Q Do Rogaine and Propecia work synergistically?
A: They are synergistic, since the mechanisms of action are different.
Rogaine directly stimulates hair growth, while Propecia is permissive for hair growth by blocking DHT, the byproduct of testosterone that causes hair to miniaturize and eventually disappear.
The important thing to remember, however, is that for most people, Propecia is far more effective.
Q: I have early thinning on the top of my scalp and I was told to use Propecia, but I heard that is was only for men. What do you think?
A: Women can’t take Propecia during the child-bearing years because, if ingested, it can cause birth defects in male offspring.
In post-menopausal women, where we see the greatest frequency of hair loss, it doesn’t seem to be effective.
In pre-menopausal women who do not plan to become pregnant or who already have children, we are still cautious about using the medication, since there effectiveness has not been proven and it’s long-term safety in this population has not been tested.
Q: How does a hair transplant prevent hair loss?
A: It doesn’t. Surgical hair restoration does just what it says. It restores hair to an area where the hair has been lost (by borrowing it from an area of greater density that is less important cosmetically, such as the back of the scalp).
To prevent, or slow down, further balding one would need to receive treatment with hair loss medication such as finasteride (Propecia).
Q: I know that I am going to be bald because my father is bald and I am losing my hair just like him. What actually causes this kind of hair loss?
A: Although there are many different causes, the overwhelming number of people that have hair loss have what is referred to as “patterned hair loss” or “androgenetic alopecia.”
In men, it is due to a hormone called DHT, which is a by-product of testosterone produced by the action of the enzyme 5-alpha reductase. This enzyme is inhibited by the hair loss medication Propecia. See the causes of hair loss in men page on the Bernstein Medical – Center for Hair Restoration website for more information.
In women, the mechanism is a little bit more complex as another enzyme, aromatase, is involved in the metabolic pathway. See the causes of hair loss in women page on the Bernstein Medical – Center for Hair Restoration website for more information.
We know that the inheritance comes from both the mother’s and father’s side, although the actual genes causing hair loss in men and women have not yet been identified. Statistically, the inheritance from the maternal side appears to be a bit stronger, but the reason for this is unknown.
Q: If Rogaine is used only once a day will it still be effective?
A: Once a day topical use of Rogaine (topical minoxidil 2% and 5%) is probably almost as effective as using it twice a day.
The reason is, although minoxidil has a relatively short half-life of several hours when given orally, when topically applied, it has a half-life of 22 hours in the skin.
This suggests that once a day dosing is a reasonable option. It is important to realize that Pfizer, the company that now makes Rogaine, specifically states that it will be less effective if used only once a day.
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Disclaimer: The purpose of the Hair Transplant Blog is to provide the public with general information on hair restoration. Information provided on this site should not be used for medical diagnosis and/or treatment.
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