Let’s face it – appearance is important. At least, people value looking good. And we’re not just thinking of the ladies here – men are just as prone to purchase something if they think it will amp up their appeal or keep them looking young.

So what do you do, when you are styling your hair and you notice that it’s thinning and your scalp is showing through? Or when your part seems to be getting wider? Or when you run your hand over your head and notice (egads!) there is a bald patch on your crown? Some might just take a little more time to style and secure the hair just so until it can’t be noticed or resort to perpetual hats and accessories; some might outright deny what their eyes are seeing. But eventually, most end up perusing the internet or the aisles of the pharmacy to see what they can do to regrow their hair.

If you’ve been there, you know – there are a few products that claim to restore to balding heads their former luscious locks. The one we see in our pharmacies is Rogaine®, and its generic equivalents – minoxidil. But what is it? How does it – or does it – work? Is it safe? Is it worth it? These are the questions we want to tackle in this post.

What is Rogaine® (Minoxidil)?

Rogaine® – and its equivalent generic brands – contains minoxidil, a drug that dilates blood vessels and, apparently, stimulates hair regrowth. It comes as a solution or foam that is to be applied to balding areas of the scalp. In Canada, it is labeled for use in men with androgenetic alopecia1,also known as male pattern baldness – a hereditary condition causing the hairline to recede at the front and hair to thin at the crown2. It’s available as 2% minoxidil over the counter, or in a 5% concentration by prescription.

How might it work?

Each strand of hair on your body sits in a small cavity of the skin called a follicle. Baldness usually occurs when the hair follicle shrinks over time, resulting in the growth of hair that is shorter and finer than the original hair; eventually, the follicle will not produce a hair at all. Since the follicles themselves have not died, the possibility remains of growing hair again2.  There doesn’t seem to be a clear answer on exactly how minoxidil works, but it may cause growth of the cells that make up the follicle, causing it to widen and stimulate the production of a normal hair again3.

So does it work?

Numerous studies seem to confirm that minoxidil is an effective treatment for androgenetic hair loss in men3, 4 and considered to be first-line treatment4. The best results have been seen for men younger than 40, who have noticed hair loss for less than 10 years and who have a bald patch on the top of their head that is less than 10 cm across3. It takes several months to over a year of consistent treatment before results will be observed, and ongoing therapy will be required in order to maintain the regrowth3. Studies indicate that for men, the prescription strength minoxidil (5%) is more effective than its over-the-counter counterparts (1-2%)4.

It is important to keep in mind that just because this treatment is effective for some people, that doesn’t mean it will be effective for you. The information on the Rogaine® packaging indicates that in their trials, only 8% of men felt that they had dense regrowth; 40% rated their growth as moderate, and 36% reported minimal regrowth.  16% of men had did not have any regrowth.

Is it safe?

Minoxidil is well tolerated when used appropriately – 1 ml applied twice a day to the affected areas of the scalp3. The most common side effect is local irritation – itching, burning, dryness, and flaking one the scalp; these effects may be amplified if a wig is worn over the area.3 Most have found this irritation to be mild, however, and it can usually be controlled by flushing the area thoroughly with cool water after application 3.If irritation persists, however, it is best to talk to your pharmacist or see a physician. Do not use minoxidil on broken or injured skin, as this may allow the drug to enter the blood stream and cause side effects throughout the body such as low blood pressure, swelling, and weight gain, to name a few3. These risks also increase if you are using any topical products containing tretinoin on the scalp, as tretinoin allows minoxidil to penetrate through the skin to the blood stream3.

A word to the ladies

While the Rogaine® label says women shouldn’t use it, minoxidil can be used to stimulate hair regrowth for women with Female Pattern Hair Loss (FPHL)3.  Unlike male pattern baldness, female pattern hair loss doesn’t involve bald patches or the hairline, but rather thinning all over the head due to hormones, genes, and age5. It’s not recommended that women use more than the 2% (OTC strength) minoxidil.  The combined results of four clinical trials indicated that using the 5% (prescription strength) minoxidil increased the risk of adverse events without improving results.6 The most common complaints of adverse effects were hair growth on areas other than the scalp (ex: sideburns and forehead), skin inflammation and itchiness6.

It appears that minoxidil 2% used twice daily is safe and effective for women with Female Pattern Hair Loss. However, it should be noted that only about 1 woman out of 4 reported any significant hair regrowth after being treated with minoxidil. As with the men, women should expect a delay of several months before seeing any results, and ongoing therapy will be required to maintain regrowth.3

The bottom line

Minoxidil is pretty safe and has been shown to stimulate hair regrowth in some men and women. But it won’t work for everyone and it won’t work quickly.  For those who do get results, ongoing twice daily application is required to keep the regrowth. Retailing at about $60 per bottle for the brand name (that’s a one month supply) – is it worth it? It may be worth the try – but you’ll have to judge that for yourself. Keep in mind that hair loss may have various causes and as such may have different treatment options. Before starting treatment, it is important to figure out the cause of hair loss. Therefore, a consultation with your physician can help you figure out what kind of treatment you may require.

If minoxidil treatment does not produce the full results you are looking for (or does not work for you at all), cosmetic aids or even hair transplant surgery may be worth consideration.6

 

Written by Jennifer Winters

Edited and Reviewed by The Health Aisle Team

 

References:

  1. Rogaine Mongraph. Compendium of Pharmaceuticals and Specialties, online version (e-CPS).
  2. Berman K. (2013). Male Pattern Baldness. Medline Plus. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/001177.htm.
  3. Minoxidil (Topical). (2013). DynaMed.
  4. Tsuboi R, Itami S, Inui S, et al. (2012). Guidelines for the management of androgenetic alopecia. Journal of Dermatology. 39: 113–120
  5. Berman K. (2012). Female Pattern Baldness. Medline Plus. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/imagepages/18164.htm
  6. Van Zuuren EJ, Fedorowicz Z, Carter B, et al. (2012). Interventions for female pattern hair loss (Review). The Cochrane Library. Issue 5.