The first FDA-approved drug for treating hair loss was minoxidil, which was also known as Rogaine. It is currently sold as a topical solution that is applied directly to affected areas on scalp. Originally, it was a prescription drug, but now available as OTC medication (generic minoxidil solution and Rogaine), men get 5 percent concentration, while women get 2 percent. Recently, Rogaine released a new formulation that takes form as 5 percent topical foam. It is easier to apply and less greasy.
How minoxidil works?
Before topical minoxidil was available, it was used as an oral blood pressure drug. Doctors observed that those who took oral minoxidil not only had lower blood pressure but started to grow body hair as well. Researchers assumed that applying minoxidil on a bald scalp might encourage hair growth without causing side effects as what was found on oral drugs. With topical formulation, patients can at least get modest hair growth.
It is not well understood how minoxidil can promote hair growth. Minoxidil is a vasodilator (it causes blood vessels to expand or dilate) and may improve the blood circulation around hair follicle, but how it relates to hair growth is unclear. Additionally, minoxidil can also lengthen the hair follicle growth duration while improving hair quality, in terms of diameter, color and durability.
How effective is minoxidil?
Early researches on minoxidil were focused on the crown of human head, so some believe that it is only useful in this area. This drug may work nicely in the crown area, but can work in other areas to a lesser degree, provided that there are still some fine hairs. However, it does not work in a totally bald area that’s devoid of hair follicles.
The effect of minoxidil is visible after six months or more. The result is gradual, so you will continue to lose hair, although at a slower rate until you begin to have positive hair growth. Minoxidil effectiveness in treating men with pattern hair loss had been investigated since the 1980s and was scientifically proven. Men tend to respond better to 5 percent concentration of minoxidil than the 2 percent solutions.
The effects can wear off if minoxidil is no longer applied and hair loss will resume. Unfortunately, when restarting the treatment, you generally won’t regain the hair that is recently lost after the previous treatment, so it’s a bad idea to stop and restart the treatment after a few months.
Does it work for women?
Yes, it still can work for women that have pattern hair loss, however, women is only approved to get 2 percent concentration of minoxidil. In a research, it was discovered that about 60 percent of women who took 2 percent minoxidil show some improvements.
The researchers concluded that it is an effective way for treating women’s pattern hair loss however, it may not work in some patients. Although, women is only approved for 2 percent minoxidil solution, women with more severe pattern hair loss may need to get a 5 percent minoxidil solution.
What are minoxidil’s side effects?
Most likely side effect is localized irritation, if you tend to get severe irritation, you should choose foam formulation. Women may also get unintended facial hair development. Although it may decrease after the treatment is discontinued, but sometimes unintended hair must be removed with either lasers or electrolysis. To reduce the likelihood of unintended hair growth, you need to avoid the solution from dripping down onto the forehead and temples! Women are more likely to get systemic side effects like lower blood pressure. Some women may feel lightheaded as the result of lower blood pressure after using topical minoxidil. There is also a risk of allergic skin reactions around the scalp. Unfortunately, minoxidil can cause congenital defects. Women who are planning to become pregnant, already pregnant or breastfeeding shouldn’t use minoxidil.
Minoxidil and finasteride
Studies have shown that minoxidil is less powerful compared to finasteride when treating male pattern hair loss. In general, 80 percent of the men that use finasteride and 50 percent that use minoxidil show improvements in hair density. In general, both medications are effective, although finasteride is more effective. Additional studies discovered that combination of minoxidil with finasteride is better than finasteride alone and both seem to have synergistic relation.
Doctors advise for direct application of minoxidil on the scalp (it will be useless to apply it to the hair) twice a day. To successfully regain lost hair, you should apply the minoxidil solution to any thinning area, including the temples and frontal hairline. Using minoxidil once a day is perhaps almost as effective as applying it twice a day because it has 24 hours of effectiveness. Taking minoxidil once a day is a sensible option if it is not practical for you to use minoxidil solution twice a day.
A study showed that using one combined dose of 5 percent concentration of minoxidil and very few tretinoin (a substance that allows the minoxidil penetrates the scalp better) is comparable to two dosage of conventional 5 percent minoxidil. Unfortunately, topical tretinoin can cause irritation on the scalp and cause too much minoxidil to enter the bloodstream.