December 1, 2007

The two FDA approved medications for hair loss; Propecia (finasteride) and Rogaine (minoxidil) are now being used by many patients with hair loss. But, to benefit from these drugs, they must be used properly. There are a number of misconceptions about their use that keep people from getting the most benefit from them. The following tips help to clarify some of the main points regarding their use.

Finasteride (Propecia)

  • Finasteride is a prescription oral medication that is now generic (in the 5mg dose). This formulation is just as effective as the brand name Propecia and is about 1/3 the cost.
  • The normal dose of finasteride is 1mg a day. You can either take one 1mg Propecia tablet or 1/4 of a 5mg tablet of generic finasteride each day.
  • If you chose to use the generic medication, a pill-cutter can be purchased from any pharmacy for a few dollars.
  • The finasteride does not have to be cut into equal parts to be effective.
  • Finasteride can be taken any time of the day without regard to food or other medications.
  • You may experience shedding during the first 3-6 months of treatment. This generally is an indication that the medication is working.
  • It takes a full year to see the effects of Finasteride, so be patient.
  • We recommend generic finasteride over Finpecia. Finpecia (finasteride 1mg) is manufactured in India by a slightly different method than the way generic finasteride is produced in the U.S. Generic medications produced in the U.S. are under FDA supervision.

Minoxidil (Rogaine)

  • Minoxidil comes in a generic formulation and can be purchased over the counter.
  • Minoxidil can work anywhere there is miniaturized hair (where the area is not totally bald); therefore, minoxidil will work in the front part of the scalp and temples if these areas are just starting to thin.
  • Minoxidil only works where you apply it.
  • If the 5% solution is irritating to your scalp, try the 5% Foam which does not contain propylene glycol, the most common irritant.
  • The 5% Foam is less greasy, but it is harder to spread on the scalp if you have a lot of hair.
  • Minoxidil can be applied to damp scalp when you first get out of the shower and this may make grooming easier.
  • You may experience some shedding during the first 3-6 months of treatment. This generally is an indication that the medication is working.
  • For minoxidil to be effective it must be used continually and on a regular basis.
  • It works best if used twice a day, but is still useful if used only once a day.
  • Many patients finding using the medication once a day at bedtime to be most convenient. Using it once a day will still have some benefit.

Combination Therapy

Finasteride is generally a more effective treatment for hair loss than minoxidil. Minoxidil works best when used in combination with finasteride. When using these medications, be sure to stay on finasteride for at least one year before assessing the results and minoxidil for at least six months. Starting and stopping either of these medications will result in the loss of any benefit gained from using them. Although these medications have no effect on a hair transplant per se, they can prevent further balding after a surgical hair restoration procedure. If patients chose to use either of these medications, they should be continued after the procedure as well.

For more information, visit the section on Hair Loss Medications.

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