Minoxidil Has Long Been the Gold Standard Hair Regrowth Ingredient in the U.S., But New Options Are Gaining Steam

Photo: Stocksy/Caleb MacKenzie Gaskins
In the United States, topical minoxidil is an oft-recommended chemical hair growth ingredient, and it's one of the only approved by the FDA for hair regrowth. Yet, dig a little deeper and you'll see that it's not a silver bullet: There are multiple possible side effects from dizziness and eczema to worsening hair loss. And no matter what, it’s an endless commitment. Once you stop using it, it stops working—and even causes the new growth to shed. Given this, in the past few years, brands have started innovating beyond minoxidil, bringing new, cutting-edge options to the table.

It comes at a fitting time: “There is a definite uptick in hair loss with the pandemic,” says Rita Linkner, MD, a New York City dermatologist. “Stress-related telogen effluvium [temporary hair loss due to a traumatic event] is causing hair loss that is pervasive, but commonly reversible.” To understand hair loss, it might be helpful to take a step back and explain the phases of hair growth, which in broad strokes are anagen, when the hair is growing with the blood supply; catagen, when the hair begins detaching from its life source; telogen, when the follicle rests, or "hibernates"; and exogen, when the hair sheds as the follicle makes room for new growth. With telogen effluvium, this resting cycle kicks in and extends to the point that extreme, sudden shedding—sometimes around 70 percent of hair—occurs weeks or months after a traumatic event.

In years past, the only real option on the market was minoxidil, but given sweeping new technology and changes to hair health behavior, in general, there now are options. Here’s how they stack up.

Experts In This Article
  • Gretchen Friese, hairstylist and certified trichologist based in Colorado

How alt-DHT blockers are gaining steam

One key reason that minoxidil isn't always effective: It's not particularly easy to use and has to be applied to the scalp via either a liquid or a foam, usually twice a day. “Minoxidil is tedious to use, making non-compliance common,” says Dr. Linkner, and non-compliance stirs up the efficacy of any given minoxidil product. “In cases when minoxidil is used and stopped, the new hair growth can fall out, but the hair that was there when you started using the product will still be there,” says Gretchen Friese, a certified trichologist working with BosleyMD on their new range of minoxidil-free options like a Follicle Energizer ($30) designed to penetrate the scalp and “wake up” dormant follicles.

“I prefer oral supplements and protein dietary intake as these measures have proven more efficacy in my personal patient experience,” says Dr. Linkner. Many brands, these days, are doing so by identifying and formulating with DHT (or dihydrotestosterone) blockers. DHT is a hormone that can both shorten the hair growth cycle and shrink the follicle. She recommends Nutrafol ($79), one of the most frequently derm-approved, drug-free options available that is thought to work by blocking DHT. “Nutrafol is a great hair supplement with just the right amount of biotin to avoid acne along with turmeric, ashwagandha, and saw palmetto,” says Dr. Linkner.

Featured in topicals and nutraceuticals alike, saw palmetto, extracted from the fruit of its small palm tree species, is believed to be a DHT blocker. “The herb functions much like finasteride without the hormonal side effects,” she says. Finasteride (the active ingredient in Propecia) is a prescription DHT-blocker typically prescribed to men, as it isn’t safe for pregnant women and can disrupt hormones in all genders. Another option: Hush & Hush Deeply Rooted ($75) contains a mix of actives including horsetail extract, saw palmetto, green tea leaf extract, and pumpkin seed oil, the latter three reportedly considered to naturally block DHT. A study published in the Journal of Cosmetics, Dermatological Sciences and Applications showed that 91 percent of patients who took Hush & Hush supplements saw improved hair growth after three months.

Caffeine-infused formulas, likewise are becoming more popular for their purported ability to block DHT. Friese points out that, “if you stop using the treatment, the follicles won’t necessarily go ‘back to sleep.’ That all being said, it is important to remember that DHT will continue to attack the follicles unless there is something there to fight it.” Vegamour’s much-reviewed Gro Hair Serum ($44) blends caffeine and curcumin in a formula that’s been clinically tested to show up to 52 percent more density and 76 percent less shedding after four months of use. The brand makes it clear that to see optimal results, you should plan for 120 days of consistent use. It’s valuable transparency for consumers who need to gauge real product expense and convenience for the long term.

