Minoxidil (Rogaine)

Minoxidil (Rogaine) is a medication known for its ability to slow down or prevent hair loss and promote hair regrowth. Rogaine was the first FDA approved medication that was used for hair loss prevention.  It is available without prescription (over the counter) for treatment of hair loss in men and women, among some other baldness treatments such as finasteride or hair transplant, but measurable changes disappear within one to two years after discontinuation of treatment.

Minoxidil was first used exclusively as an oral drug for treatment of high blood pressure. It was, however, discovered to have the interesting side-effect of hair growth and reversing baldness, and in the 1980s a topical solution of it was produced contained 2% minoxidil to be used to treat baldness and hair loss, under the brand name Rogaine in the United States. Treatments usually include a 5% concentration solution that is designed for men, whereas the 2% concentration solutions are designed for women.

In 2007 a new foam-based formulation of 5% minoxidil was shown to be an effective treatment of male pattern baldness without the usual side-effects of the topical solution such as itching and skin irritation.

The mechanism by which minodixil promotes hair growth is not fully understood. Minoxidil is a potassium channel agonist.  It contains the chemical structure of nitric oxide, a blood vessel dilator, and may be a nitric oxide.  Studies show that minoxidil is less effective than finasteride but the combination of the two drugs can be more potent.

Side Effects of Minoxidil

As a drug to prevent hair loss, the most common side effect is itchy scalp. In some cases minoxidil may initially cause an increase in hair loss within the first few weeks. This is called shedding and is seen as a long-term positive effect during hair loss treatment since the shedded hair strands will regrow within a few months with renewed strength.

There have been cases of allergic reactions to minoxidil or some of its non-active ingredients, which is found in some forms of topical Rogaine. Large amounts of minoxidil can lower the blood pressure.  If a person uses minoxidil to stop hair loss for a length of time and then stops taking the drug, hair loss will occur again.  This phenomenon is called catch up hair loss.

Other rare side-effects include acne on the area where it is being used, headaches and lightheadedness, drop of blood pressure, blurry vision and chest pain.  All the side-effects in the above list except for acne or allergic reaction may be an indicator that too much of the drug is being used. It has also been found that the drug can be passed from a mother to a child via breast milk.  

Women and minoxidil

Minoxidil unlike finasteride could be used in women with hair loss to increase the bulk of hair and prevent further hair loss.  Only the 2% concentration of minoxidil is approved for use in women. Women are generally more sensitive to the side effects of minoxidil in decreasing blood pressure (hypotension). The allergic reaction to this medication is also more common.  Facial hair could occasionally be seen in women who use minoxidil for the treatment of their hair loss. Limiting the application of medication carefully to the scalp can prevent this side effect.

At US Hair Restoration, we perform microscopic miniaturization study before starting patient on any anti hair loss medications.  This way, we can have a complete mapping of scalp hair miniaturization that could be used to follow the effectiveness of our treatments.