In our last update we featured a highly effective evidenced based approach to treating hair loss that just happened to be “Natural.” I personally could care less if a hair loss treatment happens to be a drug produced by the pharma industry, or a plant extract or topical animal fat used by indigenous peoples as long as there is reasonable evidence it works and it is side effect free. I don’t get caught up in the semantic distinction between “Drugs” and “Natural” treatments. Our recommendations are purely based on what works, and more specifically what works without the risks of long term health or quality of life consequences.

      My personal regime is almost exclusively “Natural,” and gives results not only in terms of hair density restoration, but multiple cross over health anti-aging benefits as well. My treatment protocol in many ways doubles as an anti-aging regime. I didn’t design it as such –it just happens to be that way. The only pharmaceutical I have used in my regime since I dropped Proscar/ Propecia in 2004, is Nizoral Shampoo. Despite the concerns of some purists about the potential for the systemic absorption of its active ingredient , ketoconazole, I will continue to use it, because there is solid evidence it helps with hair loss, and virtually no evidence suggesting problematic side effects, at least in its shampoo form. Having said that, I wouldn’t touch Propecia with a ten foot pole, because there is a growing body of evidence of associated and possibly permanent neurological, cognitive deficits associated with its usage.

      There are however, many, who unlike me, feel that only pharmaceuticals prescribed by doctors work- and the good news is that at least some of them in combination actually do. If I, as a male were to use a purely pharmaceutical approach to treating hair loss, I would use the following approach that would pose a relatively lower risk for potential side effects and to maximize effectiveness.

Nizoral Shampoo– 3 times a week

Piroctone Olamine Shampoo, ( such as Follicure para Caspa)- 3 times a week

Finasteride,(Propecia/Proscar)– 1.25 mg (1/4 tablet of Proscar) daily

Low Dose Dutasteride, (Avodart)– .5mg – only once a week

Australas J Dermatol. 2013 Feb;54(1):49-51. doi: 10.1111/j.1440-0960.2012.00909.x. Epub 2012 Jun 12.
Combination therapy with finasteride and low-dose dutasteride in the treatment of androgenetic alopecia.
Boyapati A, Sinclair R.


Department of Dermatology, St Vincent’s Hospital Melbourne, Victoria, Australia.


We report on a 47-year-old man who was initially treated with finasteride for androgenetic alopecia. Despite continuous treatment, after year 4 his hair density was not as good as at year 2, and low-dose dutasteride at .5 mg/week was added to the finasteride therapy. This resulted in a dramatic increase in his hair density, demonstrating that combined therapy with finasteride and dutasteride can improve hair density in patients already taking finasteride.

Comment: Women could do exactly the same thing, and even include 50-100 mg of Spironolactone for an added effect.

      There are stronger pharmaceutical drugs one could take, ie Spironolactone at 400 mg plus, Flutamide, Cyproterone Acetate that would bring faster, and more thorough hair growth results. However if Breast Cancer, Chemical Castration, and ultimately gender reassignment aren’t your thing, we recommend steering clear of these.

      A glaring omission from our pharmaceutical recommendations is Rogaine, due to its limited effectiveness and immense and disproportionate amount of shedding it causes upon discontinuation of usage. This oft reported phenomena was published in the medical literature.

Post Rogaine Shed Documented in Archives of Dermatology

      Then there are those who strike a balance and manage the side effects of these drugs with the concurrent usage of natural compounds, some of which actually have additional hair growth properties of their own. More information on that here: Propecia: The Pros, Cons, and Alternatives

      To be clear –I am not recommending anyone use pharmaceutical drugs outside of Nizoral Shampoo, to treat hair loss. The risks for side effects ( particularly neurological deficits and aggressive forms of prostate cancer) is clearly there, and more significantly, they are not necessary and/or as effective as several well documented, patented treatments that are health promoting and considered to be “natural.”

Propecia Linked with Infertility, Avodart causes Erectile Dysfunction in 100% of Rats.

Effects of Propecia documented to be Permanent 

PROPECIA: Disturbing Implications for Stress Management, OCD, and Substance Abuse