- Rogaine (Topical)
- Commonly used brand name(s)
- Uses for Rogaine
- Before using Rogaine
- Proper use of minoxidil
- Precautions while using Rogaine
- Minoxidil vs Finasteride: Do Either Really Work?
- Minoxidil vs Finasteride: What’s The Difference?
- Do Minoxidil and Finasteride Work?
- Are Minoxidil and Finasteride Safe to Take Together?
- Minoxidil vs Finasteride: Which is Better?
- What it is
- What it Does
- Results Vary
- Now Available Without a Prescription
- Benefits of Minoxidil
- Risks and Disadvantages of Minoxidil
- Minoxidil Variations
- Minoxidil Candidates
- Who can expect results?
- Minoxidil Treatment Described
- Salt and Water Retention (see WARNINGS: Concomitant Use of an Adequate Diuretic is Required)-Temporary edema developed in 7% of patients who were not edematous at the start of therapy.
- Pericarditis, Pericardial Effusion, and Tamponade (see WARNINGS).
- Dermatologic-Hypertrichosis-Elongation, thickening, and enhanced pigmentation of fine body hair are seen in about 80% of patients taking minoxidil (minoxidil (minoxidil (minoxidil tablets) tablets) tablets) tablets. This develops within 3 to 6 weeks after starting therapy. It is usually first noticed on the temples, between the eyebrows, between the hairline and the eyebrows, or in the side-burn area of the upper lateral cheek, later extending to the back, arms, legs, and scalp. Upon discontinuation of minoxidil (minoxidil (minoxidil (minoxidil tablets) tablets) tablets) , new hair growth stops, but 1 to 6 months may be required for restoration to pretreatment appearance. No endocrine abnormalities have been found to explain the abnormal hair growth; thus, it is hypertrichosis without virilism. Hair growth is especially disturbing to children and women and such patients should be thoroughly informed about this effect before therapy with minoxidil (minoxidil (minoxidil (minoxidil tablets) tablets) tablets) is begun. Allergic-Rashes have been reported, including rare reports of bullous eruptions, and Stevens-Johnson Syndrome.
- Hematologic-Thrombocytopenia and leukopenia (WBC < 3000/mm3) have rarely been reported.
- Gastrointestinal-Nausea and/or vomiting has been reported. In clinical trials the incidence of nausea and vomiting associated with the underlying disease has shown a decrease from pretrial levels.
- Miscellaneous-Breast tenderness-This developed in less than 1% of patients.
- Altered Laboratory Findings-(a) ECG changes-Changes in direction and magnitude of the ECG T-waves occur in approximately 60% of patients treated with minoxidil (minoxidil (minoxidil (minoxidil tablets) tablets) tablets) . In rare instances a large negative amplitude of the T-wave may encroach upon the S-T segment, but the S-T segment is not independently altered. These changes usually disappear with continuance of treatment and revert to the pretreatment state if minoxidil (minoxidil (minoxidil (minoxidil tablets) tablets) tablets) is discontinued. No symptoms have been associated with these changes, nor have there been alterations in blood cell counts or in plasma enzymeconcentrations that would suggest myocardial damage. Long-term treatment of patients manifesting such changes has provided no evidence of deteriorating cardiac function. At present the changes appear to be nonspecific and without identifiable clinical significance. (b)-Effects of hemodilution-hematocrit, hemoglobin and erythrocyte count usually fall about 7% initially and then recover to pretreatment levels. (c) Other-Alkaline phosphatase increased varyingly without other evidence of liver or bone abnormality. Serum creatinine increased an average of 6% and BUN slightly more, but later declined to pretreatment levels.
Read the entire FDA prescribing information for Minoxidil (Minoxidil Tablets)
Generic Name: minoxidil (Topical route)
Medically reviewed by Drugs.com. Last updated on Nov 18, 2018.
- Side Effects
Commonly used brand name(s)
In the U.S.
- Men’s Rogaine
- Rogaine For Men Extra Strength
- Women’s Rogaine
- Hair Regrowth Treatment
- Med Minoxidil
Available Dosage Forms:
Therapeutic Class: Alopecia Agent
Uses for Rogaine
Minoxidil applied to the scalp is used to stimulate hair growth in adult men and women with a certain type of baldness. The exact way that this medicine works is not known.
