Minoxidil has been clinically proven to slow down and even stop hair loss in some cases, and to help regrow hair on the vertex (crown) in others. Minoxidil 2% solution, approved by the U.S. Food and Drug Administration (FDA), is the first medication for application to the scalp that has been proven to grow human hair. However it has demonstrated little effect on frontal baldness, the area of greatest concern to most men with male pattern baldness. To remain effective Minoxidil must be used on a daily basis and can be bought from pharmacies and online.
Regaine is the brand name for the topically applied Minoxidil solution which can be purchased over-the-counter in either 2% or 5% solution. It appears that the 5% solution is approximately 50% more effective than the 2% solution. The greatest benefit from the medication is seen from 5 months to 2 years, with a gradual decrease in effectiveness after that. Evidence has also shown that using Regaine at night is up to 80% more effective than its use in the daytime.
Although the mechanism by which Minoxidil stimulates hair growth is not known, it probably works by prolonging the hair follicle growth cycle. The effect of the medication is to increase the quality of the hair by increasing the diameter and length of miniaturized (fine) hair. Most patients who do grow hair grow only short, thin fuzz, “peach hair”. It does not grow hair in areas that are bald. It appears that Minoxidil’s effects may only be temporary. Once the drug is stopped, the previous pattern of hair loss resumes, and any effects are lost within 2 to 3 months, even if the medication had been used for many years. This same limitation applies to other drugs used for hair loss.
With time, men using Minoxidil continue to bald, although at a somewhat slower rate. The concomitant use of Minoxidil and Finasteride is strongly recommended as there appears to be a synergy between these 2 medications. That is, they confront hair loss in a different but complementary way.
Because the effects of Minoxidil are temporary, the lifetime cost of using Minoxidil can be more expensive than the cost of hairpieces or surgical treatments for hair loss.
Use in women
The early studies with Minoxidil were on balding men, but it appears that Minoxidil may actually be more effective in women. In fact, Minoxidil is the only FDA approved medication for women with hair loss. As with men, Minoxidil is only modestly effective in restoring hair and it does not seem to work in older, post-menopausal women. Although women are advised to use the 2% alcohol based solution, many of our female patients use the 5% solution with improved results.
Women seem to be a little more sensitive to the medication and have an increased risk of developing contact dermatitis. A more significant local reaction is the development of facial hirsuitism. The development of facial hair slowly resolves when the medication is discontinued. Although it seems that the topical preparation of Minoxidil is innocuous, the long-term safety is not known. There may be potential long-term problems that we are presently unaware of. HRBR patients receive a discount on Regaine from the Blackrock Clinic Pharmacy. It can be obtained without a prescription.