Minoxidil and finasteride are two of the most common medications used to treat hair loss. Finasteride is an FDA approved medication for treating male pattern baldness. Finasteride is most often prescribed for males who have androgenic alopecia. Many men have been effectively treated for decades using finasteride to maintain their hair at optimum condition and density without issues. Finasteride is not prescribed for women of childbearing age or those who are pregnant or those who plan to become pregnant because it is a teratogen, meaning it can cause birth defects. In certain cases, it is prescribed off label for post menopausal women, but this is always under strict medical supervision. Women should never take finasteride under any circumstances other than as prescribed by your physician or fully qualified hair loss specialist. Topical minoxidil (Rogaine) is FDA approved for use in both men and women with hair loss.
Finasteride works by blocking the conversion of testosterone into dihydrotestosterone (DHT), the hormone that contributes to the hair follicle eventually shrinking and producing thin and weak hair. This is referred to as miniaturization. Eventually this hair falls out during the telogen phase and does not grow back. Finasteride protects the hair follicle by blocking the formation of DHT in the hair follicle. Reduction of DHT levels in the scalp not only prevents hair loss, but it can promote regrowth in follicles that are still viable. Finasteride is most effective for hair loss at the crown and mid scalp.
It is best to consult with hair loss specialist when you notice thinning hair before excessive follicular damage occurs. Results are noticeable within three to six months. Finasteride must be continuously taken throughout one’s life in order to keep the hair. Once finasteride is stopped, all the hair gained will be lost within 3-4 months and the hair will rapidly revert to its normal balding pattern.
Minoxidil was originally developed as an oral anti hypertensive drug. Scientists discovered that minoxidil did not work consistently at controlling blood pressure however, many women complained about hair growth on the face and body while taking it. When it was applied topically it grew hair. The topical application of minoxidil results in less medication being absorbed systemically but not enough to impact blood pressure significantly. Minoxidil stimulates the secretion of growth factors and promotes hair growth by the stimulation of dermal papilla and epithelial cells. Minoxidil increases blood flow to the hair follicles providing nutrients and oxygen which extend the Anagen or growth phase of the hair cycle.
Minoxidil requires consistent use to maintain the hair. The full effects of minoxidil are seen at the 12th month.
Because these medications work by different mechanisms there are situations where your hair loss specialist may combine both therapies. It is always best to consult a hair loss specialist so that they can diagnose the exact cause of your hair loss and prescribe the treatment that will be more effective for you.
