How Balding Treatments Became the New Botox (2025)

Photo-Illustration: New York Magazine; Photos Getty Images

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Daniel was in his early 20s when he noticed he was losing his hair. He freaked outandboughttopical Rogaine, the only treatment he could afford on a student budget,then dutifully applied the greasy foam to his scalp morning and night. Mostly, though, he tried not to think too much about his problem. He avoided mirrors and looking at himself in photos and used the self-checkout counter at the pharmacy so no one would spot him buying Rogaine, which he wasn’t sure was even working, since he couldn’t stand to lay eyes on his scalp. But a few years later, friends started mentioning his bald spot to him. “It was the feeling of a knife going through me,” he said. He started searching for other treatments.

Somewhere in the depths of Reddit, Daniel got interested in PRP, the shorthand for platelet-rich plasma therapy, in which the platelets from a person’s own centrifuged blood cells are re-injected into the scalp in an effort to stimulate hair growth. Earlier this year, when Daniel’s acupuncture clinic emailed with a discount code for PRP treatments at a new hair-focused med spa in Noho called Great Many, he immediately booked an appointment.The med spa is one of several balding-oriented start-ups funded — and in some cases founded — by venture-capital firms looking for a piece of the $3 billion that people in North America spend annually on staying hairy, twice the annual expenditure on erectile-dysfunction pills.

The mainstreaming of injectables — available at a fleet of wellness-oriented, well-priced med-spa chains with perky start-up names like JECT, Peachy, Ever/Body, and Upkeep — has given people plumper, smoother, more paralyzed faces and a society that no longer gives these interventions the side-eye. Now VC firms are applying that same business model to scalp care. “The hair-growth industry is almost like where skin care was ten to 15 years ago,” said Michael Pollak, co-founder and co-CEO of Great Many alongside Steve Klebanow.

Newcomers in the brick-and-mortar baldness space are seizing on the widespread availability of effective pharmaceuticals to fight hair thinning—notably minoxidil, the generic term for Rogaine, which in the last decade has increasingly been prescribed as an oral medication rather than a topical foam. For a long time, dermatology had little to offer when it came to hair loss, said dermatologist Brett King, a former professor at the Yale School of Medicine who, starting around 2015, was among a group of physicians who began to explore prescribingminoxidil in pill form. But thanks to medications like oral minoxidil, he said, “We can do a reasonably good job in many if not most people — which, for a condition that affects virtually everybody at some point in their life? That’s a lot of people.”

The exact causes of common baldness — the lay term for androgenic alopecia, one of the most ubiquitous forms of hair loss — remain stubbornly mysterious, which has complicated the search for a cure. As best researchers can tell, it occurs when the body produces a DHT, a more potent form of testosterone that wreaks havoc on hair follicles, though only in individuals whose scalps, for as-yet-undetermined reasons, are genetically predisposed to be sensitive to DHT. In women, this can be just one of several factors that lead to thinning. The only FDA-approved drugs for common baldness were discovered entirely by accident decades ago. Finasteride, a medication that reduces the production of DHT and was marketed under the brand name Propecia, was in clinical trials to treat enlarged prostates until researchers observed bald patients suddenly showing up with hair. Minoxidil was being used as a blood-pressure drug when physicians noticed a similar effect and made it into a topical formulation that went on to be sold as Rogaine. (How does it work? “Nobody has a clue,” said King.) Though oral minoxodil (unlike the foam and liquid form) is not yet FDA-approved to treat hair loss, King said it is so effective it “should be the staple for all hair-loss patients.”

Oral minoxidil could, however, make you hairier elsewhere.“You may see some brow growth, some ear growth, some lash growth. I’ve seen people with a little bit of arm growth,” said Stef Rippenbaum, a nurse practitioner at Great Many. “I say, ‘It’s a lot easier to get rid of hair than it is to get hair.’”

