Finasteride

A pharmaceutical company reportedly sought to find the smallest effective quantity of finasteride and test its long-term effects on 1,553 men between ages 18 and 41 with mild to moderate thinning hair. Based on their research, 1 mg. daily was selected, and after two years of daily treatment, over 83% of the 1,553 men experiencing male hair loss had actually maintained or increased their hair count from baseline. Visual assessments concluded that over 80% had improved appearances.

Minoxidil

Minoxidil was first used in tablet form as a medicine to treat high blood pressure, but it was noticed that some patients being treated with Minoxidil experienced excessive hair growth (hypertrichosis) as a side-effect. Further research showed that by applying topical Minoxidil solution directly to the scalp, it could prove to be beneficial to those experiencing hair loss.

FDA clinical trials showed that 65% of men with androgenetic alopecia maintained or increased their hair count from the use of minoxidil 5% in liquid form. 54% of these men experienced moderate to dense regrowth and 46% experienced hair loss stabilisation and mild regrowth.

In controlled clinical studies of women aged 18-45, two out of three women with moderate degrees of hereditary hair loss reported re-growth after using 2% minoxidil. Initial results occur at four months with maximum results occurring at eight months.

Low-level laser therapy

A low level laser is shone directly on the scalp to stimulate hair growth through "Photo-Biostimulation" of the hair follicles. One product of these low level laser therapies is the "Hairmax Lasercomb". There is no peer-reviewed evidence to support this claim. There is some debate over the FDA's acknowledgment of the Lasercomb, but it has been accepted by the FDA as effective in the submitted claims. The Lasercomb was cleared by the FDA as being Substantially Equivalent (SE) to predicate devices legally marketed before May 28, 1978. This clearance is not the same as approval because it only applies to the lasercomb and not to any other similar laser based hair devices. The devices that the lasercomb proved itself equivalent to were a variety of FDA approved laser based/non hair growth devices intended for hair removal and pain relief, and two non FDA approved non laser based/hair growth devices such as the Raydo & Wonder Brush and the Vacuum Cap. These last two devices were sold in the early 1900's and are well established as medical quackery, but they were legal to market at the time which does satisfy the FDA's 510k SE criteria. The 510k number for the Lasercomb is K060305.

The Leimo laser was recently approved by the TGA (Therapeutic Goods Administration) of Australia as a Class IIa Medical Device. It was approved for safety but not for efficacy of results. The company is advertising that this unit is TGA approved to grow hair, which is false. The TGA advertising board is now investigating all advertising that relates to Leimo Lasers.

Surgery

Surgery is another method of reversing hair loss and baldness, although it may be considered an extreme measure. The surgical methods used include hair transplantation, whereby hair-producing follicles are taken from the back and sides of the head and injected into bald or thinning areas.

Hair multiplication

Looking forward, the prospective treatment of hair multiplication/hair cloning, which extracts self-replenishing follicle stem cells, multiplies them many times over in the lab, and microinjects them into the scalp, has been shown to work in mice, and is currently under development, expected by some scientists to be available to the public in 2009–2015. Subsequent versions of the treatment are expected by some scientists to be able to cause these follicle stem cells to simply signal the surrounding hair follicles to rejuvenate. See Baldness treatments

In October 2006, UK biotechnology firm Intercytex announced they have successfully tested a method of removing hair follicles from the back of the neck, multiplying them and then reimplanting the cells into the scalp (Hair multiplication). The initial testing resulted in 70% of male patients regrowing hair. This treatment method is expected to be available to the public by 2009.

In January 2007, Italian stem-cell researchers say they've come up with a new technique for curing baldness. Pierluigi Santi of a Genoa clinic said stem cells could be used to "multiply" hair roots. He said the clinic would be ready to perform its first hair transplants on priority patients - those who have lost their hair in fires or other accidents - within a few months. After that, he said, "we'll open our doors to paying customers". Santi's approach works by splitting roots and growing new follicles.[citation needed]

Ketoconazole

Topical application of ketoconazole, which is both an anti-fungal and a potent 5-alpha reductase inhibitor, is often used as a supplement to other approaches.

Unsaturated fatty acids

Particular unsaturated fatty acids such as gamma linolenic acid are 5 alpha reductase inhibitors if taken internally.

Exercise

Regular aerobic exercise can help keep androgen levels (particularly free testosterone levels) naturally lower while maintaining overall health, lowering stress and increasing SHBG.

Weight training without aerobic exercise may increase testosterone. One study suggests that both heavy exercise and increased fat intake, in combination, are required for increased free testosterone in strength trainers. Increased total or free testosterone would help them build and repair muscle, but may cause susceptible individuals to lose hair.

However, there is at least one study that indicates a decline in free testosterone combined with an increase in strength due to an (unspecified) strength training regime.

Stress reduction

Stress reduction can be helpful in slowing hair loss.

Immunosuppressants

Immunosuppressants applied to the scalp have been shown to temporarily reverse alopecia areata, though the side effects of some of these drugs make such therapy questionable.

Saw palmetto

Saw Palmetto (Serenoa repens) is an herbal DHT inhibitor often claimed to be cheaper and have fewer side effects than finasteride and dutasteride. Unlike other 5alpha-reductase inhibitors, Serenoa repens induces its effects without interfering with the cellular capacity to secrete PSA. Saw palmetto extract has been demonstrated to inhibit both isoforms of 5-alpha-reductase unlike finasteride which only inhibits the (predominant) type 2 isoenzyme of 5-alpha-reductase.

Polygonum multiflorum

Polygonum Multiflorum is a traditional Chinese cure for hair loss. P. multiflorum contains stilbene glycosides similar to resveratrol.

Beta sitosterol

Beta sitosterol, which is a constituent in many seed oils, can help to treat BHP by lowering cholesterol. If used for this purpose, an extract is best. Consuming large amounts of oil to get at small quantities of beta sitosterol is likely to exacerbate male pattern baldness.

Anti-androgens

While drastic, broad spectrum anti-androgens such as flutamide are sometimes used topically. Flutamide is potent enough to have a feminizing effect in men, including growth of the breasts.

Hedgehog agonists

Through 2006, a drug development company spent $1,000,000 on a hair growth program focused on the potential development of a topical hedgehog agonist for hair growth disorders such as male pattern baldness and female hair loss. The hair loss research program was shut down in May 2007 because the process did not meet the proper safety standards.

WNT gene related

In May 2007, US company Follica Inc, announced they have licensed technology from the University of Pennsylvania which can regenerate hair follicles by reawakening genes which were once active only in the embryo stage of human development.

Coffee Beans

A spray made with coffee beans is on sale in certain Pharmacies. It is claimed to prevent age-related hair loss in women.