written by ADAM HURLY
Hair loss is a heavy thing to face. Your hair is a major source of your identity, and losing it can feel like a loss of youth or self-identity. A lot of us can embrace hair loss and accept a thinning crown or receding hairline. These lucky guys are indifferent to the sands of time or perhaps happy to be bald and save money on barber appointments. I am not one of these men, and many of you reading this are in the same camp as me. We want our hair. And watching it slowly recede, gradually but prominently, well...that’s got to stop.
There’s no shame in letting it go, but there’s plenty of glory in preserving it, too.
Let’s home in on hair recession for now. That is to say, the hairline that moves back from your forehead, as opposed to a more general, universal thinning all around the crown of the head. These two things are different hair loss types, believe it or not, so they need to be addressed separately.
We spoke with two hair experts for professional insight on how to prevent and treat a receding hairline. They are Penny James, Trichologist IAT, IoT, and founder of Penny James Salon in New York City and Ryan Turner, MD, board-certified dermatologist at Turner Dermatology in New York City. Here are their tips for keeping your hairline locked.
How to Prevent a Receding Hairline
When it comes to hair loss, recession is different than general thinning—particularly in its ability to regrow. “The scalp produces two types of hair growth and deterioration,” James notes. “The crown area has proven to respond very well to treatment, but the frontal area of the hairline is difficult to grow new hair.” You cannot restore the hairs that have receded, but you can prevent future loss.
Preventing a receding hairline might begin at the first signs of recession or years into the experience (to prevent it from going even further back). There is no correct time to start taking preventative measures (besides living a healthy life) since everyone’s predisposition to hair loss and recession is different.
“Hair recession can be caused by genetic predisposition, hormonal influences, and aging,” says Turner. “Certain areas of the scalp are affected differently by androgen hormones such as dihydrotestosterone (DHT) leading to hair recession and eventual male pattern hair loss.” If (and when) your body kicks this process into high gear will vary from everyone else’s case. So, if it hasn’t started receding yet, pay close attention to your hairline and act accordingly when it starts to budge. It never hurts to meet with a trichologist or dermatologist in the meantime to understand which of the following steps is good for you and when.
Consult with Your Doctor About Taking Finasteride
Finasteride is the generic form of Propecia. “It blocks the enzyme called 5-alpha-reductase, which converts testosterone to DHT,” says James. In higher doses, finasteride is used to treat prostate issues, but it is prescribed for hair loss in 1 mg daily doses. Since DHT is the primary culprit for shriveling up your hair follicles, finasteride nearly eliminates rapid hair loss. (As you age, you will still experience loss, but far less drastically if you use finasteride.)
But because finasteride comes with some major warnings, you can only have it prescribed by your dermatologist. “Anyone using finasteride should consult with their physicians about potential side effects of this medication resulting from the significant decrease of a potent male hormone,” says Turner. One infrequent side effect can be the loss of sex drive or even the ability to get erections. And secondly, as James points out, ceasing your finasteride intake will cause hair loss to continue at its original, natural rate. So, once you start, you should plan on continuing it, barring any side effects.
Consider Minoxidil, Too
Minoxidil, the generic of Rogaine, is available over the counter. Essentially, this topical solution (and sometimes oral supplement) increases blood flow and nutrient delivery to the hair follicles, keeping them stronger and healthier as long as you use the drug. It is especially effective on the crown of the head and can even revive dormant follicles (those that have failed to produce hair for as long as a year or more) and can, in turn, prevent them from drying up forever. This is why, after about 6 months of using minoxidil, you’ll notice your hair is thicker around the crown. That’s because your individual hairs are stronger and fuller, but also because you’ve likely revived a bunch of dormant follicles before it was too late.
“Minoxidil will increase the duration of anagen stage (the growth stage of each hair follicle),” says James. She adds this warning: “For the first few weeks of using minoxidil, you will experience a small amount of shedding. This is called telogen release. It is normal and will subside within three weeks.”
When used preventatively against hair recession, minoxidil can have the same impact: It can keep hairs stronger and delay recession. However, like finasteride, it cannot restore any hairs lost to recession. “No robust studies have determined the efficacy of minoxidil to the receding hairline,” says Turner. “But we understand it to have some efficacy there [in preventing loss] by increasing blood flow to the area.”
Typically, men should use the 5% topical solution, while women should only use 2% options.
Prioritize Saw Palmetto
If you want a natural approach to preventing hair loss, then James recommends saw palmetto. It can be found in some shampoos and conditioners and can also be taken as a vitamin supplement. “Studies have shown that this herb reduces the production of DHT from testosterone very similar to finasteride,” she notes. “Combined with topical minoxidil, it can be very beneficial.”