Start-up founders are expected to have a compelling, personal origin story, and Pollak and Klebanow have theirs down pat. They told me they began to think seriously about opening a hair-care company after they each started to experience their own hair loss (a thinning crown for Pollak and a receding hairline for Klebanow) and came face-to-face with the market’s inefficiencies (specifically, that companies like the VC-backed Hims and Keeps focus on selling medication by mail). Hair loss is not a term Great Many’s founders like to use. “From a brand perspective, we try to say hair growth and root everything in growth,” Pollak said. “Balding feels a little mean, so we tend to stay away from that word.” Technically, however, their company was originally the idea of the venture-capital firm BrandProject, which has funded other millennial-bait companies, such as Peachy, which specializes in lunch-break Botox, and Daily Harvest, a “clean food” purveyor.In 2023, BrandProject’s founder Andrew Black posted on LinkedIn that he was looking for a CEO to run “a business in the hair health space named Great Many, focused on helping millennial consumers who are concerned about thinning and diminishing hair.” After meeting with nearly 20 candidates, he picked Pollak, the co-founder of Heyday, a chain of facial-only spas. Some networking led the pair to Klebanow, a former Estée Lauder executive who owns a barbershop in the West Village. Together, he and Pollak have turned Great Many from an idea into a business, which opened its doors last summer after raising nearly $4 million from investors.

Earlier this fall, I met Pollak and Klebanow at what they call the Great Many “hair-growth studio,” a ground-floor retail space overlooking a Cha Cha Matcha. We began our tour in the waiting room, a space with a millennial aesthetic that falls somewhere between a boutique hotel and a Sweetgreen: forest-green walls, designer sconces shaped like lily pads, minimalist monochrome artwork evoking strands of hair. “This is the influencer area,” said Pollak, leading me into a “refresh area” with a sink, mirror, and moss-colored subway tiles.

Hair loss is fraught: A study published in JAMA Dermatology asked respondents to rate the appearance of subjects with varying levels of baldness and found that hair loss negatively affected opinions of a person’s intelligence, likability, attractiveness, and hirability — a bias that grew the less hair people had. And yet seeking a solution can be its own stressor,given the surfeit of specious claims, contradictory information, and cringey infomercials. For nearly a decade, venture-capital-backed companies like Hims and Keeps have been trying to inject a more modern aesthetic to an industry long dominated by entrenched players like HairClub (formerly known as HairClub for Men), a purveyor of hair transplants and other treatments. In New York, HairClub’s offices are located on the ninth floor of a midtown building with a gray waiting room with all the charm of a customs-inspection area. Klebanow described the industry’s standard design decisions as “almost intended to keep up some of that insecurity around hair growth, that stigma.” The idea of walking into a HairClub mortified Daniel. “I probably would have been in a disguise,” he deadpanned. “I felt more comfortable going into Great Many because yes, it does have a cooler aesthetic to it.”

Pollak, Klebanow, and I spoke in front of a flatscreen TV that played a looping video of a man with stylish stubble smiling as a nurse practitioner injected his scalp with an earwax-colored ooze — the PRP treatment that Great Many considers its “hero service.” Venture-capital-funded start-ups frequently differentiate themselves by undercutting the competition’s prices, and PRP at Great Many starts at $495 per treatment, half what many dermatologists’ offices charge. (One doctor told me she’d heard of people charging as much as $2,000.) Great Many’s relatively inexpensive prices, spalike atmosphere, and convenient hours suggest an effort to be the fast casual of hair-loss treatments. “We’ve tried to democratize it and make it more mainstream and easier to do,” said Black.

