Minoxidil (Rogaine or Regaine)
Action
The active ingredient of Rogaine or Regaine is minoxidil. It is the only over-the-counter drug clinically proven to help prevent further hair loss. Minoxidil works by helping the blood flow to the hair follicles which increases follicular size and hair shaft diameter. This stimulates and prolongs hair growth. Rogaine was discovered during clinical trials for the treatment of high blood pressure wherein participants in the study were noted to have regrown hair after Minoxidil was given to them for some time.
Minoxidil increases blood flow which stimulates hair follicles, promoting hair regrowth in 4 ways:
- Reverses miniaturisation of follicles
- Increases blood flow around follicles
- Stimulates follicle movement from resting to hair growth phase
- Extends each follicle’s growth phase
Form and dosage
Minoxidil is a topical hair restoration agent that is marketed in the U.S. under the brand name Rogaine. It is available in 2% and 5% solutions; the 5% solution is approved for use only by men in the U.S. Another form is the Topical Foam 5%.
Topical dosage (2% minoxidil topical solution)
Adult men and women
Apply 1 ml twice daily topically to area where hair growth is desired. Maximum dosage is 2 ml/day applied topically.
Topical dosage (5% minoxidil topical solution)
Adult men
Apply 1 ml twice daily topically to area where hair growth is desired. Maximum dosage is 2 ml/day applied topically.
Topical dosage (5% minoxidil aerosol foam)
Adult men
Apply one-half capful twice daily topically to area where hair growth is desired. Maximum dosage is 1 capful/day applied topically.
Mode of administration
Minoxidil comes in the form of topical solution or foam. It can be applied on the affected area once or twice a day, and it could put a stop to hair loss from male pattern baldness or androgenic alopecia.
Contraindications
Hypersensitivity
Minoxidil is contraindicated in patients with a history of minoxidil hypersensitivity.
Skin abrasion
Systemic effects resulting from topically administered minoxidil are unlikely but theoretically could occur if the drug is overused. Skin abrasion or irritations, such as excoriations, psoriasis, or sunburn, can increase the systemic absorption of topically administered minoxidil.
Precautions
This drug should never be administered to pregnant women and nursing mothers.
Undesirable effects
Severe
- Pericardial effusion
- Heart failure
- Pericarditis
- Stevens-Johnson syndrome
Moderate
- Edema
- Peripheral edema
- Sodium retention
- Hypotension
- Angina
- Sinus tachycardia
- Leukopenia
- Thrombocytopenia
- Bullous rash
- Contact dermatitis
- Erythema
Mild
- Mastalgia
- Headache
- Hypertrichosis
- Pruritus
- Xerosis
- Vomiting
- Nausea
Advantages
Minoxidil may be a good choice for hair loss treatment if you have just started losing your hair. It has these additional advantages:
- It is effective, especially for young men. When you start minoxidil early, especially if you are a man in your twenties who has thinning hair and a father and uncle with male pattern baldness, you have the best chances of responding to minoxidil as a therapy.
- It is over-the-counter drug. This means that a medical doctor’s prescription is not necessary. You can find minoxidil at your local drugstore, although some medical doctors recommend that you consult your primary doctor or dermatologist before starting the treatment on your own.
Finasteride (Propecia)
Action
Finasteride-1 mg (Propecia) is used to treat men with male pattern hair loss to increase hair growth on the scalp and to prevent further hair loss. It is intended only for men. It specifically lowers the levels of DHT in the scalp by inhibiting the action of 5-alpha reductase, thus helping to reverse the balding process. It does not affect hair on other parts of the body. Men with mild to moderate, but not complete, hair loss will benefit from the use of Finasteride-1 mg.
Form and dosage
Propecia is available in strength of 1 mg tablets; the recommended dose is one tablet (1 mg) taken once daily. In general, daily use for three months or more is necessary before beneficial effects, such as increased hair growth and/or prevention of further hair loss are observed. Continued use is recommended to obtain maximum benefit. Withdrawal of treatment leads to reversal of the beneficial effects within 12 months.
Mode of administration
Propecia is available for oral administration as tablet. It may be taken with or without food.
Contraindications
Propecia should not be used in the following situations:
- Use in women when they are or may potentially be pregnant
- Hypersensitivity to any component of the drug
- Among women and children
Precautions
Propecia may interact with other drugs. Inform your doctor about all the medications and supplements that you have been taking. It is not indicated for use in women. Women should not handle crushed or broken Propecia tablets when they are pregnant or may be potentially pregnant. Caution should be exercised in older men who have benign prostatic hyperplasia (BPH). PSA levels are decreased by approximately 50%. Men aged 55 and over have increased risk of high grade prostate cancer with this drug. Caution should be exercised in administering Propecia in patients with abnormal liver function tests. Propecia is not indicated for use among pediatric patients.
Undesirable effects
The possible undesirable effects of Propecia are the following:
- Impotence
- Loss of interest in sex
- Trouble having an orgasm
- Abnormal ejaculation
- Swelling in your hands or feet
- Swelling or tenderness in your breasts
- Dizziness
- Weakness
- Feeling like you might pass out
- Headache
- Runny nose, or
- Skin rash
The sexual side effects of Propecia may continue after you stop taking it. Consult your medical doctor if you have problems and concerns about the aforestated side effects. Propecia may also decrease the level of prostate specific antigen (PSA) in your blood, and it can affect the results of the PSA blood tests.
