Men and Hair Loss: What Are the Options?

It may seem a peculiar American vanity that men have in-boxes full of hair loss treatment offers and spend billions of dollars on hair loss treatments each year. Not so. As Gersh Kuntzman illustrates in his book Hair! Mankind's Historic Quest to End Baldness, chrome-dome anxiety has tormented us for ages. Caesar's laurel wreaths? Classic red herring, Kuntzman says.

Baldness is biblical, too -- from the Maccabees to Samson and Delilah (a story Kuntzman calls "practically a commercial for Propecia") -- the Old Testament is littered with hair loss. If there'd been email back then, it's a good bet Elijah would be agonizing over whether or not to Buy Rogaine Online Now.

For as long as men have been fretting over their expanding foreheads, they've been scrounging for hair loss treatments. From hippo fat pomades to the urine of young foals, history is full of just-so-crazy-they-might-work concoctions. They didn’t work. And a quick Googling reveals that most of the products and services marketed today are only slightly less absurd.

In reality, there’s a very limited number of effective treatments for male pattern baldness. Given that two-thirds of American men will experience a significant level of thinning by the age of 35, it's worth running through the options.

The pill to prevent hair loss

Looking for a pill to keep from going bald? Finasteride, known more commonly as Propecia, is taken daily in 1 mg doses. Because it works by lowering dihydrotestosterone (DHT) levels, it’s assumed it can reduce hair loss for a majority of men. It also often achieves a measure of regrowth.

"I recommend that everyone [with any hair loss] take finasteride," says Robert M. Bernstein, MD. Bernstein is associate clinical professor of dermatology at Columbia University and founder of the Bernstein Medical Center for Hair Restoration. "To patients who are younger,” he says, “I also recommend minoxidil. But the mainstay is finasteride. The data show that, over five years, it significantly retards hair loss in 85% of users."

Both finasteride and minoxidil, the only other FDA-approved hair loss product (most commonly marketed as Rogaine), require a commitment. Stop either of these hair loss treatments and your progress vanishes. Within months, you'll lose whatever hair you managed to retain or grow back.

Finasteride does have potential sexual side effects. A very small percentage of men experience decreases in libido and other problems, but this is rare and generally temporary.