Caffeine, Biotin, “Special Sauce,” – all these ingredients are touted to improve hair just by shampooing with them daily. Often, these ingredients come packaged in an attractive bottle with equally attractive marketing to help you make the choice to buy it, but do these really work?
The good news is that there are shampoos that work for hair. In fact there are several! The shampoos that have been shown to improve hair growth contain ingredients that are easy to add to the shampoo base, and completely “un-sexy,” which means companies typically cannot make as much money off them! They ARE effective, though, especially when added to other hair loss therapies. The key to using these shampoos is to lather and leave on the scalp for 5 minutes before rinsing off. You may use a regular shampoo or conditioner after if you do not like the texture it leaves your hair (and admittedly, these are not the most luxurious shampoos) and it does not change the efficacy.
2% Ketoconazole is an anti-fungal shampoo that may be the most effective of these for unknown reasons. It is used 2-3 times per week and is available by prescription only. The over-the-counter (OTC) version is the 1% formulation (known as Nizoral) and can be used daily. You can also alternate with zinc shampoos (e.g. Head and Shoulders), selenium shampoo (e.g. Selsun Blue), or coal tar shampoo (e.g. T-Gel). Check the label for “active ingredients” to see whether your own favorite shampoo might contain these ingredients. All of these are also available with higher concentrations of their active ingredient, either in proprietary formulations like the ones I provide at my office, or through your provider (often made at a compounding pharmacy).
Again, these shampoos effectiveness is in the single-digit range percent-wise, so the key to boosting their impact on your hair is to use them in addition to other hair loss therapies. For instance, we have also found that PhotoBioModulation Treatments (PBMT, also known as low level light treatments or LLLT) are particularly well-suited to help grow thicker hair – particularly those with finer hair to begin with. The ideal wavelength is not yet known, and dosing the light therapy to the scalp can still be improved, but current science indicates the therapeutic wavelengths are likely to be between 668-684nm, or possibly in the 830nm range. As with all hair loss treatments, this requires a year of therapy before full results can be evaluated, but the treatments are safe and require a twenty-minute session several times per week (I recommend daily or every-other-day therapy).
What doesn’t work? Honestly, biotin. It is a component of hair skin and nails, but does not get “absorbed” and is not effective as an ingredient all by itself. This is not to say that shampoos containing biotin are not helpful – they can be! But if they do “thicken” your hair it is usually as a result of one of the other ingredients in the shampoo.
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