A: Nioxin has no active ingredients that can grow hair. There is an increased incidence of scalp irritation when used with Rogaine – i.e., the likely reason for their warning. I would stick with the medications that are proven to work, i.e. finasteride and minoxidil.

A: Minoxidil has been prescribed (off-label) in combination with other medications, such as topical retinoic acid (Retin-A), to enhance its penetration into the skin and thus increase its effectiveness. This combination of medications, however, can significantly increase the absorption of minoxidil into the bloodstream and may increase the risk of potential side effects, including changes in blood pressure and severe scalp irritation that has, on occasion, led to scarring.

If person wants to add Retin-A to the minoxidil regime, the Retin-A should be applied only once a day, since the Retin-A will bind to the skin and will last for at least 24 hours.

Applying Retin-A more frequently will not increase its effectiveness (in facilitating the absorption of minoxidil); it will only increase the incidence of side effects. Retin-A can be applied to the scalp at the same time as Minoxidil, or by itself.

Retin-A should not be compounded with minoxidil (mixed together by your pharmacist or your doctor) for the following reasons:

1. Minoxidil works best when used twice a day. Retin-A is best used once a day.
2. Using Retin-A twice a day wastes money and increases the incidence of side effects
3. If you develop side effects from the Retin-A, it is best to stop only the Retin-A. If they are compounded, you would need to stop both and will lose the benefit of minoxidil.

Explore the pro’s and con’s of Minoxidil — also known by its over-the-counter product Rogaine — at the Rogaine/Minoxidil page on the Bernstein Medical – Center for Hair Restoration website or by viewing minoxidil-related posts on the Hair Transplant Blog.

A: Minoxidil does work on the front of the scalp to prevent the progression of hair loss and may thicken areas of early thinning, although it won’t re-grow hair in areas that are bald.

I would also consider using finasteride (the active ingredient in the hair loss medication Propecia) as this will also work on the front of the scalp to prevent further hair loss and to increase areas of thinning – and it is more effective than minoxidil.

A: The advantage of the in-office LLLT systems are that the units are more powerful and that the delivery of the energy is the same each time. The treatment is also not dependent upon the patient having to remember to do the treatment and does not require the person to spend 15 minutes each time concentrating on using the hand-held machine correctly. It also had the important advantage of requiring an initial evaluation by a physician who can diagnosis the hair loss and make sure that it is the genetic type that may respond to this type of therapy. And the effectiveness of the treatment can more readily be monitored over time.

The disadvantage of the office- or medispa- based system is that the treatments are significantly more costly than the home machine and require periodic visits over an extended period of time – a nuisance for working people, or for those who do not live close to a facility offering this service.

The advantage of the hand-held system is that it is much less expensive than the office based machine and it is much more convenient to do the treatment at home than to go to a doctor’s office several times a week. There may also be a potential advantage for patients that still have a significant amount of hair. In these people, the hand-held system (that is able to part the hair) may allow the laser light to more effectively reach the scalp.

The major disadvantage of the hand-held device seems to be with patient compliance as people get tired of having to run the instrument through their hair for 15 minutes several times a week. It is also hard for the person himself to judge if the treatments are working, how to taper the treatments and if, and when, to stop.

A: As with other medical therapies for hair loss, once the treatment is completely stopped, any benefit should subside.

It is anticipated, therefore, that periodic treatments will be needed after than the initial treatment course.