hair health & recovery: The evidence based Dr. Munroe guide

Written By Tiffany Munroe

Journal Club · Dr Munroe Recommends

Hair Health & Recovery: The Evidence-Based Guide

Please read first: This guide is intended for adults. It is not a substitute for individual medical advice. If you are under medical care for any condition affecting your hair or scalp, please discuss any new products or supplements with your treating clinician before starting.

Hair loss and hair damage can have a significant impact on people's lives — and often small fixes help tremendously. There are also fantastic treatments available in clinic, and with specialist prescription medications, to support recovery. A key focus throughout this guide is optimising hair preservation and reducing breakage, because protecting the hair you have is just as important as encouraging new growth.

Top Tip: Hair grows approximately 1–1.5 cm per month. Any intervention — topical, dietary, or lifestyle — takes a minimum of 3–6 months to show results. Be consistent, be patient, and do not give up too soon.
Last reviewed: 11 June 2026 Medically reviewed by Dr Munroe

Key Takeaways

  • Get baseline bloods (ferritin, vitamin D, thyroid, B12, zinc) before buying any supplement — biochemical deficiency is one of the most common (and most correctable) causes of hair loss.
  • Aim for a ferritin level above 70 ng/mL — several studies link levels below this to diffuse shedding, even within the "normal" laboratory range.
  • Minoxidil remains the best-evidenced over-the-counter topical for androgenic alopecia, particularly the 5% strength most commonly recommended today.
  • Biotin is not supported by current evidence for hair loss in people without a genuine deficiency, despite heavy marketing.
  • Mechanical protection — silk pillowcases, gentle brushing, avoiding tight hairstyles — has a real, low-risk evidence base and is often overlooked in favour of products.
Shampoo & Conditioner — what to choose and what to avoid
  • Sulfate-free, gentle shampoos: sulfates (SLS/SLES) strip the scalp's natural oils and weaken the hair shaft over time.
  • Ketoconazole shampoo (e.g. Nizoral 1%) used 1–2× per week: shown in clinical studies to reduce scalp DHT (dihydrotestosterone, the hormone responsible for shrinking hair follicles in genetic hair loss) and inflammation, a key driver of androgenic hair loss.
  • Caffeine shampoos (e.g. Alpecin for men, Plantur 39 for women): caffeine can penetrate the follicle and has evidence for countering DHT-related miniaturisation. Leave on the scalp for a full 2 minutes; contact time matters.
  • pH-balanced formulas (ideally pH 4.5–5.5): keeps the cuticle sealed and protects the shaft.
  • Apply conditioner to mid-lengths and ends only: never massage into the scalp, as it can clog follicles.
⚠ Nizoral (ketoconazole shampoo) in pregnancy: generally considered low risk given its negligible systemic absorption when used on the scalp only. The UK SmPC (Summary of Product Characteristics — the official UK medicines information leaflet) does not contraindicate it but advises caution: always check with your GP or midwife. Safe to use whilst breastfeeding provided it is not applied to the breast or nipple area.
  • Shampoos containing SLS/SLES, parabens, or synthetic fragrances.
  • Dry shampoo as a regular habit: starch and alcohol build up, clog follicles, and cause chronic scalp inflammation.
  • Washing with very hot water: finish with a cool rinse to seal the cuticle.

Dr Munroe's Recommended Products

Nizoral 1% Ketoconazole Shampoo Use 1–2× per week, leave for 3 mins. Available in all UK pharmacies without prescription. For the scalp. View at Boots
Alpecin C1 (men) / Plantur 39 (women) Leave on the scalp for 2 mins every wash day. View at Boots
Philip Kingsley No Scent No Colour Gentle Shampoo Trichologist-developed, fragrance-free, sulfate-free. Best everyday base for washing the whole hair. View at Philip Kingsley
Behentrimonium Chloride 2% Conditioner — The Ordinary Lightweight, fragrance-free, non-clogging. Apply mid-lengths to ends only. View at The Ordinary
Scalp Care — healthy hair starts with a healthy scalp

The scalp is skin, and it has a rich blood supply. Most people focus on the hair and neglect the environment the follicle grows from. Dr Munroe will forever go on about sun protection for your skin, but don't forget the scalp is skin too. Look after it with scalp SPF or, even better, wear a hat.