If hair growth is going to occur with the use of minoxidil, it usually occurs after the medicine has been used for several months and lasts only as long as the medicine continues to be used. Hair loss will begin again within a few months after minoxidil treatment is stopped.
In the U.S., this medicine is available without a prescription.
Before using Rogaine
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies have not been performed on the relationship of age to the effects of topical minoxidil in children. Safety and efficacy have not been established ..
Appropriate studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of topical minoxidil in the elderly. However, studies have shown that the medicine works best in younger patients who have a short history of hair loss. Minoxidil has not been studied in patients older than 65 years of age .
|All Trimesters||C||Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.|
Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.
Interactions with medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter ) medicine.
Interactions with food/tobacco/alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other medical problems
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Any other skin problems, an irritation, or a sunburn on the scalp—These conditions may cause too much topical minoxidil to be absorbed into the body and may increase the chance of side effects.
- Heart disease or
- Hypertension (high blood pressure)—Topical minoxidil has not been studied in patients who have these conditions, but more serious problems may develop for these patients if they use more medicine than is recommended over a large area and too much minoxidil is absorbed into the body.
Proper use of minoxidil
This section provides information on the proper use of a number of products that contain minoxidil. It may not be specific to Rogaine. Please read with care.
This medicine usually comes with patient instructions. It is important that you read the instructions carefully.
It is very important that you use this medicine only as directed. Do not use more of it and do not use it more often than your doctor ordered. To do so may increase the chance of it being absorbed through the skin. For the same reason, do not apply minoxidil to other parts of your body. Absorption into the body may affect the heart and blood vessels and cause unwanted effects.
Do not use any other skin products on the same skin area on which you use minoxidil. Hair coloring, hair permanents, and hair relaxers may be used during minoxidil therapy as long as the scalp is washed just before applying the hair coloring, permanent, or relaxer. Minoxidil should not be used 24 hours before and after the hair treatment procedure. Be sure to not double your doses of minoxidil to make up for any missed doses.
To apply minoxidil topical solution:
- Make sure your hair and scalp are completely dry before applying this medicine.
- Apply the amount prescribed to the area of the scalp being treated, beginning in the center of the area. Follow your doctor’s instructions on how to apply the solution, using the applicator provided.
- Do not shampoo your hair for 4 hours after applying minoxidil.
- Immediately after using this medicine, wash your hands to remove any medicine that may be on them.
- Do not use a hairdryer to dry the scalp after you apply minoxidil solution. Blowing with a hairdryer on the scalp may make the treatment less effective.
- Allow the minoxidil to completely dry for 2 to 4 hours after applying it, including before going to bed. Minoxidil can stain clothing, hats, or bed linen if your hair or scalp is not fully dry after using the medicine.
- Avoid transferring the medicine while wet to other parts of the body. This can occur if the medicine gets on your pillowcase or bed linens or if your hands are not washed after applying minoxidil.
To apply minoxidil topical foam:
- Open the container by matching the arrow on can ring with the arrow on cap. Pull off the cap.
- Part the hair into one or more rows to expose the hair thinning area on the scalp.
- Hold the can upside down and press the nozzle to put foam on your fingers.
- Use your fingers to spread the foam over the hair loss area and gently massage into your scalp.
- Immediately after using this medicine, wash your hands to remove any medicine that may be on them .
If your scalp becomes abraded, irritated, or sunburned, check with your doctor before applying minoxidil.
Minoxidil topical foam or solution is for use on the scalp only. Keep this medicine away from the eyes, nose, and mouth. If you should accidentally get some in your eyes, nose, or mouth, flush the area thoroughly with cool tap water. If you are using the pump spray, be careful not to breathe in the spray .
Do not use the foam near heat or open flame, or while smoking. Do not puncture, break, or burn the aerosol can .
The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For hair growth:
- For topical solution dosage form:
- Adults—Apply 1 milliliter (mL) to the scalp two times a day.
- Children—Use and dose must be determined by the doctor.
- For topical foam dosage form:
- Adults—Apply half a capful to the scalp two times a day.
- Children—Use and dose must be determined by your doctor .
- For topical solution dosage form:
If you miss a dose of this medicine, apply it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Flammable: Keep away from fire or flame.
Precautions while using Rogaine
It is important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.
