Image courtesy of Men's Health

When a man begins to go bald, two things go down the drain--his hair and his confidence. Some 62 percent of balding guys in a Spanish study said losing their locks could deflate their self-esteem. This isn't 21st-century superficiality: "Thick hair has always been associated with youth and masculinity," says Albert Mannes, Ph.D., a University of Pennsylvania researcher who's studied perceptions of balding. "Hair loss signals aging."

But baldness can be deceiving: Two-thirds of men face hair loss by age 35, and a bad genetic hand is often to blame. Male-pattern baldness is an inherited sensitivity to dihydrotestosterone (DHT, a by-product of testosterone), which leads to finer hair, a receding hairline, and finally a deserted scalp.

That's why scientists--who may be thinning up top themselves--have put balding in their crosshairs. Read on for new ways to save what's there, regain what's gone, or--if it comes to it--learn that you can lose and still win.

1. FIND THE CAUSE

Doctors often diagnose balding by sight alone: If your hair is only on the sides and middle top of your head, the bare areas form the letter M (as in male-pattern baldness). But thinning that spreads across your scalp and not to your crown or temples often indicates an underlying health issue. "Hormonal or nutritional deficiencies, such as thyroid problems, low iron, or low protein, can cause shedding," says Carolyn Jacob, M.D., the founder of Chicago Cosmetic Surgery and Dermatology. In other words, "don't assume it's genetic," says Marc Avram, M.D., a clinical professor of dermatology at Weill Cornell Medical College. One hitch: A discernible pattern may take years to emerge, so pinpointing the cause simply by the look of your locks may be difficult. That's why Dr. Avram suggests seeing a dermatologist as soon as thinning begins so you can have a scalp biopsy to rule out worrisome triggers. To find a dermatologist specializing in hair loss, go to aad.org/find-a-derm, enter your zip code, and select "hair disorders" as the specialty. (What your hand says about your penis, the link between your lips and brain, and more: 10 Crazy Body Connections Explained!)

2. SIDE WITH THE SCIENCE

Late-night TV ads offer legit fixes for many problems--stains, clogged gutters, subpar pancakes--but balding isn't one of them. "Be wary of infomercials or Internet ads touting hair-growing shampoos or pills," warns Marc Glashofer, M.D., a dermatologist in Long Beach, New York, who specializes in hair loss. "Most haven't been clinically studied and are usually a waste of your money." (An effective hair-growth shampoo is out there, but it isn't advertised as such. Keep reading.) Stick with the drugs that have been green-lighted by the FDA: finasteride (Propecia) and minoxidil (Rogaine). "Both are better at maintaining what you have than regrowing what you lost," says George Cotsarelis, M.D., a professor of dermatology at the University of Pennsylvania.

Propecia works by blocking the conversion of testosterone to DHT, but there's a side effect to consider: It could mess with nerve-signaling pathways to your penis, resulting in ED and a loused-up libido, a study in the Journal of Sexual Medicine found. Dr. Cotsarelis says most men don't experience these side effects, but if you're uneasy about the ED risk, skip the Propecia.

As for Rogaine, it's thought to stimulate hair growth, although scientists aren't sure how. "Rogaine often gets a bad rap because people don't use it correctly," Dr. Cotsarelis says. "You have to use Rogaine at least twice a day and for at least six months before you see any results. It can actually cause shedding in the first month or two." In other words, don't give up after just a week of slathering it on your scalp. (Bald is beautiful...take notes from these 10 celebrities and athletes who shed their locks and never looked back.)

3. SWITCH SHAMPOOS

Dozens of shampoos claim to make your hair look thicker, but only one ingredient has been shown to truly preserve your pate. Ketoconazole, an antifungal used to fight dandruff, may save your mane by reducing production of testosterone (and therefore DHT) in hair follicles, say scientists at the University of British Columbia. In fact, in a Belgian study, balding men who used a 1 percent ketoconazole shampoo two or three times a week for six months saw a 17 percent reduction in hair shedding.

Try Nizoral A-D, the only nonprescription shampoo that contains ketoconazole. "Use it with Propecia or Rogaine, especially if you have dandruff, because flaking can prevent penetration of Rogaine into the scalp," suggests Dr. Avram. Lather up with a quarter-sized dollop two or three times a week; any more could dry out your hair and cause breakage. Use non-irritating baby shampoo in between. (For more ways to destroy dandruff, read the 6 Surprising Ways to Tackle Dandruff.)

4. EAT SMARTER

Cleaning up your diet may save you from the Mr. Clean look. Start by skipping fried foods; this may reduce oil-gland activity, slowing the switch from T to DHT, according to research from India. And watch the desserts: The insulin flood from consuming a lot of sugar can trigger the release of testosterone, making it available for conversion to DHT.