Besides PRP, Great Many’s other offerings include proprietary hair-care products, such as a root serum infused with seaweed bioferment, as well as supplements, prescriptions for hair-growth medications (including oral minoxidil), and access to a staff “Hairline” where you can text hair-related questions. Pollak and Klebanow talk enthusiastically about being “partners” in “your hair journey.” According to Pollak, nearly half of their clients are women, and Klebanow said they’ve tried hard to make their brand feel “gender agnostic,” since hair loss doesn’t discriminate between genders. Given their studio’s location in Noho’s wellness corridor — nestled between a Pressed Juicery, a Peachy, several “clean” markets, and various gyms — Pollak told me that there are many clients who walk in off the street, and couples frequently get treatments in tandem. The CVS Pharmacy next door might also be a boon for business: The cameras in the self-checkout lane offer an unsparing view of people’s thinning crowns. The location was “a coincidence,” said Klebanow. “But helpful.”

For many people, there comes a point when hair loss solidifies into hair lost. As long as you still have some hair on your head (even just on the sides), this is when hair transplants can enter into the equation. They are expensive, painful, and time-intensive, but, done correctly, they work. Venture capital has its sights set on this corner of the hair-loss industry, too.

James — who is in his mid-30s and, for professional reasons, asked to be identified by first name only — had known for years that his hairline was receding, but a photo of himself taken from above made him realize the situation was far more advanced than he’d realized. “I was like, Oh my God. I just don’t like this.” He looked into Bosley, a four-decades-old chain offering transplants and other services that leans heavily on before-and-after images of grinning men, “at which point,” he said, “I was kind of turned off by the whole thing.” More Googling led him to Ample, a year-old transplant clinic in midtown that, like Great Many, was first conceived and funded by a venture-capital firm, Redesign Health. According to PitchBook, Ample has raised nearly $8 million, though the company wouldn’t confirm this.

James went for a consultation at Ample’s “hair restoration studio,” which, on my recent visit, felt more like a living room than a doctor’s office. In the waiting room, an elegant swoop of a couch overlooked a white marble coffee table accessorized with a succulent and a book on Andy Warhol. There was a Nespresso machine, Kind bars, and Apotheke air diffusers. “Pine?” I asked, sniffing. “Charcoal,” corrected Ample CEO Ross Jacobson, who previously co-founded the anti-aging clinic Modern Age. Ample impressed James. “I love their furniture, all of that,” he remembered thinking. He told me Ample’s knack for making hair transplants “seem a little bit cooler is 100 percent a thing.” He scheduled his transplant surgery.

In a carefully accessorized lounge next to a treatment room occupied by a man whose head was bandaged in gauze, James’s surgeon, HardikDoshi, walked me through the mechanics of repopulating a bald spot. Doshi, a facial plastic and reconstructive surgeon who also has his own private practice with three locations around New York, said he connected with Jacobson over the idea of creating a patient-focused clinic that felt like “a very friendly place.”

A transplant does not regrow hair but rather rearranges it for maximal effect. Either by using what he calls “very, very small cookie cutters” to extricate one to four follicles at a time or else by removing a very narrow strip of scalp, Doshi harvests what some doctors call “immortal hairs,” given their resistance to falling out from the back of a patient’s head. (In the first process, the follicles are carefully excised in a pattern that should disguise their absence; in the latter, the scalp is stitched back together where the small strip of skin was cut out.) With a needle, Doshi then reinserts the immortal hairs into the scalp, sometimes a single follicle at a time, where the hair is thinning. At Ample, transplants begin at $9,500; Bosley, which James also considered, says on its website that “the majority of our procedures cost between $6,000 and $12,000.” A large transplant, in which numerous follicles are grafted, can easily cost $20,000 at a dermatologist’s office. In Turkey, known for a booming (and, in some cases, reportedly perilous) surgery-tourism market, transplants can cost as little as around $3,000.

After a brief chat, Doshi excused himselfto see a patient. Like many doctors who treat hair loss, he’s experienced growing demand for his services, driven in part by COVID (which can cause thinning), Ozempic (ditto), and social media (which features an endless parade of beautifully coiffed humans offering tips to get that way), as well as a growing arsenal of effective tools to treat balding. Anti-aging interventions have also decisively crossed gender lines. Doshi told me that more men than ever — “professionals, police officers, judges, lawyers” — are coming to him for cosmetic surgeries.