Tell your doctor if you notice continued itching, redness, or burning of your scalp after you apply minoxidil. If the itching, redness, or burning is severe, wash the medicine off and check with your doctor before using it again.
Hair loss may continue for 2 weeks after you start using minoxidil. Tell your doctor if your hair loss continues after 2 weeks. Also, tell your doctor if your hair growth does not increase after using minoxidil for 4 months.
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- Itching or skin rash (continued)
- Acne at site of application
- burning of scalp
- facial hair growth
- increased hair loss
- inflammation or soreness at root of hair
- reddened skin
- swelling of face
Signs and symptoms of too much medicine being absorbed into the body—Rare
- Blurred vision or other changes in vision
- chest pain
- fast or irregular heartbeat
- numbness or tingling of hands, feet, or face
- swelling of face, hands, feet, or lower legs
- weight gain (rapid)
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Copyright 2019 Truven Health Analytics, Inc. All Rights Reserved.
- Side Effects
- During Pregnancy or Breastfeeding
- Dosage Information
- Drug Interactions
- Support Group
- En Español
- 27 Reviews
- Drug class: miscellaneous topical agents
- FDA Alerts (1)
- Rogaine (Minoxidil Topical Foam)
- Rogaine (Minoxidil Topical Solution)
- Minoxidil topical (AHFS Monograph)
- Women’s Rogaine Topical
- Rogaine For Men Extra Strength Topical
Rogaine is the brand name for topical minoxidil.
People with thinning hair or male pattern baldness use Rogaine to slow hair loss and stimulate hair growth.
Minoxidil was first developed to treat high blood pressure, but people taking the medication reported an unusual side effect: Hair began to grow on various parts of their bodies.
Researchers began to study the effect of applying a minoxidil solution directly on the scalp. They found daily use slowed hair loss and produced some new hair growth.
Rogaine, which is minoxidil in solution, was first marketed as a topical prescription drug and is now available over-the-counter (OTC).
No one’s really quite sure how it works, but some scientists think that Rogaine causes hair growth by shortening the resting phase of the hair follicle during its life cycle
The Food and Drug Administration (FDA) approved prescription 2 percent minoxidil topical solution for hair loss in men in 1988 and for women in 1992.
Later, it was approved for over-the-counter (OTC) use in both 2 percent and 5 percent strengths. Johnson & Johnson manufactures the products.
Rogaine for Women
Many different factors cause hair loss or thinning in women, including thyroid conditions, hormone changes with age and other hormonal disturbances, and reactions to certain medications.
Once your doctor determines the cause of your hair loss, you can work together to figure out which treatment options will work best for your situation.
If you’re hair is thinning, make an appointment with your doctor to find out what’s causing your hair loss before using Rogaine.
You may have an underlying health condition that, when identified and corrected, may reverse your hair loss.
Rogaine for Facial Hair and Beards
There are anecdotal reports that when applied to facial skin, Rogaine encourages growth of facial hair.
However, Rogaine is not approved for this use, and there are no studies showing it’s effective for beard growth.
You shouldn’t take Rogaine if you’re allergic to minoxidil or any other ingredients found in the medication.
Avoid applying Rogaine to irritated areas of the your scalp.
If you have kidney problems, ask your doctor if Rogaine is safe for you to take.
Pregnancy and Rogaine
Rogaine may not be safe for a developing baby. Most doctors, however, consider Rogaine safe to use while breastfeeding your baby.
Talk to your doctor before using Rogaine if you’re pregnant, planning a pregnancy, or breastfeeding.
Minoxidil vs Finasteride: Do Either Really Work?
Search for information about hair loss drugs and you’ll see two options mentioned frequently: minoxidil and finasteride.
Both drugs have been around for decades and both are widely used to treat hair loss. But do either of them work? If so, which of them is the most effective?
In this post, we’ll look at how minoxidil and finasteride work, how effective they are when used properly, and how each drug compares to the other. We’ll also compare their effects, since both drugs have a slightly different effect on hair loss and the growth of new hair.
Minoxidil vs Finasteride: What’s The Difference?
Minoxidil and finasteride are two of the most popular hair loss treatments on the market. Both are pharmaceutical medications, and both are available either as prescription medicine or as over-the-counter treatments in most countries.