While studies can’t prove that saw palmetto is as potent against hair loss as finasteride, the results lean towards favorable. One study summarized an examination of 34 men and 28 women (18-48 years) with topical saw palmetto extract via lotions and shampoos for three months. This application “led to 35% increase in hair density and 67% increase in sebum reduction.”
Maintain a Healthy Lifestyle
It will come as no surprise that leading a healthy, active lifestyle will also significantly benefit your hairline. “Stress reduction is an important component to managing hair loss,” says Turner. Stress can come from bad behaviors, like smoking, drug use, alcohol consumption, high sugar intake, poor rest, dehydration, malnutrition, and more. You can even consider adding hair-friendly supplements to your regimen, many of which even target hair growth specifically.
“Most of us are depleted in vitamin D,” James points out. “Vitamin D has proven to be very beneficial in helping with hair loss and strengthening hair. So are B-complex vitamins, which contribute to hair density and quality of the hair shaft.” And that’s to name a few. Turner adds Biotin to the roster of good supplements (along with saw palmetto) since it can fortify hair and help it grow faster and stronger. He also tells his patients about the potential benefits of essential oil application: “Peppermint oil has some limited data that it may stimulate hair growth by increasing blood flow to the area. In addition, rosemary oil, lavender oil, and tea tree oil have limited evidence as natural options to help regrow hair for those looking for alternative options.”
Get Familiar with PRP and LLLT
PRP and LLLT are two next-level methods used to keep hair strong. They stand for Plasma-Rich Platelets and Low-Level Laser Therapy, both of which are worth inquiring about with your doctor.
With PRP, a blood sample is extracted from the patient’s arm, and then it is placed in a centrifuge to separate the plasma from the blood. “Plasma contains certain proteins and growth factors that may help cellular repair and regrowth of hair follicles,” Turner says. This is why the plasma is then injected around the head to jumpstart hair follicles and boost hair’s growth and strength.
Then there is LLLT. “Low-level laser therapy is an emerging method to treat hair loss, as it may stimulate cellular regrowth and improve blood circulation,” Turner says.
These technologies, along with other emerging techniques, can evolve quickly. They’re often quite expensive, too. So, it’s important to speak with your doctor about effective treatments that work for you.
How to Treat a Receding Hairline
We’ve said it once, but it bears repeating: The hair lost through recession is not restorable through pills, supplements, lasers, injections, or topical remedies. Once the hairline recedes, the follicles that existed in front of that new hairline will dry up and cease to produce new hair, even if you treat them like you would the rest of the scalp.
You can often restore the hairs on your crown—those lost in recent year(s) that still have a dormant, living follicle—but science has yet to understand the distinction between these two types of losses. However, Turner offers a sharp perspective on the matter and suggests that many of us act too late on hair recession instead of paying closer attention to our crowns' density. So perhaps, at the first sign of hair recession, it’s not too late if you act quickly: “The issue is that the receding hairline often happens first, and many years pass and the hair follicles go completely dormant and may scar down permanently, so there is no potential for regrowth [at the hair line]. Whereas the crown may happen later, men seek treatment, and there is still time to reactivate the hair follicles before permanent loss.”
Consider a Hair Transplant (Yes, Really)
Regardless of the matter, the best way to treat a receding hairline is to prevent the recession altogether.
Because if it’s gone, then the only way to fill that hairline back in is a hair transplant. And don’t let that scare you—transplants are much more effective (and extremely realistic) these days, as opposed to the plugs of the past. Doctors can now implant hairs uniformly, densely, and at the proper angle of growth. They can also do so without leaving any scar tissue from the donor site (the rear of your head). While hair transplants can be expensive in the US, they’re much more cost-friendly (and every bit as effective) if you get them overseas. (I got mine in Turkey; shout-out to Dr. Serkan Aygin Clinic.)
And since they take the hairs from the rear of your head—hair that is not genetically designed to recede, thin, and fall out—the effects are lasting. Though, be warned: You will need to keep taking other proactive measures, like finasteride and minoxidil, to keep the rest of your hair full and strong.
The Final Word
When it comes to hair loss—specifically hair recession—the best offense is a good defense. Stay proactive, and talk to your board-certified dermatologist now about your own specific scenario. They can prescribe or recommend the best methods for you. A certified trichologist can also make these same recommendations and advise on natural dietary and lifestyle best practices.
