What Medications Treat Hair Loss?
Your doctor will need to determine what the cause of your hair loss is. If hair loss is caused by iron deficiency or thyroid insufficiency, treatment of the underlying condition is the best way to stop the hair loss. There are a number of systemic causes of hair loss including stress, shock loss or new medications. For most people, the pattern of hair loss is the biggest indicator of the cause. If it looks like male pattern baldness, it probably is. Androgenic alopecia tends to have identifiable and reproducible patterns. In cases of androgenic alopecia, the Food and Drug Administration approved two medications for treatment: Rogaine and Propecia.
Originally Minoxidil was a medicine used to treat high blood pressure. In a fortunate coincidence, many men taking this oral medication started growing hair on their scalp. It was later demonstrated that applying Minoxidil topically could also stimulate hair growth.
Minoxidil is an over-the-counter drug and can be found in many pharmacies in the shampoo aisle. Unlike Propecia, Rogaine can be used by both men and women. Rogaine was more effective in stopping hair loss in the crown and vertex than in the temples. Rogaine takes longer than Propecia to create a noticeable effect and most people require at least four months of use before noticing a difference. Rogaine requires daily usage to retain benefits.
Side Effects of Rogaine
All medicines have risks of side effects or unwanted outcomes. The most common side effect of topical Minoxidil is scalp irritation and can also be unwanted hair growth on the adjacent skin of the face (forehead and periorbital areas). There may also be changes to the heart rhythm and blood pressure. For most patients, topical Minoxidil does not cause systemic side effects.
Minoxidil is available in generic form and under the brand name Rogaine. The 2% shampoo is available for both men and women. The stronger 5% is recommended only for use in men. Minoxidil is more effective in stopping hair loss in men than it is in women.
Propecia is a 1 mg dose of Finasteride taken orally every day. This prescription drug is available only to men and should not be handled by women. The primary goal of Propecia is to stop or slow hair loss but some men may experience regrowth of hairs in certain areas. Hair follicles that are in a telogen phase, falling out as a result of stress, may regenerate their life cycle. Once a hair follicle dies, there are no medical or laser treatments that can restore hair. Only hair transplantation will regrow hair in that area of baldness.
Propecia has a long track record of success and this medicine received it’s FDA approval in 1997 for treatment of androgenic alopecia in men. Propecia is much more effective than Rogaine for treatment of male pattern baldness. For many men, the primary concerns of Propecia are related to the cost of the medicine and the potential for systemic side effects. Propecia can have many systemic side effects and you need to keep taking the medicine to suppress hair loss.
How Does Finasteride Work?
Finasteride is a medicine that works by preventing the conversion of testosterone into dihydrotestosterone (DHT). Finasteride’s biochemical classification is a Type II 5-alpha-reductase inhibitor (5-ARI). Dihydrotestosterone is potent androgen and is more associated with male pattern baldness than testosterone. When used appropriately Propecia can effectively lower DHT levels by as much as 60%. DHT is the hormone that causes susceptible hair follicles to shed their hafts, regress and die. The greater the number of follicles possessing a DHT receptor the greater the pattern of baldness in androgenic alopecia. In clinical trials, Propecia was shown to stop the progression of hair loss in 86% of men, specifically more in the crown and vertex than in the temples.
Rogaine vs Finasteride
For Men: Both Minoxidil 2% and 5% shampoo and Finaseteride 1 mg
For Women: Only Minoxidil 2% shampoo
Minoxidil: Up to 62% of men experienced a slowing / stopping of hair loss
Finasteride: Up to 86% of men experienced a slowing / stopping of hair loss
Minoxidil:Generally limited to topical skin irritation but can lead to hypotension in some cases
Finasteride:The risk of systemic side effects are much greater. Reversible gynecomastia and irreversible erectile dysfunction have been reported
Propecia is much more expensive than Rogaine because Propecia requires a prescription and Minoxidil can be obtained over the counter
Contact our office for more information on medications to treat hair loss