Both minoxidil and finasteride are proven to be effective at preventing hair loss. However, the two drugs work in completely different ways.
How Minoxidil Works
Minoxidil is a vasodilator. This means it widens the blood vessels and increases blood flow in certain areas of the body. Put minoxidil on your scalp and it will relax the muscle walls of the blood vessels, making it easier for blood to flow to your scalp and hair follicles.
This vasodilating effect causes more nutrients and oxygen to flow through your blood to your hair follicles, potentially promoting growth.
Technically, minoxidil doesn’t stop hair loss. Instead, it actively promotes the growth of hair by causing hairs in a resting state (known as the telogen phase) to shed and replacing them with new hairs in the growing (or anagen) phase.
Because of this, one of the most common side effects of minoxidil use is rapid hair loss. This is a temporary effect that happens as your resting hairs shed. Once they’re replaced with hairs in the anagen phase, minoxidil can produce a noticeably thicker head of hair.
Minoxidil is available as a spray, as a liquid, and as a topical foam. It’s also available in a variety of concentrations, letting you apply a heavy or light dose of minoxidil to the areas of your scalp that are affected by hair loss.
How Finasteride Works
Finasteride is a 5α-reductase inhibitor. It prevents hair loss by stopping testosterone from being converted into dihydrotestosterone — the powerful androgenic hormone that causes damage to hair follicles in men.
The process by which DHT affects hair is quite complicated. If you’d like to learn more, give our Guide to DHT and Male Hair Loss a read — it explains how DHT is formed and how it causes irreversible damage to male hair follicles.
Finasteride acts like a barrier, preventing your body’s testosterone from converting into DHT. By blocking testosterone from converting into DHT, it reduces your body’s DHT level and stops the hormone from binding to your hair follicles and causing damage.
Because it takes quite a lot of time for DHT to damage your hair follicles, finasteride can even cause mild regrowth in patches of hair that are starting to thin.
Meanwhile, minoxidil exclusively acts as a growth agent, helping your hair grow thicker, faster and better than it normally would. Unlike finasteride, minoxidil has no known effect on DHT or other hormone production.
Do Minoxidil and Finasteride Work?
Put simply, yes. Both minoxidil and finasteride have been scientifically proven to help either stop hair loss or promote hair growth.
Finasteride has been proven to work in numerous studies. A 1998 study from the Journal of the American Academy of Dermatology shows that finasteride produces a measurable increase in hair growth on the scalp, with an average increase of over 15% after two years.
Other studies show a reduction in hair loss and a noticeable increase in hair growth over a year of use. There are even five-year studies showing durable improvements in scalp hair over long periods of time.
There are also numerous studies showing that Minoxidil is effective at promoting hair growth. In a four-month study, 74% of men judged that minoxidil improved their hair density, with 93.8% of study participants judging minoxidil as very effective, effective or moderately effective at stimulating new hair growth.
There is no shortage of hair loss treatments out there built on hype instead of results. However, countless studies show that finasteride and minoxidil are real hair loss treatments that produce real results, especially when taken long term.
Are Minoxidil and Finasteride Safe to Take Together?
Studies show that minoxidil and finasteride are safe to take together. In fact, many studies have been conducted using finasteride and minoxidil together to prevent hair loss while fueling new growth of healthy hair.
A 2015 study in the Indian Dermatology Online Journal shows that use of both finasteride and minoxidil together helps maintain a good hair density level. Interestingly, this study uses topical finasteride instead of the more common oral finasteride tablets.
Finasteride and minoxidil work through different mechanisms — minoxidil as a vasodilator and finasteride as a 5α-reductase inhibitor that targets DHT. Since they target different parts of the body, there’s no risk in taking them together.
You should always check drug interactions before beginning any hair loss treatment. If you take any other medications, it’s worth talking to your doctor to make sure that they can’t interact with either minoxidil or finasteride.
Minoxidil vs Finasteride: Which is Better?
Minoxidil and finasteride are different medications designed for different purposes. While both prevent hair loss and encourage hair growth, one does it at the topical level while the other is a hormonal medicine that stops hair loss at its source.
Because finasteride stops DHT production, most hair loss doctors will recommend it as a first course of action before using minoxidil. Both drugs are also commonly used together to get a stronger, more noticeable effect.
