Hair Loss Products Are the Next Frontier in Wellness. Do They Live Up to Their Promises?

Getty Images/Amanda K Bailey

Helen Avery vividly recalls the day she felt a cold breeze on the back of her head. She touched her scalp and discovered a shocking development: a bald spot the size of a tennis ball.

Avery, then 40 years old, had survived breast cancer just a year before. She had lost her hair during chemotherapy but it had all grown back. There were no patches, no noticeable thinning. Prior to getting sick, her hair had never been an issue: “I was the woman who would walk into the hair salon and people would be like, ‘Oh, you have a lot of hair.’”

But by the following year, she was losing it. Over several months, things got worse and worse. At one point, Avery says she lost nearly half her hair. “I completely panicked,” she recalls. “Does this mean I’ll have no hair in two months?, I thought. I had no sense of how bad it could get.”

Avery’s discovery propelled her into research mode, sending her down a YouTube rabbit hole of hair regrowth products ranging from pricey shampoos to high-tech LED hair helmets, all of which claimed to regrow hair. She, like many other consumers, was willing to give them a chance before going to a medical specialist. “Do I need this treatment, that treatment?” she asked. “There’s just an overwhelming amount of products out there all making similar claims. What’s good and what’s not?”

Avery, now 47, isn’t alone in her marketplace frustration—or her pain. People who find themselves losing their hair often experience anxiety, embarrassment, depression, and even social withdrawal. Hair is tied up in our identity, self-expression, and confidence (as anyone who has suffered a disastrous dye job knows). And despite the fact that women in the US have made some progress in the past decade when it comes to traditional beauty standards and gender norms, long, thick, silky hair still reigns supreme. It starts early, when we’re first introduced to Disney princesses with impossibly perfect manes, and continues well into adulthood, when we’re awash in images of gorgeous celebrities, many of whom quietly use hair extensions to achieve their improbably magnificent yet still “effortless” styles.

It doesn’t help that we have different expectations around aging and hair than we used to. “People want their hair to stay the way it looked when they were in their 20s or 30s,” cosmetic scientist Perry Romanowski, who has worked in the beauty and hair industry for 30 years, tells SELF. Compare the cast of And Just Like That… to that of The Golden Girls—both shows featuring women in their 50s. “[The actors today] look so much younger even though they’re the same age,” Romanowski says. “Our perceptions have really changed.”

But hair thins with each passing decade. In fact, more than half of women will experience some form of visible hair loss in their lifetime. And it’s probably become even more prevalent in the last few years, thanks to the COVID-19 pandemic.

Stress of any kind, including childbirth, emotional trauma, and surgery, can lead to telogen effluvium, which is the medical name for stress-induced hair shedding. The 2020s have been hard and uniquely challenging for women. “Women take on so much these days, juggling careers, families, relationships, and more—this stress takes a toll,” Hardik Doshi, MD, lead surgeon at Ample, a New York City hair restoration clinic, tells SELF.

And while SARS-CoV-2, the virus that causes COVID-19, doesn’t specifically cause hair loss, infections are a well-established trigger of telogen effluvium. “Every time you put stress on the body, physiologic or otherwise, it can affect the hair growth—from counts, thickness, and quality to grain,” explains Natasha Atanaskova Mesinkovska, MD, the vice chair for clinical research, dermatology, at the University of California, Irvine School of Medicine.

Naturally, the hair industry responded. Today drugstore shelves are bursting with bottles and gadgets promising improved hair density, reduced hair loss, and other Rapunzel-like aspirations. Sephora has an entire section dedicated to thinning hair solutions, and the hashtag #HairLoss boasts millions of views on TikTok. Even J.Lo has gotten in on the trend: The singer partnered with telehealth company Hers in 2019 to launch a hair treatment kit.

This abundance of choice is relatively recent. Unlike the skin care market, which spans prescription products, injectables, and in-office treatments (on top of what’s long existed in the beauty aisle), there wasn’t much available to improve hair as you age—until now. “Hair is the next frontier,” Dr. Mesinkovska tells SELF.

So far, the FDA has approved only one topical hair loss solution for androgenetic alopecia, the most common type of hair loss, in women: minoxidil (made popular by the brand Rogaine). But now our Instagram feeds are being flooded by competitors—many of which might feel a bit more sus. “It’s a very emotional issue, and that’s why it’s easy to market products that are going to supposedly help you recover that hair loss,” Kelly Dobos, a cosmetic chemist and adjunct professor of cosmetic science at the University of Cincinnati, tells SELF. Further complicating this issue is the fact that there are lots of potential causes of hair loss, ranging from nutrient deficiency to genetics, making effective treatment more challenging.

