Currently, two medications for treatment of androgenetic alopecia are approved by the US Food and Drug Administration (FDA). They are finasteride oral pill and minoxidil topical medication. The most recognized brand names for these are Propecia® and Rogaine®. Approval by FDA means that the drug has undergone the FDA’s approval process through extensive research to be safe and effective specifically for the indicated medical condition. As a side note, the medications or medical devices with “Approval by FDA” must have demonstrated through rigorous study that they are both safe and effective treatment, while recognition “Cleared by FDA” can be achieved as long as it is safe alternative treatment – a subtle and confusing distinction which even some doctors do not recognize.
Like all medications, there are benefits and potential side-effects. Both of the medications are relatively safe medications for the patient, but it is important to discuss what these side-effects are and whether these medications are suitable for the patients before starting them.
We recommend medical treatment for patients who are affected by androgenetic alopecia. Even if the patient elects to proceed with hair transplant surgery, it is helpful to be on medical treatment concurrently.
Medical treatments work by preventing and reversing the miniaturization process. These are the areas where hair has become thin and loses its volume. However, if the process has advanced beyond miniaturization and the hair is lost permanently, then the medication will not help regain the lost hair. For these areas, the only treatment is to transplant a new set of hair. When the medications are discontinued, its effect tends to wear off and the patient will revert to an ongoing process of hereditary hair loss. This reversal effect, however, will not affect the transplanted hair, because they are resistant to the DHT-mediated effect.
Propecia® (1 mg finasteride tablet)
As reviewed from above, hereditary hair loss is caused by dihydrotestasterone (DHT). The hair follicles that are sensitive to DHT will begin its miniaturization process and eventually become lost permanently. Finasteride, which has been used for a long time in patients with prostate problems, works by blocking the DHT synthesis. Unlike the finasteride which is used for prostate problems (5mg tablet), Propecia which is indicated for hair loss comes in 1mg tablet form.
Numerous clinical studies have shown that Propecia® ¬is effective in increasing the density of the hair in male patients affected by androgenetic alopecia. Having been on Propecia® for 5 years, about 90% of patients reported either improvement in hair growth or arrest of further hair loss. Studies have demonstrated an actual increase in hair count after 5 years of Propecia®. While most studies have shown an increase in growth at the vertex area of the head, both Propecia® and Rogaine® will improve the loss of hair throughout the scalp.
Rogaine® (5% or 2% minoxidil topical solution or foam)
Minoxidil was originally a blood pressure medication taken as a pill. It was observed that these patients also experienced growth of body hair. Based on this observation, the medication was developed into topical solution form to be applied only to the areas of hair loss. This way there is no systemic effect such as blood pressure change during use.
Numerous studies on the efficacy of minoxidil have been reported. Generalizing from these studies, one should expect that 80-90 % of patients who strictly adhere to treatment with minoxidil topical will experience improved hair growth and hair density. While most studies have shown an increase in growth at the vertex area of the head, both Propecia® and Rogaine® will improve the loss of hair throughout the scalp. Patients should expect to use the medication daily for at least 6 months before any noticeable change is seen.
Double board-certified Facial Plastic Surgeon Dr. Sang W. Kim at Natural Face Clinics specialize in aesthetic enhancement of the face, head, and neck, exclusively. Patients come to see us from the Syracuse metropolitan area and Central New York area including Ithaca, and Rochester. At Natural Face Clinics, we specialize in restoring the youthful neck contour, tired appearance of the brows and eyes, and skin laxity. We offer customized treatment, both surgical and non-surgical, including facelift, eyelid surgery (blepharoplasty), nose surgery (rhinoplasty), brow lift, neck lift, and skin resurfacing. Find out more by scheduling your personal consultation today.