The Big 3 Treatments to Beat Hair Loss

Hair loss is something 2/3 of all guys will suffer from in their life time. Many are unlucky inheriting genetics that make them more susceptible to hair loss. But there are also other reasons for hair loss.

For the aging male, testosterone replacement therapy (TRT) is growing popular all over the world. You either love it or hate it. For a lot of men, it can be a godsend, especially for those suffering from low testosterone or those who want to build muscle. When used properly, it increases libido and improves mood, increases work capacity, energy and productivity, protects you from osteoporosis and has been found to help with cognition and memory.

Unfortunately, TRT is also associated with a few side effects, the most common of which is hair loss.

Before we delve deeper into this issue, it is important to get the point across that not everyone who undergoes the therapy or treatment lose hair, and not everyone with genetics for it will lose their hair. The idea that increased testosterone in the body leads to hair loss is quite a misconception. Hormones do play a role in the process, but it is only part of the bigger picture.

A certain percent of testosterone gets converted into the androgen dihydrotestosterone or DHT, concentrations of which can be found on the scalp. DHT comes into contact and binds on to receptors of the hair follicles with sensitive hair follicles. For some people, this whole “binding” does not cause any effect. However, there are others who have sensitive follicles (genetically prone to hair loss), and when that binding occurs, their follicles shrivel up, causing hair to fall out. Thus, hair loss when undergoing TRT often only happens to people who are genetically predisposed and have sensitive hair follicles.

If you are on THT or experience genetic hair loss, then you might be one of the many who belong to this “genetically predisposed” demographic. And while it may be a common reaction to take DHT blocking supplements and medications – you might want to reconsider this move and treat your hair loss problem where it happens: right at the scalp.

Here are three of the biggest treatments that you can use to help you combat hair loss while on TRT.


Spironolactone is no stranger in the market – in fact, it has been used for years to treat hypertension, edema and potassium deficiency. When taken orally, spironolactone has very potent anti-androgen effects. So strong, in fact, that it is not generally recommended for men because it can have feminizing effects.

When used by women, it counters the effects of excess androgen in the body – thereby treating hair and skin issues that come as side effects of having too much of the male hormone in one’s system. Some hormone-related problems that are treated by spironolactone include face and body acne, and hirsutism or excessive growth of body hair in areas not normal for women.

As a topical treatment, spironolactone blocks the action of androgens by preventing it from binding on to androgen receptors in the hair follicles. It is this binding process that causes follicle damage and hair loss.

While spironolactone is effective, it has a notorious reputation for being foul smelling, somewhat reminiscent of rotting eggs and cabbages. In fact, several brands have day and night creams, bearing in mind that a lot of users would want something more pleasant smelling for daytime use. The reason for this is the product’s formulation, as it often reacts with alcohol, which is a common ingredient in many similar products.

The good thing though, is that many pharmaceutical companies are now developing odorless spironolactone lotions using more stable formulas that can be used for both day and night.

What should be noted, though, is that this treatment does not help you grow new hair, but simply prevent you from losing them.


Ketoconazole is rather common, and is more known as the active ingredient for the anti-fungal product Nizoral. It’s generally available as a pill, cream or shampoo.

Aside from being an anti-fungal treatment, it has been shown to also have beneficial effects for hair loss. Studies show that when used topically, it can blocks the synthesis of DHT in the scalp. By blocking DHT synthesis, it stops the androgen from affecting follicles as well. What’s also good to note is that this drug goes beyond being anti-androgenic. Quite a number of researches have found it to also have hair growth stimulating effects, even comparable to the effects of Minoxidil, which we will talk about below.

Ketoconazole can also be used to treat hair loss that is caused by other factors such as fungal infection, for example.

If you look at hair loss shampoos available in the market, you will most probably find ketoconazole listed as a main ingredient. These can be products worth considering. Or, for something more potent, you can use a shampoo that lists 1% ketoconazole instead.


Minoxidil’s history is quite similar to spironolactone, as it was also originally formulated for hypertension. When used for the purpose, however, it was seen to cause hyptertrichosis or excessive hair growth. The occurrence of this side effect led to its use as a treatment for hairloss.

The exact explanation as to why Minoxidil works remains quite unknown. What is understood, however, is the fact it is a vasodilator. The theory is that it dilates blood vessels in the scalp, thereby improving the function of hair follicles and stimulating hair growth.

Choosing The Best Among The Big Three

A presentation of these three big solutions might warrant the question – what’s the best treatment for genetic hair loss or people suffering hair loss from TRT?

A quick answer to that question: there is no best solution.

That is not to say that the three treatments we mentioned above do not work, because they do. However, their effects cover various components of hair loss. Using the three, however, allows you to cover all bases and gives a comprehensive treatment that targets all aspects of the problem. We recommend the following in combination with a good shampoo:

Spironolactone, which comes in the form of either cream or lotion, can be used in the morning and night to block DHT from binding on to follicles. This mode of treatment prevents hair loss from occurring in the first place.

Ketoconazole works similarly, but as it often comes in shampoo form, you can use it as you shower, alongside spironolactone. A quick word though – the product, in its pure form can have drying effects, so you might want to use this only from time to time, or choose a combination shampoo that has nourishing properties. Ketoconazole is also great for fungal infection and dandruff, which can be a common problem among men.

Lastly, Minoxidil can be used to supplement both, as it targets the second phase of treatment, which is eventually to encourage hair regrowth.

If you are lucky enough to only have minor hair loss so far, you should consider that maybe a solution enough for you is just using products that might help thicken your hair more.

Natural Options to Consider

The three different treatments we mentioned above are pharmaceutical products, which may not sit well with a lot of people. The three treatments are topical and are not absorbed in the bloodstream and do not cause systemic effects in comparison to oral drugs.

If you’re not really keen on the three options above, you may want to consider natural options, which produce similar effects.

Carnitine and topical raspberry ketones, for example, have been noted to produce hair regrowth effects. A recent study done on L-carnitine found that it can promote human hair growth by slowing down follicular cell death and improving cellular metabolism. While this study was done in vitro, the results are very promising and may work as well on actual scalps. Studies on raspberry ketones, however, are a bit limited, but the ones that exist today are also just as promising. Given that they are alternative options, they might still be worth considering.

Caspiacin and soy, on the other hand, both have anti-androgenic properties. They can be taken internally, but there are also products with these as main ingredients that can be applied directly on the scalp. We have seen a few organic shampoos containing caspiacin in the market, which promise to reduce DHT activity in the scalp and stimulate follicles for hair growth.


When it comes to combatting hair loss due to TRT, we greatly recommend using the Big 3 treatments we mentioned above.
We would also recommend the natural options if you’re really against using pharmaceutical products. However, do keep in mind that as all three treatments are applied topically, very little (if any at all) of the solution is absorbed into the blood. Thus, the risk of them interacting with one another, or with other medication that you may take, are very low.
If you do decide to use the three products, it would be wise to design a treatment strategy that will allow you to use all the three alternately for maximum hair growth, even while undergoing TRT treatments.


Alex Eriksson is the founder of Anabolic Health, a men’s health blog dedicated to providing honest and research backed advice for optimal male hormonal health. Anabolic Health aspires to become a trusted resource where men can come and learn how to fix their hormonal problems naturally, without pharmaceuticals. Check out anabolichealth.com to learn more about Alex and his work.


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