At the end of the day, the best option for hair loss depends on your personal needs. If you’re interested in stopping your hair loss using finasteride or minoxidil, complete an online consultation with our expert hair loss doctors to learn more about your options.
Article reviewed by Brendan Levy, MD.
Androgenic alopecia is the only form of hair loss with FDA-approved nonprescription treatments. Androgenetic alopecia, commonly known as male-pattern baldness, is the most common form of hair loss for both men and women. It can be caused by either hormonal or hereditary factors and is the only form of hair loss for which the FDA has approved the use of nonprescription hair loss products.1
Androgenetic alopecia is an androgendependent hereditary disorder in which dihydrotestosterone is a significant contributing factor.2 The condition affects Caucasian men more than men of other ethnicities. It can start at any age, but approximately 30% of men will experience some hair loss by the age of 30 years, 50% by the age of 50 years, and 80% by the age of 70 years.1
In addition, up to 13% of premenopausal women experience some degree of androgenetic alopecia, and the incidence may increase significantly after menopause.4 By the age of 70 years, approximately 40% to 50% of women experience hair loss.1,3
Signs and Symptoms of Hair Loss
Unlike those affected by other types of hair loss, patients with androgenetic alopecia experience gradual hair loss with no signs of inflammation or scarring. Men with androgenetic alopecia tend to experience hair loss beginning at the temples and crown, and some men may experience partial or complete baldness.1
Women with the condition typically experience thinning of the hair at the front of the hairline as well as at the sides or crown.1 Women experiencing this type of hair loss may also have severe acne, hirsutism, menstrual irregularities, and infertility due to hyperandrogenism.1 Women experiencing these symptoms should be referred for medical evaluation to find out the cause of their hair loss before treatment with OTC products.
Topical formulations of minoxidil 2% and 5% are the only FDA-approved nonprescription products available for the treatment of androgenetic alopecia.1 Minoxidil is available as a topical hydroalcoholic solution or solvent-free foam. The 2% formulation is indicated for treatment of baldness at the crown of the head in men and treatment of thinning of hair at the frontoparietal region in women.1 Topical minoxidil 2% can be used in both men and women, but 5% topical minoxidil is indicated for use by men only.1 Use of 5% minoxidil by women is contraindicated due to an increased risk of facial hair growth.1
Although its exact mechanism of action is unknown, minoxidil appears to increase cutaneous blood flow directly to the hair follicles, which in turn increase in size after treatment. The medication also promotes and maintains vascularization of hair follicles in alopecia.1,4,5 Minoxidil’s efficacy in treating other types of hair loss, such as alopecia areata, is not well established, but some patients with these conditions have reported successful use of minoxidil products.1 Patients with sudden hair loss or nonpattern hair loss should always be encouraged to seek medical advice before using minoxidil products.
There are no known drug interactions associated with the use of topical minoxidil. However, it is important to note that the concurrent use of minoxidil with guanethidine may increase the incidence of orthostatic hypotension.1,4 Because topical minoxidil is absorbed through the skin in low concentrations, the incidence of systemic adverse effects is rare. The most common adverse effects associated with the long-term use of topical minoxidil are transient hypertrichosis and local itching or irritation.1,2 Minoxidil should only be used by patients 18 years and older.
Counseling Patients with Hair Loss
Because hair loss may cause emotional distress and affect self esteem, health care professionals should be supportive and empathetic to patients experiencing it. Pharmacists can assist patients experiencing hair loss by reviewing medication profiles and possibly identifying pharmacologic agents that may be associated with increased risk of hair loss. Prior to recommending the use of topical minoxidil products, it is important to determine whether self-treatment is appropriate and whether the cause of the hair loss has been identified.
Patients should always be referred to their primary care physician for further evaluation if the cause of their hair loss is unknown or sudden. It is particularly important for women who experience sudden hair loss to seek counsel from their primary care physician to identify causes or contributing factors.1
To ensure that their medication is effective, patients should be counseled on how to properly apply topical minoxidil according to manufacturer recommendations.1,3 Patients should also be made to understand the importance of using the product continuously to maintain regrowth of hair, because discontinuation of treatment can result in a rapid reversion to the pretreatment balding pattern.1,4
Patients should be advised to not apply the product more than twice a day and not to apply it to damaged or inflamed areas of the skin.1 The product should also not be applied 24 hours before or after the use of a hair color, relaxer, or permanent.1
Pharmacists should also inform patients that the product may not be effective for everyone, that it is a suppressive therapy and not a cure, and that hair growth may not be apparent until 4 months after initiation of therapy.1,3 If hair growth does not occur after 4 to 6 months of consistent use, the patient should be advised to discuss other possible treatments with their primary health care provider.
