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What Are the Big 3 for Hair Loss?: The 3 Treatment Combo Explained

Just what are "the big three" treatments for hair loss? In this article we explain the big three, and why some people think there is a fourth to include here.

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If you have been browsing hair loss forums or subreddits about hair loss, it shouldn’t take too long for you to stumble upon the idea of there being a “‘big 3” when it comes to hair loss treatments.

These “big 3” aren’t always spelled out for you, so you may have landed here trying to get some clarification.

Below, we will go over just what the big 3 are, the specifics of each one and how they may add to your hair loss regimen, and also some good sources to get started on your own “big 3” treatment plan (spoiler: It’s through us).

What are “the big 3” for hair loss?

Most of the time when people are chatting about the big 3 for hair loss, they are referring to Minoxidil, Finasteride, and Ketoconazole (Nizoral) shampoo.

Although, there are some who feel like the third component of the big 3 should be microneedling in place of Ketoconazole shampoo. However, there is no reason why microneedling can’t just be number 4 here.

Why is it a good idea to combine hair loss treatments?

The idea behind these big 3 hair loss treatments is that you may have better results when you combine multiple approaches to patterned hair loss.

With these specific medications, this makes sense because all of these do different things for your scalp, hair follicles, and hair growth cycles. This ensures that you aren’t just piling on more medications that are doing just about the same thing, and possibly going overboard.

Some studies have shown that using certain hair loss approaches combined may deliver better results than just picking one.

Minoxidil for hair loss

Minoxidil is the first medication to be FDA-approved for hair loss treatment. You may recognize it is the active ingredient inside of Rogaine.

The exact mechanism for how Minoxidil helps with hair loss is not fully known. But, it may help with increasing blood flow to the follicles and stimulating the hair to stay in the growth phase longer.

This makes Minoxidil a good choice to help target general growth optimization for the currently growing hair follicles.

Minoxidil is commonly seen in strengths of 2% or 5% over-the-counter, and you can sometimes find even stronger prescription formulations made up through compounding pharmacies.

The most common way to use Minoxidil is topically on the scalp, although some people are switching to off-label oral Minoxidil tablets to avoid having to deal with an applied formula.

Finasteride for hair loss

Finasteride is the second medication to be FDA-approved for hair loss. This is considered a 5-Alpha Reductase (5-AR) inhibitor medication, and it is in the same class as Dutasteride.

Basically, these 5-AR inhibitor medications help inhibit the conversion of testosterone into another hormone, DHT. DHT is the main culprit in hair loss from patterned hair loss, and it can cause hair follicles to shrink and produce finer and shorter hairs over time. Eventually, these follicles may stop producing hair altogether and go dormant.

So, Finasteride helps target this hormonal component of patterned hair loss.

However, it is important to mention that a small percentage of men may experience negative side effects from oral Finasteride and 5-AR blockers, including sexual side effects. If this is very concerning for you, you may want to consider a different option, or try a topical Finasteride formulation which may deliver fewer of these effects.

Finasteride for hair loss is typically used in tablet form once daily, although you can also find off-label topical Finasteride formulations from certain compounding pharmacies.

Ketoconazole (Nizoral) shampoo for hair loss

Ketoconazole shampoos are commonly considered the 3rd portion of the big 3 for hair loss.

The most common brand name of Ketoconazole shampoo is Nizoral, although the generic Ketoconazole shampoos will work the same and may deliver a cost savings.

Ketoconazole is thought to help focus on the health of the scalp. Specifically, it can help clear out dandruff, since it is an antifungal medication, and it may help deliver anti-inflammatory effects to the scalp.

Since patterned hair loss may come along with some level of scalp inflammation, taking care of this by occasionally using a ketoconazole shampoo focused on the scalp may help in your hair loss treatment process.

Microneedling for hair loss

Microneedling is the proposed swap-out for Ketoconazole shampoos, or an addition to the triad, depending on who you are asking.

Microneedling is the activity of using a microneedler, or dermaroller, with fine needles rolling over your scalp to help stimulate the hair follicles. For some people, they may see enhanced hair growth from this stimulation, or it may even help topical medications penetrate deeper and be more effective.

There is no prescription needed for this treatment, and you can either have scalp microneedling done in an office setting, or do it yourself at home if you are careful.

Strut Health can be your source for “the big 3” (or four) online

Now that you know what people are talking about when they mention the big 3 for hair loss, you may want to consider building your own regimen taking this info into account.

Here at Strut Health, we consider ourselves to be at the forefront of hair loss treatment options for men and women. 

We offer the tried-and-true hair loss go-tos like topical Minoxidil and oral Finasteride, but we also venture into the off-label realm and put together topical Finasteride and Dutasteride with the power of compounding pharmacies. We also carry some of the newer hair loss treatment options like off-label oral Minoxidil, or scalp microneedling rollers.

Get started building your own personal version of the big 3 (or 4) today with Strut Health. Simply select your treatments, complete a free online questionnaire and image-based doctor’s consultation, and checkout.

If you are a good candidate for treatment, your U.S. doctor will issue a prescription to a U.S. compounding pharmacy and your hair treatment(s) will be out to your front door with our free shipping.

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