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Hair Loss

Drug Treatments

Thursday, March 29, 2012 - 20:51

Contributing Author: Guy Slowik FRCS

Two medications have been approved for the treatment of hair loss:

Both of these medications also can be used preventively to help keep hair loss from happening.

Minoxidil (Rogaine)

Minoxidil (sold under the brand name Rogaine and also available generically) is applied to the scalp to stimulate hair growth in adult men and women. Medication applied to the body is called "topical" medication.

In the U.S., minoxidil is available without a prescription. The exact way in which this medicine works is not known.

Side effects of minoxidil are rare and include:

  • Itching or skin rash on the scalp
  • Headaches
  • Dizzy spells
  • Irregular heartbeat or chest pains
  • Decreased sexual ability or desire

Need To Know:

Minoxidil should not be combined with the topical application of corticosteriods (cortisone-like medicines), petrolatum (Vaseline), or tretinoin (Retin-A), because the use of these products on the scalp may cause too much minoxidil to be absorbed into the body.

In addition, individuals with other skin problems or irritations, heart disease, or high blood pressure may not be able to take minoxidil, because more serious problems may develop.

Minoxidil does not work for everyone, and it does have some limitations:

  • Minoxidil may help hair to grow in 10% to 20% of the population, and in 90% it may slow the loss of hair.
  • If hair growth is going to occur with the use of minoxidil, it usually occurs after the medicine has been used for several months.
  • When the use of minoxidil is discontinued, hair loss will recur.
  • If minoxidil is not allowed to completely dry (which may take two to four hours), it may stain clothing, hats, and bed linen.

Nice To Know:

Minoxidil originally was used as a treatment for high blood pressure and was found to cause increased hair growth all over the body in people taking it regularly. It was then prepared as a lotion for direct application to the scalp.

Finasteride (Propecia, Proscar)

Finasteride (sold under the brand names of Propecia or Proscar) is a medication taken by mouth. It belongs to a group of medicines called enzyme inhibitors. It is primarily used to treat urinary problems cause by enlargement of the prostate in men (benign prostatic hyperplasia, or BPH).

Finasteride has been found to stimulate hair growth in some men. Women, however, should not take finasteride. The medication is available only with a doctor's prescription. In clinical studies, it stopped hair loss in 83% of men.

If hair growth is going to occur with the use of finasteride, it usually will happen after the medicine has been used for about three months. The effect lasts only as long as the medicine is taken; new hair is lost within a year after finasteride treatment is stopped.

Side effects of finasteride are uncommon and include:

  • Breast enlargement and tenderness
  • Skin rash
  • Swelling of lips
  • Abdominal pain
  • Back pain
  • Decreased sex drive
  • Decreased amount of semen that is ejaculated during orgasm (this should not affect sexual performance, however)
  • Diarrhea
  • Dizziness and headaches
  • Impotence (inability to achieve or maintain an erection)

Need To Know:

Finasteride tablets may be crushed to make them easier to swallow. However, women who are or who may become pregnant should not take finasteride or handle crushed tablets, because the medication may cause birth defects in an unborn child.


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