Why Men’s Hair Health Is Moving From a Cosmetic Concern to a Clinical One

In this Nutritional Outlook video, board-certified dermatologist and Nutrafol chief medical advisor Heather Woolery-Lloyd, MD, FAAD, joins Senior Editor Nicholas Saraceno to discuss the clinical and commercial dimensions of men's hair health, a category she says is more complex and more promising than its reputation suggests.

Woolery-Lloyd opens by pushing back on the idea that male hair loss is primarily a dihydrotestosterone story. While she acknowledges that dihydrotestosterone-driven miniaturization of the hair follicle is a well-established mechanism in androgenetic alopecia, she argues that it represents only one thread in a much more complex picture. Nutrition, oxidative stress, inflammation, metabolism, sleep, and lifestyle factors all influence follicle function in men just as they do in women, and any formulation strategy that focuses narrowly on hormone modulation is leaving significant opportunity on the table.

For finished product manufacturers, her most pointed advice concerns study design. Ingredient-level research is a useful starting point, she says, but what matters most to her as a clinician—and what she believes should drive label claims—is evidence on the final formulation itself. She cites Nutrafol's 26 published clinical studies, including 3 randomized controlled trials, as the standard she holds herself to when recommending products to patients. She is equally emphatic about safety, noting that efficacy and safety carry equal weight in her evaluation and flagging the brand's NSF Certified for Sport status as an example of rigorous third-party validation.

The conversation turns to stigma. a real barrier in men's hair health that has historically suppressed help-seeking behavior. Woolery-Lloyd acknowledges it, but offers an encouraging counterpoint grounded in data: once men do engage with hair health products, they are significantly more committed than their female counterparts. She cites internal Nutrafol data showing that male subscribers have a 12-month lifetime value nearly 40% higher than women, a figure she says reflects a growing proactivity among men of all ages, from younger consumers responding to early thinning to older men simply looking to maintain what they have.

On stress and adaptogens, she highlights tocotrienols—a concentrated form of vitamin E—as one of the better-evidenced stress-pathway ingredients for hair, supported by a randomized controlled trial showing benefits for hair growth and count. But she is careful to frame stress as one of several root causes rather than a standalone driver, and returns to her core message: final formulation studies, not ingredient studies, are what matter most when it comes to substantiating claims.

A transcript of their conversation can be found below.

Nicholas Saraceno: Ladies and gentlemen, welcome to another Nutritional Outlook video series. I am Nico Saraceno, senior editor of Nutritional Outlook magazine. And today I am joined by Dr. Heather Woolery-Lloyd. She is not only a board-certified dermatologist, but she is also Nutrafol's chief medical advisor. And we have a lot to get to today, especially concerning hair thinning and some of the drivers and things of that nature. But before we do, Dr. Woolery-Lloyd, thank you so much for taking the time to hop on today. I really appreciate it.

Dr. Heather Woolery-Lloyd: Thank you. I'm excited to be here.

Saraceno: So let's dive right in. Of course, as I hinted at the top of the recording, hair thinning in men, it's oftentimes discussed as a cosmetic concern, but the underlying drivers, so hormonal shifts, the chronic stress, nutritional deficiencies, inflammation, they all have and present broader health implications. So I'm curious from a clinical standpoint, could you explain what the research tells us about the relationship between systemic health status and hair follicle function in men? And the 1B of that, why, why is that so important? Why does that matter for how the supplement industry approaches this category?

Woolery-Lloyd:This is such an important discussion because for everyone, including men, systemic health status does impact our hair health. We definitely know things like nutrition, oxidative stress, lifestyle hormones, like DHT, all of these things can influence the hair follicle. So it is very multifactorial. I think it's such an important point to recognize that.

And DHT is, when we think about men, we think about DHT a lot and how it influences the hair follicle. Specifically, it leads to miniaturization of the hair follicle. Ee talk a lot about that with men, but that's not the whole picture when it comes to men. They, just like everyone, men and women are influenced by all of these different things that can affect the hair follicle. Like I said, nutrition, metabolism, lifestyle, all of these things influence our hair health.

The reason why this matters, I think, is because when you're thinking about hair growth nutraceuticals, it's important to take a whole body approach. So at Nutrafol, we do that. We're really focused on this comprehensive whole-body approach to addressing root causes that influence that hair follicle. So the formulas include ingredients that address these key root causes. We actually just came out this year with a new formula, a men's 50+ formula.

That nutraceutical contains an ingredient called spermidine, which is specifically helpful for cellular health, so it influences things like autophagy and senescence, which are things that become much more important as men age. So this men’s 50+ formula is designed for those root causes. This comprehensive approach is really important. Although we think a lot about DHT and hormones for men. I think all people, men and women, have systemic things that can influence our hair health, and that's something that's so important for us to think about.

Saraceno: Totally. You can't narrow it down to one factor. And you alluded to DHT, obviously dihydrotestosterone-driven androgenetic alopecia. That's considered the most common form of hair loss in men. But like you were getting into, it's not the only factor that's at play nowadays. I'm curious, how do you think finished product manufacturers should be thinking about this multifactorial nature of male hair thinning when they're evaluating ingredients or formulating products, because they're going to be wondering what kind of evidence actually supports like pathways behind hormone modulation and things of that nature. So could you maybe get into the psyche of formulators?

