Over the Counter: Tips for preventing hair loss

Steve Bernardi and Dr. Gary Kracoff More Content Now

Boston-born musician James Taylor is known for such soft-rock hits as “You’ve Got a Friend” and “Fire and Rain.” As he’s aged, on stage in front of millions of fans, the singer-songwriter also has become distinguishable by his receding hairline.

“I collect hats. That’s what you do when you’re bald,” Taylor once quipped about his androgenic alopecia, also known as male pattern baldness.

But, besides investing in fedora futures, there are a variety of health-care solutions that can help head off hair loss. Options range from prescription drugs designed to stimulate re-growth, to natural supplements that have been found to be effective at preventing hair loss.

First, a few basics about hair, how it grows and why it starts falling out. Hair has two parts, the follicle that extends down into the skin and the shaft, which is visible above the scalp. We are actually born with all of the follicles we will ever have, or about 5 million across the entire body, including about 1 million on the head.

We never generate new hair follicles as we age and grow. The hair shaft is made of a protein, in part, that is not a living structure. That’s why we can go to the barber and not feel a thing when he cuts our hair. Other parts of the shaft contain pigment, giving hair its color. The hair on our head grows about 6 inches per year, on average, according to the American Hair Loss Association, going through three phases of growth, eventually shedding the shaft and restarting from within the same follicle.

Genetics play a major role in male pattern baldness, the most common type of hair loss. The condition affects up to 70 percent of men at some point in their lifetime. About 40 percent of women experience similar thinning over their scalps; however, total hair loss in women is rare.

In the case of genetic hair loss, a hormone called dihydrotestosterone attacks the hair follicles on the head, causing them to shrink until they are no longer able to produce hair. DHT is a derivative of the male hormone testosterone that’s produced through a metabolic process in the body, specifically within the oil glands of hair follicles.

Finasteride, better known by its brand name Propecia, is one of the most common prescription medications for treating male pattern hair loss. The drug blocks the enzyme that creates DHT. While effective, finasteride has serious side effects ranging from erectile dysfunction to prostate cancer. Another common hair-loss treatment is minoxidil, or Rogaine, now available over the counter. Rogaine is purported to stop hair loss and promote re-growth, and can be used for long periods of time. While common side effects include itching, redness and irritation, a compounded version of minoxidil can reduce some of the irritation.

For people with the type of hair loss that comes with age there are many natural options for preventing hair loss. Taking a daily dose of fish oil or regularly consuming foods rich in omega-3 fatty acids, such as salmon, walnuts and flaxseeds, may help encourage hair growth, according to the University of Maryland Medical Center.

Many people use biotin, a vitamin found in certain foods and also available as a supplement, for various health benefits - including preventing hair loss. Biotin may improve the protein infrastructure in the hair shaft.

Other nutrients that may be beneficial to hair include herbal supplements that contain turmeric (of the ginger family), milk thistle, and nettle leaf. These herbs help the body clean up metabolic waste and ensure proper liver function. Vegetable silica, an extract from the horsetail plant, is another natural treatment for healthy hair. Another plant extract, saw palmetto, has shown promise as a DHT inhibitor in research related to hair loss. A 2009 study by Korean scientists found increased hair growth in balding men who took regular doses of pumpkin seed oil.

Many people with significant hair loss learn to live with it, and are more than fine with their appearance. Others will seek a treatment, with the assistance of their health-care provider, that helps prevent what may be inevitable. That may be a prescription medication, or a natural remedy with fewer side effects.

Maintaining an overall healthy lifestyle, including reducing stress levels to keep the body’s metabolic processes on the right track, may also slow hair loss.

Rather than wait for nature to take its course, take steps now to consider your options and give your hairline a fighting chance.


Steve Bernardi is a compounding pharmacist and Dr. Gary Kracoff is a registered pharmacist and a naturopathic doctor at Johnson Compounding and Wellness Center ( in Waltham, Massachusetts. Readers with questions about natural or homeopathic medicine, compounded medications or health in general can email