Ms. Terrie is a clinical pharmacy writer based in Haymarket, Virginia.
What it is
Sold under the brand name “Rogaine”™, this topical lotion is the only medication approved by the FDA to stimulate the regrowth of hair for those men and women who have a hereditary tendency for pattern baldness or hair loss. Rogaine™ topical lotion is 2% and also 5% minoxidil in a solution of water, alcohol, and propylene glycol.
What it Does
Minoxidil topical lotion work on active hair follicles still capable of producing hair. For those with pattern hair loss, minoxidil can reduce and reverse the rate of hair follicle miniaturization, and can reverse the transformation of terminal follicles that produce full-size hairs from vellus follicles that only grow “peach fuzz”. With minoxidil, vellus follicles enlarge back to their full size.
As with any medication, the results vary from person to person.
Minoxidil is safe. When used as directed in lotion form applied to the scalp, only very small amounts of minoxidil reach the blood. The risk of serious side effects is very small. Change is gradual.
Now Available Without a Prescription
As a hair growth treatment, minoxidil is applied as a lotion on the scalp two times each day. This method of administering the drug causes the hair-growing effect to be on the scalp only, and not on other parts of the body. There is no effect on blood pressure when applied as directed. In 1995 the US FDA declared that minoxidil in a 2% topical lotion form no longer required a prescription from a Medical Doctor for purchase in the US.
Benefits of Minoxidil
Clinical studies were run during which some men and women with pattern hair loss applied Rogaine topical lotion to their scalps, and others with pattern hair loss applied the same mixture of water, alcohol, and propylene glycol used in Rogaine lotion, but without the minoxidil (a placebo). The men and women selected for the study had thin hair or baldness on the top of their heads, where minoxidil is most effective at promoting hair regrowth. The effectiveness of the minoxidil treatment was compared to the placebo lotion. The results of clinical studies involving thousands of men and women have shown Rogaine topical lotion is able to cause statistically significant increases in hair regrowth.
Risks and Disadvantages of Minoxidil
Minoxidil treatment does not work on everybody with thinning hair due to inherited pattern hair loss. It is less effective for hair loss at the hairline than on the top of the head. It is less effective on large bald spots than small ones. It is less effective on small bald spots than on diffuse thin areas. It is less effective on long-established baldness than recent hair loss.
Continuous use Required
Minoxidil treatment is not a permanent cure. It must be applied twice-daily for as long as the newly regrown hairs are desired to be retained. It requires commitment. Those treating their hair loss with minoxidil have to think about treating their hair loss every day.
Skipping a day or two occasionally is not likely to cause any measurable difference in the effectiveness of minoxidil treatment. However, after several months of discontinued use, the regrown hairs are likely to be shed. Also, the hairs that would have been shed if the minoxidil had not prevented follicle miniaturization will also be lost as those follicles begin to shrink. Regrown hairs may be shed within just a few months after discontinuing use of minoxidil.
In clinical studies involving 6,000 men and women about 7% of those using Rogaine lotion experienced some degree of scalp Itching, inflammation, dryness, or flaking.
Lotion on the Scalp
Although Rogaine topical lotion is a colorless, odorless, and non-greasy liquid that dries quickly and without any visible residue, some people simply do not like putting lotions on their scalp.
Minoxidil With Betamethazone Valerate
Betamethazone valerate is a cortisone medication that helps to prevent scalp inflammation. In addition to reducing possible scalp irritation, it may also enhance the hair restoration effect of minoxidil in two ways: First, it helps block the metabolism of testosterone in the cells of the hair follicle where the hormone signal to “stop producing new hairs” takes place. Blocking this signal may keep more hairs growing. Second, betamethazone valerate helps to disperse the white blood cells that are called up to push the hair shaft out of the hair follicle. This may keep more hairs in place longer. Dr. Panagotacos has published this information on his Website since 1993. A study done in 2001 demonstrated increased hair density in one year of use.
