Hair loss can occur in both men and women for a variety of reasons: stress, hormones, diet, health or hereditary conditions. The American Academy of Dermatology recommends washing your hair with a shampoo as often as once a day depending on your hair or scalp type.

Choosing a shampoo may be a matter of personal preference. The type of shampoo that works for you may not work for someone else. Determining the underlying cause of your hair loss, as well as having a trial-and-error approach to the types of shampoos and products you use, can make a difference.

Here, we take a look at the available scientific data and studies to determine which shampoo ingredients are the most effective for hair loss.

Minoxidil

Topical Minoxidil is the only topical treatment option for male-pattern and female-pattern hair loss recognized by the FDA. It has shown effectiveness and a good safety profile in clinical trials. In Singapore, Topical Minoxidil is available over-the-counter, without a prescription as a lotion with concentrations of 2%, 3% or 5%. The foam formulation at a concentration of 5% is also available here.

In male-pattern hair loss, current evidence supports the higher concentration of Minoxidil 5% compared with Minoxidil 2%. In female-pattern hair loss, it was found that there was no difference in effect between Minoxidil 2% and Minoxidil 5%; hence a lower concentration is often recommended in women to minimize the side effects of Minoxidil.

Minoxidil 5% foam formulation, unlike Minoxidil lotion, is free of propylene glycol, an ingredient that can potentially irritate the skin. As the most common side effect of Topical Minoxidil is an itchy scalp at the application area, Minoxidil 5% foam formulation may be a good alternative to circumvent side effects experienced with the use of the traditional lotion formulation.

Topical Minoxidil found in hair products is to be used as a scalp treatment and not a hair treatment. It should be applied daily to the affected areas on a dry scalp, exactly as prescribed for maximum benefit.

It is also important to understand that patience is required in hair regrowth. Hair shedding may occur at the initiation of treatment with Topical Minoxidil and usually decreases within two months. It has to be used daily for at least four months for potential visible results to be seen, and it would take a full year of dedicated treatment to determine the effectiveness of the product.

Finasteride (DHT-blocker)

You may find Topical Finasteride available at specialized clinics in Singapore. Finasteride works by lowering DHT levels in the body, allowing hair to regenerate. Multiple studies have shown that Topical Finasteride can be effective with a favourable safety profile, but more research is still needed to determine the exact concentration that is safe and effective. To err on the side of caution, always speak to your doctors.

DHT-Blocker shampoo ingredients (found in Singapore)

There are many shampoo ingredients in the market claiming to be “natural DHT-blockers”. Here, we explore a few notable ones and the evidence supporting their use.

Caffeine

Studies have shown that caffeine blocks DHT in hair follicles and extends the life cycle of hair follicles, allowing more hair to grow. Caffeine is also a stimulant – it increases blood circulation to hair follicles, helping hair to grow faster and stronger. However, few studies have been done to establish the use of caffeine alone in the treatment for hair loss. More studies are also required to determine the concentration of caffeine that is effective and safe in the treatment of hair loss.

Rosemary Oil

Of the many nutrients and oils claiming to work as natural DHT blockers, rosemary oil has one of the best supporting evidence. A research study done in 2015 found that men with male-pattern hair loss who applied rosemary oil to their scalp twice daily for six months had the same increase in hair thickness as those who used minoxidil. However, this is just one study with a small number of 50 men in the study, more studies are still required to establish its role in the treatment of hair loss.

Saw palmetto extract

Saw palmetto is an extract from the berries of the Serenoa repens dwarf tree, used by Native Americans as medicine and food for hundreds of years. Animal studies have shown the potential of Saw palmetto extract to block DHT, significantly encouraging follicle growth and reduce inflammatory damage to hair follicles. However, research on whether Saw palmetto works to treat hair loss in humans have not been fully established.

Ketoconazole

Ketoconazole is an anti-fungal medication that is approved by the FDA to treat skin fungal infections. Common uses for ketoconazole shampoo include treating fungal infections, reducing dandruff and providing relief from skin conditions such as psoriasis. 

Several studies have found that ketoconazole shampoo might help slow the effects of male-pattern baldness and stimulate hair growth. However, the how and why ketoconazole works to stimulate hair growth has not been fully understood.

Can a shampoo save your hair loss?

Shampoo ingredients listed as natural DHT blockers may be worth trying as a preventive measure or in addition to medical treatments for hair loss in early stages of common balding for a potential additive effect. 

However, it is unlikely to make a difference in more advanced stages of hair thinning. 

When dealing with hair loss, always consult a doctor to address your issue head-on before starting on shampoo treatments containing medicated ingredients like Minoxidil, Finasteride or Ketoconazole. 

Whether or not hair loss shampoos work, there is one truth that cannot be avoided: hair loss shampoo ingredients work locally on the scalp and hence the concentration of tissue uptake is lesser as compared to oral intake.

The question now is why not make some of these ingredients in a pill form. There are some ingredients that you can take orally: vitamins such as vitamins B1, B6 and B12, Biotin or zinc, but there are others such as ketoconazole that you can’t take orally. 

Ketoconazole is not specifically designed for oral intake for hair loss, and instead is used for other medical conditions. When taken orally, it can stress the liver.

Furthermore, vitamin- or mineral-infused shampoos’ effectiveness in reversing hair loss has not been proven.

Are Korean shampoos better for hair loss? Find out here.

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