Minoxidil (Rogaine®)

Minoxidil – mostly known under its established brand name, Rogaine® – was the first hair loss treatment to receive FDA approval. Although it’s unclear exactly how Minoxidil works, it is generally believed to accomplish two things.

The first is that Minoxidil enlarges hair follicles, which extends the hair’s “growth phase”. One of the causes of hair loss is follicular miniaturization, in which the hair follicles shrink and the hair’s growth phase becomes shorter, until the hair eventually might stop growing. If Minoxidil enlarges the follicles and extends the growth phase, it increases the chances of the follicle re-growing thicker and stronger hair. This hair should continue to grow for as long as treatment is continued.

Secondly, Minoxidil is a vasodilator, meaning that it increases blood flow to the scalp. This, in turn, may stimulate hair growth. If the hair follicle is enlarged, the increased blood flow should help keep that follicle healthy and possibly encourage even more hair growth on the scalp.

Minoxidil is not a DHT blocker: it reduces neither Dihydrotestosterone (DHT) nor the enzyme (5-alpha reductase) that are believed to cause hair loss.

History

Minoxidil, under the trade name Loniten, was originally developed as an oral drug to treat severely elevated blood pressure. One of the drug’s side effects was a measurable thickening and darkening of body hair and, in some cases, Minoxidil caused considerable hair growth. As a result, Minoxidil was put through clinical trials as a possible topical application for the treatment of hair regrowth.

2300 male patients with vertex baldness (male pattern baldness on the top of the head) participated in the clinical trials. Some were treated with Minoxidil, while others were given a placebo. After 4 months, patients using Minoxidil had significantly more hair growth than those who had been given a placebo. 26% of the patients using Minoxidil indicated in their self-evaluations that they had experienced moderate to dense hair regrowth. By the end of the first year of clinical trials, almost half the men (48%) continued to rate their hair regrowth as moderate to dense.

Rogaine®, containing 2% Minoxidil, was given FDA approval and launched as a topical application for re-growing hair in men. Four years later, it was approved for use by women as well. In 1996, Rogaine® for both men and women was approved for over-the-counter use.

A solution containing 5% Minoxidil and 5% Rogaine® foam are both now available without prescription (for men only). Users of regular strength (2%) Rogaine® have claimed success rates of 30 to 40%. Users of the extra strength (5%) Rogaine® have claimed success rates of 50-60%.

Because Rogaine® is safe for women to use, and has shown to work better for slowing hair loss in women than in men, it’s a very popular first option for women with hair loss. However, it’s not quite understood why Rogaine® appears to work better for women than men.

Procedure

Rogaine® is a topical agent that is applied to the balding area twice daily – in the morning and again at night. One (1) millilitre (ml) of the liquid Rogaine® is applied directly onto the head with a dropper, and then gently massaged into the scalp. Men using the foam simply squirt half a capful into their hands and massage into the scalp. For maximum effectiveness, the solutions should remain in contact with the scalp for at least 4 hours before the hair is washed or wetted. If a dosage is missed, the user can just resume the treatment as usual.

The results of Rogaine® treatment are generally visible in approximately 4 months. The initial hair growth may be the fine, colorless hair growth that’s traditionally referred to as “peach fuzz”, but it will eventually grow to be like the user’s other hair – thick, strong and dark.

New users are warned that they may experience some hair loss in the early stages of using Rogaine®. However, this indicates that the Minoxidil may actually be stimulating hair growth, shedding the fine vellus-type hairs and reversing the hair loss process. If a user experiences continued hair loss while using Rogaine®, they should speak with their physician or a hair loss specialist to determine if Minoxidil is the right medication for you.

Results are usually noticeable within 4 to 6 months of beginning treatment. Users report new hair growth or less hair loss, and eventually report that the new hair is growing in darker and thicker. If you don’t see measurable results after 6 months of treatment, it is best to discontinue use and try another option.

Accessibility

Because Minoxidil dilates the blood vessels, it is important to consult your physician before using Rogaine®.

The ideal candidate for Rogaine® treatment is male, in his early 20s and in the very early stages of hair loss. Males with vertex baldness whose bald spot is no more than 2” in diameter are considered good candidates. Ideally, there should still be some hair – even fine, vellus-like hairs – in the balding area.

For women, Minoxidil is most commonly used to slow hair loss or to control thinning of the hair in the frontal areas of the scalp. Only the regular strength (2%) Rogaine ® treatment is recommended for women. Women should be in the early stages of hair loss and still have even fine hair growth in the affected areas. Women who are pregnant or nursing should not use Rogaine®, as no studies have been done to determine the effects of Rogaine on the fetus or on breast milk.

The younger the male candidate, the more effective Rogaine® may be. With women, however, age plays less of a factor, as hair loss is sometimes attributable to menopause. Rogaine® has been successful in helping menopausal women maintain their hair and significantly curb hair loss.

People who begin a hair growth regimen with Rogaine should have reasonable expectations of what Rogaine® can do for them. Rogaine® cannot cause hair to grow where there is none (perfectly slick bald spots) and it doesn’t work for everyone.  As with all hair loss or regrowth treatments, Rogaine® requires a long-term commitment. Results will be visible only as long as the treatment is maintained. Users who stop using Rogaine® will lose any new hair growth in about 2 to 3 months.

A 60 ml (or one-month’s) supply of brand-name Rogaine® costs approximately $29.95, but there are generic brand Minoxidil treatments available at a lower cost.

Side Effects

The most common side effect of Rogaine® is itchy scalp. You should consult with your physician to ensure that this is simple skin irritation and not an allergic reaction to the Minoxidil. Contact dermatitis and drying/flaking of the scalp have also been reported.

A less common side effect of Minoxidil is dizziness and/or shortness of breath. Because of this, people known to have low blood pressure should not take Rogaine® without speaking with their physician first.

A user should discontinue use if they experience: chest pain or rapid heartbeat, faintness, sudden, unexplained weight gain (5 pounds or more), swollen hands or feet, redness or irritation on treated areas of your scalp, unusual lesions or sores on the scalp, unusual headaches, and/or excessive hair growth on the arms, face or back.

Testimonials/Links

Visit the official Rogaine website for the most complete overview of the product and read testimonials from users who have experienced measurable results from using Rogaine.

Rogaine’s U.K. YouTube site can also be visited to learn more about the product, and view more testimonials from satisfied customers.

Dateline NBC’s 2005 story entitled ”The Follicle 5“ followed five balding men as they followed a variety of different hair loss procedures, including Minoxidil.  View all five parts of their extensive, year-long experiment on YouTube to see the results.