Medical Management

When consistently used, prescribed treatments can boost hair restoration efforts. Hair loss is a lifelong process, but the journey can be made easier with treatments that protect against further loss and simulate new growth.

Minoxidil

Minoxidil (Rogaine) was originally an anti-hypertensive medication that was noted to have hirsuitism (hair growth) as a side effect. Applying it topically on the scalp was shown to grow hair. This is the first FDA-approved medication for hair loss. Minoxidil is a topical liquid that was originally used for the apex of the scalp. This led to the misconception that this was the only area it can be effective for. Rogaine can be used on the entire scalp, but will not be effective on a completely bald scalp.

Minoxidil truly stimulates hair growth. It increases the time the hair follicles spend in the growth phase. This drug stimulates follicular growth as well. It can be used in tandem with Finasteride that works by inhibiting the effects of the hormone DHT on hair follicles.

Both men and women can use Rogaine. It comes in various strengths; 5% for men and 2% for women. Various compounding shops produce 10% solutions, that may be even more effective. Rogaine comes in a solution that can create a “wet greasy” look and feel. There are also foam preparations and shampoos available. Women are more sensitive to the effects of minoxidil, and if the liquid runs down the face, facial hair can grow in these areas. If Minoxidil treatment is stopped, in three months, the effects will be lost and the hair loss pattern will return. Many patients state that “ when I stopped the Rogaine, all my hair fell out.” Medical treatment for hair loss is a perpetual requirement.

 

Finasteride

This drug prevents the conversion of the hormone DHT from testosterone. DHT causes susceptible hair follicles to slowly become dormant by shortening the growth phase, decreasing follicle size, and miniaturization of hair shafts. After 5 years of treatment, 90% of men halted their hair loss and 48% grew new hair. Patients must take this medication for at least a year to see its effectiveness. As with Minoxidil, cessation of this medication will cause the hair loss to return to pre-treatment stages and usually more pronounced seeing as hair loss would have progressed during the treatment period. This drug, unlike Rogaine does not stimulate hair growth, it prevents hair loss, therefore it can be used with Rogaine to have a two-pronged treatment of hair loss.

Propecia is a pill, and therefore can have side effects throughout the body. Sexual dysfunction that is reversible can occur when the medication is stopped. Breast enlargement has been reported as well as breast tenderness. PSA levels can be reduced in 50% of men which is important when screening for prostate cancer. Your physician should be made aware if you are taking this medication. Propecia has been shown to decrease the likelihood of prostate cancer, but the tumor grade may increase.

Propecia has not been FDA approved for women and has shown no effect on post menopausal women. Finasteride is a great adjuvant treatment in conjunction with hair replacement.