  • Daily scalp massage: 4–5 minutes with your fingertips (not nails) or a massage tool. Research shows consistent scalp massage increases dermal papilla cell activity (dermal papilla cells sit at the base of each follicle and signal hair growth) and can improve hair thickness over 6+ months.
  • Exfoliate weekly with a gentle scalp scrub or salicylic acid scalp serum: removes product build-up and dead skin cells that can block follicles. The Ordinary Glycolic Acid 7% Toning Solution applied to the scalp weekly is a cost-effective option.
  • Minoxidil (5% foam for men; 2–5% for women): the gold-standard over-the-counter topical for hair loss. Apply to a dry scalp only, not to the hair itself. Allow at least 4–6 months and do not stop suddenly.
  • Rosemary oil serums: a 2015 randomized comparative trial found rosemary oil, applied twice daily, produced hair-count improvements comparable to 2% minoxidil (also applied twice daily) over 6 months.[1] Worth noting: 2% is the lower of the two minoxidil strengths in common use, and is now mostly superseded by 5%, which a separate trial found produced 45% more hair regrowth than 2% in men.[5] Rosemary oil has not been directly compared against 5% minoxidil, and has far less research behind it overall. Dilute in a carrier oil if using pure essential oil and apply twice daily.
  • The Ordinary Multi-Peptide Serum for Hair Density: a leave-on treatment containing REDENSYL™, Procapil™, CAPIXYL™, BAICAPIL™, AnaGain™ and 1% high-solubility caffeine. Apply to the scalp nightly.
⚠ Minoxidil: NOT recommended in pregnancy or breastfeeding. Discontinue prior to conception if possible and discuss timing with your doctor. Minoxidil is also potentially fatal if ingested by pets — keep out of their reach.

Dr Munroe's Favourites

🛠 Favourite Tool — Scalp Massager (silicone fingertip or electric) Inexpensive and remarkably effective. Use daily for 4–5 minutes — in the shower during conditioning or dry. Even better if you massage in your serum. Search on Amazon
🧴 Favourite Serum — The Ordinary Multi-Peptide Serum for Hair Density Six evidence-adjacent peptide and plant technologies plus 1% caffeine. Fragrance-free, lightweight, and genuinely one of the best-value hair serums available. Apply nightly with the dropper. View at The Ordinary
💊 Budget Pick — L'Oréal Elvive Growth Booster Anti-Fall Scalp Serum (102ml) Contains Aminexil, a minoxidil-adjacent compound working by non-hormonal mechanisms to soften follicles and prolong the growth phase. Clinical data showed a reduction in hair loss of over 67% in men and 43% in women after 45 days by pull test. Also contains niacinamide, ginger root extract, piroctone olamine, and lactic acid. Apply daily to the scalp. If you have a very sensitive scalp this product may not be for you, as it contains fragrance and alcohol — The Ordinary serum above is the better choice in that case. View at Boots
Brushes & Combs — reduce mechanical breakage
  • Wide-tooth comb for detangling: always start from the ends upward, never root to tip.
  • Boar bristle brush (or mixed boar/nylon): distributes scalp oils down the shaft, adds shine, and is the least mechanically damaging brush available.
  • Wet brush or Tangle Teezer-style for wet hair: flexible bristles dramatically reduce snap and breakage.
  • Fine-tooth combs on wet hair.
  • Brushing wet hair aggressively: hair is at its weakest when wet.
  • Metal or sharp-bristle brushes.
🪮 Favourite Brush — Tangle Teezer The Original Detangling Hairbrush The gold standard for detangling. Flexible two-tiered teeth absorb pressure rather than pulling, dramatically reducing breakage — especially important on fragile or thinning hair. View at Boots
Oils & Hair Masks — between-wash support

Used between washes, oils can support the scalp environment and reduce breakage.