Minoxidil With Tretinoin (Retin-A)
Tretinoin is a prescription acne medication applied to the skin, and is also famous for helping to reduce facial wrinkles. Minoxidil lotion applied with low concentrations of tretinoin has been show to promote greater hair growth, and possibly faster results, than minoxidil used alone. Tretinoin may increase the absorption of minoxidil through the skin, as well as having additional hair growth promoting effects. In addition to the risks and advantages of minoxidil use, tretinoin adds additional risk of skin irritation and inflammation. These studies were done in the early 1980’s.
Minoxidil With finasteride
Finasteride is another medication that demonstrates significant hair restoration effects. Combining finasteride with minoxidil can produce better hair restoration results than using either medication alone.
Other medications are progesterone derivatives, and spironolactone-like compounds.
People respond differently to minoxidil. For some people with pattern hair loss it works very well, and for others there seem to be no results at all. The only sure way to determine if minoxidil will be effective is to try it twice-daily for at least 4 months.
Who can expect results?
Those likely to achieve the best results are in the early stages of pattern hair loss. On average, younger people get better results than older people. Those with thinning or baldness on the top of their heads generally get better results than those with hair loss at the hairline. People with diffuse hair loss, especially women, tend to get better results than those with clear bald spots. Those with smaller bald spots usually show more regrowth than those with large bald spots.
What if I stop?
If minoxidil treatment is discontinued for several months, the regrown hairs will probably be shed, and hair loss will resume.
Minoxidil Treatment Described
Easy to Use
Rogaine topical lotion is easy to use, and only takes a few minutes each day for application. It is applied to a clean and dry scalp twice each day using a dropper or sponge applicator.
In the Morning
The first application is usually done in the morning, after shampooing and towel drying. The lotion is applied directly to the scalp, and not to the hair.
It takes about 4 months of twice-daily treatment before initial results are noticeable, if at all. Initial results can include less hair shedding and some new hair growth. The newly regrown hairs may be finer and substantially less pigmented than other full size hairs, however many of these hairs will enlarge and darken as they grow out. The results may improve over the next several months with continuous twice-daily use. After about 12 months of minoxidil use, the maximum benefit is usually achieved, and hair regrowth tends to stabilize.
Other Hair Growth Drugs
Avodart, dutasteride, was released at the end of 2001 for treatment of benign prostate hypertrophy. It blocks both Type I and II 5-alpha-reductase and lowers DHT by over ninety-five percent in men, whereas Propecia lowers it only sixty-six percent. Type II is found in the prostate gland and Type I in skin and hair. Women only have type II, therefore women with thinning hair may benefit from Dutasteride. I routinely place my male patients on Dutasteride if they are part of the small group who continue to lose hair while on Propecia. Avodart (dutasteride 0.5 mg) daily lowers DHT 90% whereas finasteride only lowers DHT 65 – 70%. Although it has not been approved by the FDA for hair loss, I prescribe Avodart when Propecia is not strong enough.
Dutasteride is currently being studied for hair loss, but results have not yet been published.
Learn more about “Drugs That Grow Hair” by reading Chapter 9 of Dr. Panagotacos’ book, Hair Loss Answers
Even for those people, however, Rogaine does not always work, said Ivy Kupec, a spokeswoman for the F.D.A. It helps about 25 percent of men and 20 percent of women to grow back moderate amounts of hair very gradually, mostly on the very top of the head. They must keep using Rogaine indefinitely to keep the new hair.
Some experts warned the F.D.A. in November that if Rogaine was available without a prescription it would be overused by desperate consumers who refused to admit it was not helping their particular hair loss. So how long should people try Rogaine?
“We recommend people try it for four months, but we actually had people in clinical studies who took longer than that,” said Dr. Joann Data of Pharmacia & Upjohn, the drug’s manufacturer.
People should try Rogaine only if hair loss runs in their family and is not a sudden or patchy type that might come from an endocrine imbalance, infection, pregnancy or even some hairstyles, like tight braids, Dr. Data said.
If people use Rogaine for the wrong type of hair loss, “it won’t exacerbate the balding they do have,” she said, adding, “but say they have a fungal infection, it would prolong the time to diagnosis and appropriate treatment.”