Beware of “science-washing”

Many of the products being heavily promoted right now have impressive-sounding terminology like “based in science,” “clinically proven,” or “scientifically formulated” in their marketing copy. But any brand can conduct a study and make impressive-sounding claims regardless of what it says, according to Romanowski: “Whether it was positive or negative results, it doesn’t really matter. You can just say it was ‘clinically tested.’” Other terms like “research-backed” could simply mean that a product was formulated by cosmetic chemists with a research background, Romanowski says.

OTC supplements are a marked example of these misleading tactics. As SELF previously reported, it’s shockingly easy for manufacturers to slap these buzzwords onto their bottles because the FDA doesn’t regulate dietary supplements for efficacy, meaning brands don’t have to prove their products actually do what they say they’ll do before they start selling them. Some popular hair growth supplements that can run you close to $100 a month are advertised as “clinically proven”—but there’s no standard definition for making that kind of claim, meaning it’s up to the brands’ interpretation. And that’s why it’s so important to keep this big caveat in mind: Supplements (which also include things like biotin gummies) are “not intended to diagnose, treat, cure, or prevent a disease,” per the FDA. In other words, whatever grand promises they make or imply, they cannot promise to treat a serious hair loss condition because they haven’t gone through the rigorous study and extensive approval process that the FDA requires of pharmaceutical treatments.

The same goes for trendy topical solutions like rosemary oil. Videos about the suddenly everywhere ingredient topped 200 million views on TikTok, while internet searches surged 26% as of January 2024 compared to the previous year—averaging a whopping 100,000 searches a month—according to market research firm Spate. “You know how kale could cure everything a couple of years ago? Well, that’s rosemary oil this year,” Deborah Scott, MD, codirector of the Hair Loss Clinic at Boston’s Brigham and Women’s Hospital, tells SELF.

At first glance, rosemary oil does look promising. In one clinical trial published in 2015, researchers found rosemary oil worked as well as 2% minoxidil after six months of applying it to the scalp. The study specifically focused on men with androgenetic alopecia (pattern baldness), the most common type of hair loss that impacts more than 80 million Americans. However, some dermatologists and cosmetic scientists have criticized this study, pointing out what they say has a number of issues. For one thing, studies usually recommend using at least 5% minoxidil (versus lower concentrations) for improving hair growth, so rosemary oil wasn’t tested against a rigorous treatment regimen. “If the ingredient really did work [for hair loss], why haven’t there been a bunch of other studies published in the last 10 years [replicating results]?” Romanowski says. A promising ingredient would have likely been more thoroughly studied to replicate results and confirm efficacy.

In addition, the actual hair count increase was minimal, with before and after photos nearly indistinguishable. “Most of the evidence is anecdotal,” says Dr. Scott, who doesn’t think rosemary oil offers significant improvement. And yet it’s often touted as “clinically studied,” without much further clarification.

Similar to supplements, it’s also important to read the fine print on a topical product. When Avery was looking for affordable solutions, she picked up an Aveda Invati Advanced shampoo, which advertises its ability to reduce hair loss by 53%. But on closer inspection, she noticed an asterisk: “Due to breakage from brushing, after using the Invati Advanced system for 12 weeks.” Avery was confused. “What woman is buying this shampoo to reduce hair loss due to breakage from brushing?” she says. “I would imagine 95% of the women looking at this package are buying it for hair loss coming from the top of their head, not from brushing.”'

So be sure to read the teensy, tiny print at the bottom or back of a product. Turns out it might not really be able to do what you (reasonably!) assume it does.

You should also be aware of the way brands often generalize when it comes to issues that are trickier to tackle than it may seem. Ashwagandha supplements, for example, are touted by brands for their ability to “balance” stress hormones, and, by this logic, treat hair loss. But the most common type of hair loss is actually related to sex hormones and genetics, Carolyn Goh, MD, associate clinical professor of dermatology at David Geffen School of Medicine UCLA, who specializes in hair loss and scalp disorders, tells SELF. So even if this supplement did work for stress-related shedding, it still might not be appropriate for most consumers.

Moreover, stress itself is a very complex concept, as anyone who has tried to manage work, parenting, and commuter traffic can attest. “It’s kind of crazy to say that a supplement, whether it’s a single supplement or multiple herbs, can tackle stress,” Dr. Goh says. “People could say, ‘Oh, well, it reduces your stress hormones.’ But it’s hard to know necessarily if it does that on a molecular, cellular level.” And even if, in theory, ashwagandha had a meaningful effect on your stress levels, Dr. Goh says, there’s still limited evidence to support its use for hair loss.