Argan Oil: excellent for sealing the hair shaft and reducing breakage. Apply a few drops to damp ends. The Ordinary's 100% Organic Cold-Pressed Argan Oil is fragrance-free and good value. View at The Ordinary

Hair masks

DIY options: egg + olive oil + honey (protein + moisture, 20 mins once weekly); aloe vera gel applied directly to the scalp; yogurt + banana for conditioning.

💆 Favourite Ready-Made Mask — Virtue Mask for Thinning Hair Too lazy to faff with making your own mask? Same! Contains Alpha Keratin 60ku CLINICAL®, a bio-identical human keratin protein originally developed in regenerative medicine, which binds to damaged areas of the hair shaft to help repair and strengthen it. Also contains caffeine, red clover extract, green coffee and beet extract. Free from sulphates, parabens, phthalates, synthetic colours, and gluten. Apply to clean, damp hair, leave 5 minutes, rinse. Once weekly. View at Space NK
Towels & Drying — gentle handling matters
  • Use a microfibre hair wrap or soft cotton T-shirt to absorb water — do not rough up the cuticle with a standard towel.
  • Pat or squeeze gently — never rub.
  • Allow hair to air dry as much as possible before applying any heat.
  • Rubbing vigorously with a regular towel — significant mechanical breakage and frizz.
  • Wrapping hair in a tight, heavy turban for long periods — weight and friction cause hairline breakage.
🏖 Favourite Hair Wrap — Dock & Bay Hair Wrap Made from 100% recycled microfibre, this compact wrap absorbs water efficiently without the weight, friction, or breakage of a terry towel turban. Lightweight, quick-drying, gentle on fragile hair. View at Dock & Bay
Pillowcases & Night Protection — 7–8 hours that matter

What your hair rests on every night matters far more than most people realise.

  • 100% mulberry silk pillowcase — the single highest-return overnight investment for hair health. Reduces friction, prevents breakage, and does not absorb your hair's moisture the way cotton does. Look for long-strand mulberry silk at 19–25 momme. Bonus: your pillow stays cool and it's incredible for your skin too.
  • Loose braid or 'pineapple' (gathered loosely on top with a silk scrunchie) before bed to prevent matting.
  • Cotton pillowcases if you are experiencing active hair loss — the friction is real and avoidable.
  • Tight hair ties or elastics overnight — these create a consistent traction line of breakage.
  • Sleeping with wet hair — hair is more fragile when wet.
🌙 Favourite Pillowcase — Gingerlily Mulberry Silk Pillowcase The UK's leading silk bedding brand — designed in London, crafted from the finest long-strand mulberry silk. Naturally smooth, hypoallergenic, and gentle on both skin and hair. A genuinely worthwhile investment for your hair and your face. View at Gingerlily
Important: What to Avoid — the most preventable causes of loss
  • Tight hairstyles: ponytails, cornrows, buns, or extensions worn tightly cause traction alopecia, which can become permanent. One of the most preventable causes of hair loss.
  • Heat without protection: always use a heat protectant spray before any hot tool. Keep blow dryers on medium heat.
  • Chemical processes back-to-back: space these out and complete a protein treatment in between.
  • Over-washing: 2–3 times per week is ideal for most people.
  • Crash diets: rapid caloric restriction is a well-established trigger for telogen effluvium (sudden diffuse shedding).
  • Smoking and excessive alcohol: both impair scalp microcirculation and reduce nutrient delivery to follicles.
Start Here: Baseline Blood Tests — before you buy anything

Dr Munroe would advise doing baseline bloods before investing in supplements or treatments. Hair loss can have biochemical causes that are straightforward to identify and correct — and whatever hair care you do will be far less effective unless your nutritional and biochemical foundations are solid.

If you are post-partum or breastfeeding, you are very likely to have some form of deficiency. This is one of the most common (and most correctable) drivers of hair loss Dr Munroe sees in clinic.

Who can do your bloods? Your GP can request these — simply ask for a hair loss or fatigue screen and reference the list below. Dr Munroe can also arrange bloods for you, organising them at a facility convenient to you and reviewing the results together. If anything significant comes back, Dr Munroe will refer you back to your GP or guide you to the right support.

