictive; it means hair loss
is often a chronic process. If the underlying trigger is still present — such as genetics, DHT sensitivity,
inflammation, stress, or nutrient deficiency — stopping the support allows the process to continue.
What's useful about ordering hair loss treatments online, and what might patients be missing out on by not seeing an expert in person?
Online ordering can be useful because it is convenient, private, and sometimes helps people start earlier
instead of doing nothing. The problem is that hair loss is not all the same. A patient may think they have
male or female pattern hair loss when they actually have thyroid issues, low iron, autoimmune hair loss,
medication-related shedding, scalp inflammation, traction alopecia, or stress-related telogen effluvium.
An in-person expert can examine the scalp, look at the pattern, check for miniaturization, review medical
history, ask about weight loss drugs or rapid dieting, and decide whether labs or a dermatology referral
are needed. Online care can be a doorway, but it should not replace a real evaluation when the diagnosis
is uncertain or the loss is progressing quickly.
Do you recommend serums, pills, or a combination of both, and why?
For many patients, a combination works better than one product alone because hair loss usually has
more than one driver. A topical serum can support the follicle locally and may have fewer whole-body
effects. A pill may be more convenient and can address systemic hormonal factors, but it also may carry
more systemic side effects. I do not believe every patient needs the same program. A younger man with
clear DHT-driven thinning may need a different plan than a woman shedding after stress, menopause,
low ferritin, thyroid changes, or rapid weight loss. My preference is to combine therapies carefully when
the benefits outweigh the risks, rather than throwing everything at the patient without a diagnosis. At
ReGen Therapeutics I use a combination of amniotic mesenchymal (embryonic) stem cells, natural non-
prescription DHT blockers, and natural supplements to improve scalp/follicle health.
What side effects can one expect from taking minoxidil vs. finasteride?
Topical minoxidil can cause scalp irritation, itching, dryness, flaking, or unwanted hair growth if it runs
onto the face. Oral minoxidil, which some clinicians use off-label for hair loss, can cause fluid retention,
ankle swelling, dizziness, headaches, faster heart rate, palpitations, or unwanted hair growth on the face
or body. Finasteride works differently because it lowers DHT. It can help slow male pattern hair loss, but
possible side effects include decreased libido, erectile dysfunction, reduced semen volume, breast
tenderness or enlargement, mood changes, and rarely persistent sexual or mood-related symptoms after
stopping. Women who are or may become pregnant should not handle crushed or broken finasteride
tablets because of risk to a male fetus. This is exactly why the risk-benefit conversation matters before
starting treatment. At ReGen Therapeutics I do not use any prescription strength medicines because of
side effects.
Are natural supplements for hair loss actually worth taking?
They can be worth taking when they correct a real deficiency or support a patient who is nutritionally
depleted, but they are not a cure-all. If someone is low in iron, vitamin D, zinc, protein, essential fatty
acids, or B vitamins, correcting that may improve shedding and hair quality. But taking random hair
vitamins when you are not deficient usually will not overcome strong genetic hair loss. I also warn
patients that rapid weight loss, crash dieting, and even popular GLP-1 weight loss programs can be
associated with shedding if the person is not getting enough protein and micronutrients or if the body
experiences the weight loss as a stressor. Supplements are best used as part of a complete plan, not as a
substitute for diagnosis and treatment.
Quick clinical notes / sources checked
- The American Academy of Dermatology and Mayo Clinic describe diagnosis as important because treatment depends on the type and cause of hair loss.
- Minoxidil and finasteride are widely used evidence-based treatments for androgenetic hair loss. Other options include low-level laser therapy, PRP, and hair transplantation.
- Mayo Clinic notes that low-level laser devices have FDA clearance/approval for hereditary hair loss, although more long-term evidence is needed.
- Finasteride labeling includes sexual side effects and pregnancy-related handling warnings. Recent FDA communication also warned about risks reported with some compounded topical finasteride products.
- Topical minoxidil commonly causes local irritation. Oral minoxidil is used off-label by some clinicians and may cause cardiovascular or fluid-retention side effects.