Rogaine (minoxidil) is a topical medication used to treat patients with androgenetic alopecia which is more commonly known as male and female pattern baldness. Male and female pattern baldness is caused by a genetic sensitivity of hair follicles to the hormone dihydrotestosterone (DHT) which causes the hair to become thinner or “miniaturized” over time. Rogaine reverses the process of miniaturization by increasing the duration of the growth, or “anagen” phase, of the hair follicle growth cycle. This allows hairs to increase in both diameter and length.
Patients who are GOOD CANDIDATES for Rogaine include:
The following patients are NOT GOOD CANDIDATES for Rogaine:
Rogaine belongs to a class of drugs known as vasodilators. Minoxidil was originally used to treat patients with severe hypertension. However, it was discovered that one of the side effects was a stimulation of hair growth on the scalp and body. When used on the head, minoxidil dilates blood vessels in the scalp, improves follicle function and stimulates hair growth. Rogaine should be used as directed but a liberal once a day application is almost as effective as twice-daily dosing.
Rogaine must be left on the scalp for at least four hours to be effective. Therefore, most patients apply it at bedtime and wash it off in the morning. Otherwise, it can be applied in the morning and/or night. Patients should dry their hair and scalp before applying Rogaine. The dosage for the solution should be at least 1 mL topically but more may be needed for patients with extensive hair loss. When using the solution or foam, it is important that the medication is applied directly to the scalp. Parting the hair at the thinning area can facilitate this. Gently rub in the product and allow it to dry completely before using other hair products or going to bed. Avoid getting the product in the eyes, nose, and mouth. Patients should wash their hands after each application. Women run the risk of increased facial hair from the medication but it generally resolves when the drug is discontinued.
Rogaine for male pattern baldness can be used to prevent further thinning of the hair or after a hair transplant surgery to mitigate the loss of non-transplanted existing hair.
An alternative medication is Propecia. It is significantly more effective than minoxidil since it blocks DHT. However, Propecia has side effects of sexual dysfunction in a small number of male patients and is not FDA approved for women. Rogaine does not have any sexual side effects and can be used for both males and females.
The cost of Rogaine is about $50-$75 for two ounces but an off-brand label of minoxidil can be purchased for about a third of that cost.
There is no RECOVERY or DOWNTIME when using Rogaine. However, patients may notice some minor side effects when using the product such as scalp irritation and redness at the application site. These are temporary and will subside. Occasionally, women may have additional side effects such as dizziness and low blood pressure. As discussed above, increased facial hair is seen in some women who use minoxidil.
The earlier a patient with hair loss starts using Rogaine to treat patterned baldness, the better the results will be. It can take two to three months before Rogaine begins to reverse the miniaturization process. Patients often shed some of their hair during the early stages of treatment because the product causes a new growth cycle to start. The new growth cycle pushes the existing hair out of the scalp. While this shedding may cause some concern among patients, it actually means the product is working and the patient should continue the treatment. It can take four months, or longer, before the patient notices new hair growth. New hair might be soft, appear colorless and nearly invisible. With continued treatments, partially miniaturized hair can approach the same color and thickness as the existing hair.
Rogaine treatments take about a year before the maximum benefits are achieved. The patient must continue using the product to maintain the results. After the first year, responders will have fuller, thicker hair and a slower hair loss rate. However, discontinuing Rogaine will result in the loss of any benefit from the medication.
The limitations of Rogaine for male and female pattern baldness are as follows:
The potential side effects of Rogaine include:
Rogaine can slow down the rate of hair loss and stimulate new hair growth in patients with male and female pattern baldness. While Rogaine does not always show significant growth in the frontal region of the scalp, some improvements are possible in these areas as well as the top of the scalp and crown regions. Rogaine for pattern baldness can restore hair on the scalp and provide a greater density of hair. Rogaine is an attractive product for many men and women with thinning hair.
Written by Cosmetic Town Editorial Team - MA
Based on an exclusive interview by Dr. Robert Bernstein in New York, NY