Tests to request

  • Full blood count, iron studies, and ferritin — aim for ferritin above 70 ng/mL[2]
  • Vitamin D (25-OH) — deficiency is extremely common in the UK
  • Thyroid function (TSH, free T3/T4) — hypothyroidism is a major and frequently missed cause of diffuse shedding
  • B12 and folate
  • Zinc levels
  • Hormone panel if relevant (oestrogen, testosterone, SHBG, prolactin) — particularly post-partum or peri-menopausal
Supplements — what the evidence actually shows

Once you have your blood results, you can supplement intelligently. Treating a confirmed deficiency is far more effective than supplementing speculatively — and some supplements (particularly iron) can cause harm if taken without need.

Tier 1 — Best evidence (guided by blood results)

  • Iron / Ferritin: Low ferritin — even within the 'normal' laboratory range — is strongly linked to hair shedding, particularly in women.[2] Aim for ferritin above 70 ng/mL. Get tested before supplementing.
  • Vitamin D3 + K2: Deficiency is extremely common in the UK and directly linked to hair follicle cycling. 1,000–4,000 IU daily with K2. Get levels tested ideally before starting.
  • Zinc: Supports follicle protein synthesis and DHT enzyme regulation. Do not exceed 40 mg per day.

Tier 2 — Good supporting evidence

  • Collagen peptides: Supports hair shaft structural protein; good evidence for improved thickness and reduced shedding. Dr M would recommend a bovine collagen for general use; in pregnancy switch to marine collagen — not as efficacious for hair growth but a great overall collagen.
  • Omega-3 fatty acids (fish oil): Anti-inflammatory effect on the scalp.
  • Magnesium glycinate: Reduces cortisol over time — chronic stress is a major driver of telogen effluvium.

❓ Saw palmetto (320 mg): A natural 5-alpha reductase inhibitor often touted as effective, but it is not well regulated and has some drug interactions with mixed outcomes. We would advise avoiding it until the evidence is more robust.

⚠ A note on Biotin (Vitamin B7): Current evidence does not support routine biotin supplementation for hair loss in healthy individuals — a 2026 systematic review of human studies concluded the available evidence is insufficient to support routine use without a proven deficiency.[3] High-dose biotin can also interfere with blood tests including thyroid and hormonal assays. If biotin appears as an ingredient in a blend you already take (such as Viviscal or Perfectil), there is no need to worry — it is targeted high-dose biotin (5,000–10,000 mcg) marketed primarily for hair that lacks justification.

Recommended off-the-shelf supplements

No single product perfectly covers all Tier 1 recommendations — iron and vitamin D ideally need dosing based on your blood results. The most evidence-aligned approach is to layer two products:

★ Viviscal Women (90 or 180 tablets) Best in class for a hair-specific supplement. Contains AminoMar C (marine collagen complex), iron 14 mg, zinc 15.4 mg, vitamin C (aids iron absorption), and niacin. Backed by 7 published clinical trials. Take twice daily for a minimum of 3–6 months. Not for use in pregnancy. View at Boots
Wellwoman Hairfollic (30 or 60 tablets) A broad-spectrum, budget-friendly option: vitamin D 600 IU, iron 7 mg, zinc 7.5 mg, magnesium 60 mg, marine collagen 40 mg, B-complex and selenium. Less collagen than Viviscal but covers more bases for the price. View at Boots
Vitamin D3 + K2 Sublingual Drops Dr Munroe's recommended vitamin D supplement: 1,000 IU D3 + 100 µg K2 (MK-7), absorbed through the oral mucosa in 60 seconds via patented lipid technology. Vegan, sugar-free, third-party tested. Use in addition to a hair-specific supplement. View at Hinnao (Dr Munroe discount applied)
Seven Seas Omega-3 + Vitamin D Capsules A cost-effective addition if omega-3 is lacking in the diet. View at Boots
⚠ A word on gummies: Hair, skin and nail gummy supplements are predominantly style over substance. They consistently under-dose the key minerals and are formulated around biotin as the marketing pillar. Choose tablets or capsules with published ingredient quantities.
⚠ Supplement safety in pregnancy: Viviscal is NOT recommended in pregnancy due to its iron content. Always check with your GP or midwife before starting any supplement in pregnancy or whilst breastfeeding. Vitamin D3 at 400–1,000 IU is routinely recommended during pregnancy — check the dose in any product you are already taking.
At the Salon — what to ask for and what to avoid

Request

  • Olaplex, K18, or bond repair treatments before or after any colour or bleach service.
  • A trichological scalp assessment if hair loss is a concern.
  • Protein treatments if your hair feels mushy and stretchy when wet (a sign of over-porosity).
  • A cool water rinse at the end of each treatment to seal the cuticle.

