Norwood Hair Loss Type 4

This type describes a moderate amount of loss, so you have a fair to good chance of regaining most lost hair. At this level though, there is no guarantee that using all the treatments listed will bring back almost all your hair. However, it may bring back enough to be acceptable to you.

You should see a doctor to determine your treatment options. There are several treatments that may help. The cheapest and safest is Minoxidil (Rogaine) 2%. Minoxidil has been shown to prevent further loss in about 80% of men and regrows lost hair in 25-40% of men. At this stage, you are the most likely to benefit from Minoxidil. With generic minoxidil prices as low as $8-9 per month, there is no reason not to give this treatment a try. Side effects are very infrequent.

If Minoxidil alone is not effective enough to regrow a lot of lost hair or completely halt loss, you may wish to try a combination of Minoxidil 2%+Retin-A 0.025%. Retin-A greatly increases the effectiveness of 2% Minoxidil. Your doctor can prescribe this well known combination which can be made by a pharmacy.

Another option is higher strengths of Minoxidil, possibly combined with Retin-A. 3-5% Minoxidil is available by prescription. 3% Minoxidil has not been proven to be more effective than 2%, and 4% is close enough to 5% that you might as well be on 5%, so I recommend 5% if you decide to go with a higher strength. At this strength of Minoxidil, it is debatable how much added Retin-A helps, so you may choose not to get it combined with Retin-A. I prefer not to take my chances, so I generally recommend getting it with Retin-A anyway. It’s only a few dollars more than the standard 5%. Good results have been obtained from 5%. More people respond than respond to 2% and they tend to respond better. Plan to stay on 5% though until a permanent cure comes along because many doctors say your hair will be dependent on the 5% Minoxidil and probably will still fall out if you choose to switch to another treatment. Supposedly this only happens after a few months of treatment, so if you try it for a month, experience side effects and decide to quit, this will not be a problem.

There is a good chance that even Minoxidil combined with Retin-A may not be completely effective for you at this level of hair loss. Combining Minoxidil with another new treatment may be necessary for improved effect. This treatment is called Proscar (soon to be released for hair loss in 1mg form as Propecia - still prescription). It is not easy to get since it is a prescription treatment not yet approved for hair loss and is not as cheap as minoxidil. Also, there is a small chance (1-5%) that you could experience side effects including some loss of sexual desire, some loss of sexual sensation, or some loss of hardness of erections. These side effects generally go away after 1-3 months of treatment (Proscar takes 6-8 weeks or so to build up in your system) and go away if you stop treatment. At the dosage suggested for hair loss (1/5 of the normal 5 mg dosage), these side effects are even less frequent or severe. Most men experience no side effects. Proscar is almost guaranteed to halt your hair loss, which makes it a great tool if you would be satisifed with a slight improvement and staying there. It also may work better at restoring loss along the frontal line.

Other antiantiandrogens may also help. One such is Spironolactone. See the Treatment section of this web page for information on other antiandrogens.

A combination is more effective, and at this amount of loss, you will almost surely need to use a combination unless you are an excellent responder to minoxidil.

Even using all of these in combination, you may not restore a satisfactory amount of hair at this level. Unfortunately, not everyone is a good responder. There are several other recent treatments that have been released and nutritional supplements that may help in hair loss. The Treatment page lists many of these. Examples of supplements would include the Amino Acid Arginine or a topical form of Zinc. Examples of some recent treatments that may be helpful are Iamin Gel or Folligen, both of which contain copper peptide complexes, which are currently being researched in other treatments for FDA approval as a hair loss treatment.

With this level of hair loss, you have a very good chance of returning to at least a type 3, if not a type 2.