1. What are the most common causes of hair loss in men?
The most common causes include:
Androgenetic alopecia (male pattern baldness) is the most common form of male baldness. Typically related to genetics and hormones, it’s caused by the effects of dihydrotestosterone (DHT), a derivative of the male hormone testosterone. Usually starting with a receding hairline or thinning at the crown and progressing over time, it can begin as early as the late teens or early 20s, becoming more noticeable as men age.
Telogen effluvium is a temporary form of hair loss that occurs after a significant stressor, illness, surgery, or significant lifestyle changes. In most cases, hair regrowth occurs once the underlying cause is addressed.
Alopecia areata is an autoimmune condition in which the body’s immune system mistakenly attacks hair follicles, causing round, smooth patches of hair loss.
Hormonal imbalances, particularly related to thyroid function (hypothyroidism or hyperthyroidism), can contribute to hair loss.
Nutritional deficiencies, such as a lack of essential nutrients such as iron, protein, zinc, or biotin, can lead to hair thinning and shedding.
Medicationscan cause hair loss as a side effect. Common culprits include blood thinners, chemotherapy drugs, some antidepressants, and drugs used to treat high blood pressure or arthritis.
Scalp infections or conditions including fungal infections (such as ringworm) or inflammatory conditions like seborrheic dermatitis, psoriasis, or dandruff can cause itchy, irritated patches on the scalp, leading to temporary or permanent hair loss if untreated.
Traction alopecia is caused by consistent tension or pulling on the hair, often due to tight hairstyles (e.g., ponytails, braids, or man buns).
2. How effective are Hims hair loss treatments, such as finasteride and minoxidil, compared to other prescription or OTC options?
Finasteride is a prescription oral medication that works by inhibiting the enzyme 5-alpha reductase, which converts testosterone into dihydrotestosterone (DHT), a hormone that causes hair follicles to shrink and eventually stop producing hair in men with androgenetic alopecia (male pattern baldness).
Clinical studies show that finasteride can help reduce hair loss and stimulate hair regrowth in many men with male pattern baldness. It’s most effective when started early in the hair loss process.
Other prescription options include dutasteride, sometimes prescribed off-label for hair loss. It works in a similar way but inhibits both types of 5-alpha reductase enzymes (whereas finasteride only inhibits one). Dutasteride is currently not FDA-approved for hair loss. Spironolactone is an anti-androgen often used in women with hair loss, and is less commonly used in men due to its potential side effects, including feminization. It may be prescribed in cases of androgenetic alopecia that are resistant to finasteride.
Minoxidil is an over-the-counter (OTC) topical treatment that stimulates hair follicles and improves blood flow to the scalp. It’s not entirely clear how it works, but it is believed to extend the anagen (growth) phase of hair follicles and promote new hair growth. It’s effective for many men, especially when used in the early stages of hair loss.
Other OTC options include ketoconazole shampoo, often recommended as part of a hair loss treatment regimen combined with finasteride or minoxidil. Ketoconazole is an anti-fungal agent that may have anti-androgenic properties that help with hair loss. Biotin (vitamin B7) is a popular supplement for hair health, but research on its effectiveness for preventing or reversing hair loss is limited. It’s unlikely to work as a standalone treatment for male pattern baldness, though it may help improve hair strength in people with deficiencies.
3. What are the most common side effects of using Hims hair loss products, and how can users minimize these risks?
The most common side effects of using Hims hair loss products, particularly finasteride and minoxidil, are generally mild and temporary.
Finasteride can have sexual side effects, including decreased libido, erectile dysfunction, and ejaculation disorders. These affect a small percentage of men, with estimates ranging from 2% to 10% of users. They are usually reversible upon discontinuation of the medication.
Some men experience tenderness or enlargement of the breast tissue, which may be accompanied by swelling or pain. There have been reports of depression, anxiety, or irritability in some men. Rarely, some individuals may experience rash, itching, or other allergic reactions.
To minimize the risk, start with a lower dose and monitor for side effects. For best results, finasteride needs to be taken consistently. Missing doses may reduce its effectiveness, and suddenly stopping the medication can lead to a rebound in hair loss.
Minoxidil can produce scalp irritation. Some users may experience “shedding,” which is a temporary phase where weaker hair falls out to make room for new hair growth. Some report feeling dizzy or lightheaded, particularly if they stand up quickly after applying minoxidil. In rare cases, some individuals may experience an increase in heart rate or palpitations.
Always follow the instructions carefully to avoid the medication spreading to unwanted areas. Apply minoxidil only to dry, clean scalp areas, and avoid letting it drip or run down your face. Use only the recommended amount (usually 1 mL) once or twice a day, and avoid overuse, as this doesn’t speed up results but may increase the risk of side effects like unwanted hair growth or irritation.
Both treatments require consistent use to be effective. Skipping doses or using the products intermittently can reduce their effectiveness and potentially lead to side effects when restarted. Before starting either treatment, it’s important to consult with a healthcare provider.
4. For which types of hair loss or patient profiles are Hims treatments most effective?
Hims products are most effective for men and women with androgenetic alopecia, especially in the early to moderate stages of hair thinning. They’re for those seeking non-surgical options and willing to use treatments long-term. Hims is not as effective for advanced baldness or hair loss due to other causes such as medical conditions.
5. How critical is it for users to follow up with a healthcare professional while using Hims products?
While it’s not strictly mandatory to have frequent follow-ups with a healthcare professional when using Hims hair loss products, it can be highly beneficial depending on individual health factors, the type of treatment being used, and the user’s overall progress.
6. Can the telemedicine model Hims uses adequately address the individualized needs of patients with hair loss?
The telemedicine model that Hims uses is a good first step that can be augmented by more traditional in-person visits to a dermatologist. Patients using Hims products should be proactive in communicating with their healthcare team if they experience side effects, new symptoms, or concerns about the progress of their treatment. For ongoing and complex hair loss issues, follow-up care with a specialist in person is recommended to ensure the best outcomes.
7. Are there any concerns about the long-term use of Hims hair loss treatments, particularly finasteride and minoxidil?
Aside from the side effects noted above in question 3, many of the risks associated with finasteride and minoxidil are manageable with appropriate professional monitoring. Regular check-ins with a healthcare provider are recommended, especially for those on Finasteride, to monitor for potential sexual side effects, mood changes, or other hormonal issues. Minoxidil generally has a good safety profile but may require adjustments if scalp irritation or excessive shedding occurs.