Avoid

  • Tight braids, weaves, or extensions if you are already experiencing loss — particularly at the hairline.
  • Relaxers during a period of active shedding.
  • Bleach on top of a relaxer — extremely high breakage risk.
Clinical Treatments Available at Dr Munroe

If self-care measures are not achieving the results you need, or if your hair loss is more significant, there are highly effective in-clinic treatments that can help.

Polynucleotides Hair Restoration (Plinest Hair)

Plinest Hair is a PN HPT™ (Polynucleotides Highly Purified Technology) treatment designed to biostimulate the scalp, improve follicle health, and promote hair regrowth. In manufacturer-reported clinical data, over 72% of treated women showed an objective improvement in alopecia, with the product well tolerated and no reported side effects.[4]

  • Suitable for: Androgenic alopecia, hormonal hair loss, thinning hair, eyebrow restoration
  • Protocol: Phase I — one session every 14–21 days for 3 sessions; Phase II — further sessions discussed with clinic.
Top Tip: Polynucleotides work synergistically with topical minoxidil and nutritional optimisation — combining home care with in-clinic treatment gives the best overall results.

Exosomes with Microneedling (Purasomes HSC50+ Hair & Scalp Complex)

Purasomes HSC50+ combines 20 billion exosomes from bovine colostrum with 20 growth factors, vitamins (B5, B6, B12, C), and amino acids, delivered via microneedling directly to the scalp for maximum follicle stimulation.

  • Suitable for: Thinning hair, hair regrowth, preventive treatment, scalp health optimisation
  • Protocol: 6–8 sessions, every 3–4 weeks, with maintenance discussed

Book a consultation

A Note from Dr Munroe: If your shedding is sudden, heavy, or patchy — please seek a professional assessment rather than self-treating. Some causes of hair loss, such as alopecia areata, scarring alopecia, or scalp infections, require medical treatment and cannot be addressed with lifestyle changes alone. Dr Munroe is happy to discuss your concerns in clinic.

References

  1. Panahi Y, Taghizadeh M, Marzony ET, Sahebkar A. Rosemary oil vs minoxidil 2% for the treatment of androgenetic alopecia: a randomized comparative trial. Skinmed. 2015;13(1):15–21. PubMed
  2. Serum ferritin and hair loss: multiple case-control studies report significantly lower ferritin in patients with diffuse hair loss versus controls, with a commonly cited diagnostic threshold of >70 ng/mL. See review: systematic review of serum ferritin thresholds, PMC
  3. Systematic review of biotin supplementation for hair loss in individuals without proven deficiency, 2026. MDPI – Cosmetics; see also Patel DP, Swink SM, Castelo-Soccio L. A Review of the Use of Biotin for Hair Loss. Skin Appendage Disord. 2017;3(3):166–169. PMC
  4. Manufacturer-reported clinical data, Plinest Hair (PN HPT™ polynucleotide technology) fact sheet, provided in-clinic by product distributor.
  5. Olsen EA, Dunlap FE, Funicella T, et al. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol. 2002;47(3):377–385. PubMed

General background and patient information: NHS – Hair loss · NICE CKS – Alopecia

Disclaimer: All product recommendations are based on clinical experience, peer review, and client feedback. Results may vary between individuals. Please check ingredients carefully if you have known allergies or sensitivities. This guide is for general information only and does not constitute medical advice. In the interest of ease, some of the links on this page may be affiliate links — this has not influenced Dr Munroe's decision to recommend any product. Prices correct as of 2026. For further information or to book a consultation, visit drmunroe.com or contact clinic@drmunroe.com.

Tiffany Munroe