At-home hair helmets and combs—which look like they came straight out of Tron and use low-level laser therapy technology—also require a certain level of specification. (And they don’t come cheap: A lot of these tools cost hundreds of dollars, and some can even run a few thousand.) There are a few notable brands, like Hairmax and Irestore, that have invested in doing their own clinical trials. But what’s true of one device might not be true of another. Steven Daveluy, M.D., associate professor and program director at Wayne State University Department of Dermatology, says it’s important to look for a clinical study proving the exact device you’re looking at does what it promises to—but, again, that can be difficult to suss out as a consumer for all of the above reasons.

While there is some evidence that some of these gadgets can help with hair growth after certain types of loss, there’s less information on how long you should use a given device per session or what frequency and pulse rate will work best for you, explains Rob English, a consumer advocate and the founder and medical editor of Perfect Hair Health, a website dedicated to the science of hair loss, and editorial board member of the journal Dermatology and Therapy.

Speaking of anecdotal evidence: Just because a product worked for an influencer—or even your best friend—doesn’t mean it will work for you. A five-star review, no matter how effusive, is no substitute for a clinical trial.

People might give a glowing testimonial for many reasons. For some, the product might actually work. But others might simply be going through hair growth fluctuations. We tend to lose more hair during the late fall months, for example. As previously noted, illness and stress can also induce shedding, and these situations often resolve themselves in time. (With telogen effluvium, hair generally grows back after three to six months.) An influencer might have started using a product at the peak of their hair loss, for example, and then, when things naturally improved, credited it to whatever intervention they tried.

A telling example? In one study of a rigorously researched product, roughly 50% of participants in the placebo group reported hair growth improvements.

We’d like to believe our products work. But the dark side of optimism is gullibility. “Consumers generally don’t want to think that they were suckers. They don’t want to think they wasted their money,” Romanowski says.

What to do if you think you’re losing your hair

Hair loss is subjective and feels different for everyone, but for women, it often starts with thinning at the crown or center part. Before getting too alarmed, consider whether there’s been a major stressful event that could lead to the onset of temporary hair loss, Dr. Scott advises. If not, you might want to see a doctor, who can schedule some basic lab tests to ensure that nothing else is going on.

And if your hair loss progresses, you definitely shouldn’t delay seeing a health care provider. “Time is of the essence for diagnosis,” Dr. Mesinkovska says. You also don’t want to risk further aggravating the situation with over-the-counter products and light-emitting devices, which could potentially irritate the scalp. So whether you go to your primary care physician or a dermatologist, it’s worth getting a professional to take a look.

Remember that hair loss is not your fault, especially when you’re dealing with telogen effluvium. “People feel like it’s because they can’t handle the stress,” Dr. Goh says, “but it really has nothing to do with how well you can handle it or not.” Our bodies often respond in ways that we cannot control, and that, too, can be difficult to accept.

Unfortunately, there are no miracle cures, despite the impressive claims and sleek packaging taking over our feeds. “The treatment that the test of time has shown to be effective is minoxidil,” Dr. Scott says. “It has the most evidence.” But not even minoxidil will work for everyone. The unfortunate truth is that despite impressive strides in science, we haven’t yet cracked the code on regrowing hair for everyone. “And if that technology was available, that would be a drug product,” Romanowski adds. “It wouldn’t be a cosmetic product.”

After Goldilocks-ing her way through the market, Avery eventually settled on Rogaine. It took a little over four months for her bald spot to slowly fill in. “I needed to have a lot of patience,” she admitted. In 2019, she started a YouTube series about her experience, in hopes of reducing the taboo surrounding hair loss and sharing evidence-based solutions.

“I like to say, Ariana Grande tells everybody she has fake hair, so why are the rest of us so embarrassed about it?” Chasing perfection—or even how you looked at 25—can be exhausting, if not futile. Avery tries to find satisfaction in whatever small gains she’s seen from Rogaine over the last few years. “I don’t feel compelled to keep trying and getting it better and better than it is,” she reflects. “I’m pretty happy with where it is now.”

Related:

• The Truth About Popular Sleep Supplements, From Magnesium to Melatonin

• This Is What a 52-Year-Old Face Without Filters or Makeup Looks Like

• Bovine Colostrum Supplements Are Everywhere—But Are the Health Benefits Legit?

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Originally Appeared on SELF