James, now nearly a year on from his hair transplant with Ample, told me he is thrilled with the results, which helped fill in his receding hairline. The procedure has made him think differently about his physical appearance and how he’ll age. He’s started to contemplate, “Okay, now what else? How else can I better myself?” he said.

Some physicians express concern about the med-spa approach. At these facilities, hair-loss patients may be seen by nurse practitioners who, because they undergo less training than specialized physicians, may fail to diagnose certain conditions and keep patients from getting treatments that could actually help. Finding the correct treatment requires diagnosing what type of hair loss a person has. Drugs that affect androgenic alopecia, for example, won’t necessarily help with alopecia areata, an autoimmune disease. A common cause of thinning is telogen effluvium, when you temporarily shed hundreds more hairs than usual, often owing to hormonal changes, illness, or weight loss. After a few months, most cases go away on their own, though not necessarily without causing distress to the person experiencing the symptoms — or without enriching the hair-care industry. “I knew what was happening and I was still freaking out,” said dermatologist Maryanne Senna, director of the Lahey Hair Loss Center of Excellence, of her own bout of telogen effluvium. “A lot of people are being bamboozled by some of these nutraceuticals and other things, thinking that they’re regrowing hair, when in fact it’s something that in 99.9 percent of cases would’ve happened without any treatment.” In a letter published in the Journal of the American Academy of Dermatology, Senna and several colleagues reported that one in 15 patients who came to them seeking PRP were affected with scarring alopecia, a form of hair loss best addressed with a different therapy—without which they risk permanent hair loss or scarring. “It’s not health care but a business model,” King wrote of Great Many in an email to me. “People with hair loss should see dermatologists who specialize in hair loss disorders. Would you see a ‘board-certified clinician’ for heart disease or a lung disorder? No, you wouldn’t. But it’s ‘just hair,’ so the thinking goes that anyone can be trained to do it and nothing very bad can go wrong.”

Though Great Many does not have a physician on premises, its founders said their staff — nurse practitioners and physicians’ assistants— review clients’ medical backgrounds and encourage them to see doctors if the situation merits it, which they say happens “infrequently.” “We’ve referred people out to endocrinologists, dermatologists, any provider that’s appropriate,” said Pollak. “Our goal is not to diagnose every type of hair loss.” Great Many’s founders asserted that “numerous” dermatologists — who obviously have their own financial incentives to encourage people to see them over med spas — have referred patients to them.

Though the dermatologists I spoke to said pharmaceuticals are the most powerful defense against common baldness, many of them also offer PRP, “the weakest of the treatments available for androgenetic thinning,” according to one doctor. At a PRP appointment, patients at Great Many will have their blood drawn and then centrifuged to separate out the platelets (cells our bodies rely on to heal wounds), which are re-injected to the scalp wherever the hair is thinning for “about 20 small pokes” in all, according to Great Many’s Stef Rippbenbaum. She offers laughing gas or applies chilled air to patients’ heads to minimize the pain. The clinic recommends one PRP treatment a month for three months, then every six months after that. But studies on PRP’s effectiveness in treating hair loss have had more mixed results than many sales pitches let on. “There’s as much data to dispute that it works as there is data showing that it works,” King told me.

As I perused Great Many’s offerings on its website — its $134 “GrowthFactor Formula” shampoo, conditioner, and serum set; its $1,485 PRP package — I couldn’t help but think of Daniel, who now uses all of the start-up’s hair-care products and has just finished his first three PRP sessions. When you’re losing your hair, he told me, it’s easy to get hooked on snake oil. Even if you’re not sure a product is working, there’s always a nagging fear that your balding might have been even worse without it. “This is how desperate you get when your hair’s falling out,” said Daniel. “You’re just willing to try whatever because it’s better than facing reality.”

He wasn’t sure yet whether Great Many’s treatments were helping, since he still preferred not to look too closely at his scalp.

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