Woolery-Lloyd:Absolutely.I think this whole-body approach is really important. Obviously in men, DHT is important, but we know that many factors influence our hair health. When you think about ingredients, there are studies on ingredients that affect these root causes like metabolism, like nutrition. There are studies out there, but when it comes to formulation, I think it's important, once a product is formulated, to look at the study on the final product. I think ingredient studies are really interesting, but the final formulation studies are probably the most important to me as a dermatologist.

Once that formula is designed, it's really important to test the final formula. That's really what's important to me as a dermatologist. And at Nutrafol, we do that. You know, there's 26 published clinical studies and 3 of them are randomized controlled trials, which are the most rigorous type of clinical studies. When you're thinking about research, those are the types of studies that have the most rigor, and what for me as a dermatologist are most important. I always say this because we're always focused sometimes on efficacy, but I always say just as important as efficacy is safety.

Formulators also need to keep in mind focusing on safety and Nutrafol, we're NSF Certified for Sport, which is this independent, NSF is an independent, third party, not-for-profit organization that confirms what's on the labels in the bottle. This is the most rigorous level of certification that you can see in the industry. All of these things are important, especially to me as a dermatologist. Efficacy is important—it's really important that the final formulation works—but just as important as that for me is safety.

Saraceno:One hundred percent. I think a lot of people would agree with that, especially where we have to think about when it's all said and done, what are the consumers looking for on the label? Like, what are these familiar things that they want to know to feel more at ease when it comes to purchasing these products?

I feel like hair health—we're looking at men's hair health in this case—there tends to be a stigma that can, for many, perhaps it causes men and people alike, to maybe be hesitant to seeking help and to using supplements. When I was drafting these questions, I was wondering if there's data that discusses how men are engaging with hair health products differently than women. Is there some sort of data showing that? And, are there any communication strategies or like formulation strategies that can kind of help improve adherence in male consumers?

Woolery-Lloyd:Yes. I think that first of all, the discussions like we're having today are so important because it raises awareness, because you're right. In the past, men were more reluctant to seek options for hair thinning or hair shedding. So these types of discussions, I think, are so important because it raises awareness and it takes away the stigma associated with hair thinning. So that, I think, is the most important first step.

But the good news is research shows that men, once they have looked for their treatment option or found what they're looking for, they're actually more likely to stick with it. They're very, very committed. They're becoming much more proactive. I'm seeing that in my practice. So more commonly now, men will come out and say, is there something new? Is there something that I can do to address hair thinning? And we see this in younger men who have hair thinning, but also in older men who just want to maintain the hair that they already have, so they didn't have significant thinning when they were younger, but they just want to maintain their overall hair health.

I'm seeing that absolutely in my practice. And then from a data standpoint, we know that once men find a product that works for them, they are definitely more committed. And we know that at Nutrafol, we see strong loyalty among the male customers, and their 12-month lifetime value is almost 40% higher than our women subscribers. So once men seek out help, seek out options, they really are loyal, which is very, very interesting.

Saraceno: Certainly interesting and some would argue probably a bit surprising. So that's some nice positive news there. Yes. So very cool. I think another factor that plays into it is stress. Now stress is often cited as a trigger for telogen effluvium, and of course, other non-androgenetic forms of hair thinning in men. But the ingredient evidence in this area, it's less developed than for say, hormonal pathways.

Where does the clinical research currently stand on adaptogenic and stress response ingredients in the context of male hair health right now, and where do you think brands should be, or what should brands realistically be able to claim based on the evidence?

Woolery-Lloyd: So I love that you brought up stress, because stress is definitely is one of the main key root causes of hair thinning. I see that in my practice every day. It’s actually one of the first questions I ask when a patient comes in with a complaint of hair thinning is, have you had any recent stressors? And telogen effluvium after a major stressful event—it kind of pushes the hair out of that active growth phase into the resting and shedding phase.

People will see hair thinning and increased shedding around 3 to 6 months after that major stressful event. So I actually asked my patients about this when patients come in with a complaint of hair thinning. When it comes to research, there is research on ingredients that help to address stress, specifically tocotrienols, which is a concentrated form of vitamin E, and there is a randomized controlled trial that demonstrates benefits for hair growth and hair count with tocotrienols. They work primarily by reducing oxidative stress because they're antioxidants. We know vitamin E is an antioxidant.

I think it's great that you brought this up because it's something that I discuss with my patients, and it's really important for hair health. But again, it's just one of the many factors when it comes to hair thinning and shedding. It’s something I definitely talk about with my patients, but it's just one of the factors. And when it comes to evidence, again, the final formulation studies are the most important studies for me as a doctor, because they really show if you're going to make claims, the claims are on the actual final formulation. So that's what's most relevant for me as a dermatologist, and at Nutrafol, of course, we test our products. The final formulation is what all of our clinical studies are based off of.

Saraceno: And that's certainly great to hear. And there's a ton of different triggers for this form of hair thinning. As you said, unfortunately, I wish we had more time because we probably need days to kind of take a deeper dive into a lot of these. It’s hard to really pinpoint and focus on maybe just a handful of these. But I know in the short span today, I want to thank you for taking the time at least to shed some light on some of the hard-hitting facts today. I really do appreciate it, Doctor.

Woolery-Lloyd:Thank you. Thank you so much for having me. It's a very important topic. So thank you for having me.