Utilizing time-tested ingredients

While DHT blockers are one way to help fend off hair loss, other brand creators are turning to long-utilized herbs, seeds, and oils that are currently or will soon be researched in lab studies now that technology has progressed enough to measure their effects. Curcumin, the main component in turmeric, has been found to have natural hair growth capabilities, thanks to its ability to stabilize stress-triggered inflammation in follicles. Meanwhile, topical applications of peppermint oil, rosemary oil, and moringa leaf extract have matched minoxidil in hair growth studies. Ahead of cleansing, Shaz & Kiks Back to Your Roots Scalp + Hair Prewash ($38) is an Ayurvedic-inspired treatment that two sisters packed with over 20 Indian herbs, oils, and flowers like turmeric, moringa, and soybean oil. It can be worn overnight or 20 minutes before washing.

Act + Acre Scalp Renew ($24), applied as a weekly pre-cleanse treatment, exfoliates clogged hair follicles with salicylic acid as peppermint oil promotes growth, and Philip B Peppermint Avocado Scalp Scrub ($58) creates a tingly sensation while removing buildup from products like dry shampoo that can irritate and weaken follicles. DreamGirls True Essence Oil Treatment ($20), which co-founders and hairstylists Tonya Thompson and Sharie Wilson suggest applying to boost circulation and protect edges, blends conditioning soybean and stimulating peppermint oil.

At just $10, My Terra Oils Growth Nectar is infused with moringa and chebe powder. Chebe, a mix of crushed Shébé seeds from croton plants and herbs like clove, is known to fortify strands and is touted as the secret to waist-grazing hair by women in North African countries like Chad and Nigeria. Saffron, a spice notoriously worth more than its weight in gold, is rich in antioxidants believed to repair follicles. According to Joon co-founder Shiva Tavakoli, the line’s Saffron Hair Elixir Oil ($28), inspired by her Persian heritage, has potential. “The ingredient saffron has been used in DIY recipes for alopecia [pattern hair loss] for a long time,” says Tavakoli, who admits that Joon has yet to perform studies on their elixir’s effectiveness. “It does help the health of the hair because it forms a barrier to protect from further environmental damage and hot tools, so this can prevent more hair damage and hair fall,” she notes.

Soybean oil is another surprising alt-treatment, thanks to its derivative polyamine. “Clinical studies have shown that benefits of polyamine are similar to minoxidil,” says Kevin Mun, PhD, VENN Skincare's Chief Scientific Officer. “Polyamine, which is a natural compound, does not involve such side effects, but is actually also great for skin.” The brand’s Synbiotic Polyamine Shampoo ($58) is enriched with probiotics and prebiotics to balance the scalp's microbiome, while Truly Beauty Super Flower Shampoo & Conditioner ($56) offers anti-inflammatory, fatty-acid-rich qualities of hemp oil for its growth formula. And in a clinical trial, Moroccan Gold Series My NuDo Rejuvenating Shampoo ($60), a recipe of caffeine, ginseng root, and argan oil, was found to increase scalp coverage by just over 60 percent after 28 days. Incorporated before conditioning, Maria Nila Head & Hair Heal Mask ($36) harnesses apigenin, the antioxidant found in plants like parsley and chamomile that’s been proven to stimulate hair growth, and Innersense Sweet Spirit Leave In Conditioner ($26) combines rosemary extract with the antifungal properties of eucalyptus for hydration that bears Credo’s clean stamp of approval.

While minoxidil might remain an FDA-approved option, and one that works for many out there, the new class of hair growth treatments is proving promising. More modern, female-focused studies are still rolling into the field of hair health, which requires constant attention to keep up with new discoveries. And when considering a long-term treatment in any field, simply informing yourself of possibilities beyond mainstream pharmaceuticals can be a measured, forward-looking power move.

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