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Robotic Hair Transplants & Hair Restoration
Flagship: 110 East 55th Street, New York, NY
212-826-2400 - [email protected]
Bernstein Medical - Center for Hair Restoration
Hair Restoration Answers

Can Rogaine Cause Miniaturization?

Q: Can Rogaine Cause Miniaturization?

When I am on Rogaine it seems – to my untrained eye – that I am having hair miniaturization and when I stopped briefly, I had shedding. Does this seem accurate based on what you have seen? Can Rogaine cause miniaturization? Is there a point you would recommend I stop Rogaine or is it something that likely can’t cause a negative impact on hair? — B.T., Brooklyn, NY

A: Minoxidil reverses miniaturization. It does not cause it. Shedding can occur after starting use of Rogaine but this means the medication is working should resolve with continued use. New miniaturized hairs are either from the progression of your genetic male pattern hair loss or newly forming hair that was stimulated by the minoxidil which can mimic miniaturized hair.

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Hair Restoration Answers

Do Propecia (Finasteride) and Rogaine (Minoxidil) Work on Front of the Scalp?

Q: Both Propecia and Minoxidil definitely can work in the front of the scalp as long as there is some hair in the area. Although their mechanisms of action are different, both Propecia (finasteride) and Rogaine (minoxidil) act to thicken miniaturized hair regardless of where it is on the scalp. In fact, there are published data (Leyden et. al., JAAD, 1999) demonstrating this improvement in a controlled clinical trial of men with frontal hair loss. — J.S., Great Falls, Virginia

A: Both Propecia and Minoxidil definitely can work in the front of the scalp as long as there is some hair in the area. Although their mechanisms of action are different, both Propecia (finasteride) and Rogaine (minoxidil) act to thicken miniaturized hair regardless of where it is on the scalp. In fact, there are published data (Leyden et. al., JAAD, 1999) demonstrating this improvement with finasteride in a controlled clinical trial of men with frontal hair loss.

The source of the confusion on this topic is the fact that the FDA limited the application of the drugs to the crown on the package inserts for both Propecia and Rogaine. The FDA did this because Upjohn (the company that introduced Rogaine) and Merck (Propecia) only tested the medications on the crown in the clinical trials. Logically, the fact that DHT causes frontal hair loss and Propecia works by blocking DHT gives a reasonable explanation for the efficacy of the drug on the front of the scalp. Also, a side effect of the use of minoxidil is facial hair, so how could it not also work on the front of the scalp? It is regrettable that some doctors and many patients think that these medications won’t work on the front of the scalp. Unfortunately, many hair restoration surgeons have done little to educate the public and dispel this myth.

To reiterate, yes, both of these medications can work on the front of the scalp to prevent hair loss and thicken a thinning hairline. However, it is important to note that neither of these medications can grow hair on a totally bald scalp or lower an existing hairline. Hair follicles must exist for the medications to work. It is also important to stress that the best results come from using both finasteride and minoxidil together.

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