Treating Hair Loss With Minoxidil and Finasteride: Are They Effective?

Androgenic alopecia, or patterned hair loss, will affect about 80% of the population by the time they are 60 years old. It can be devastating for some and can cause significant psychological distress. Hair loss can begin as early as 20 for some and progresses with time. The earlier you treat it, the better the results.

Key takeaways:
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    Hair growth occurs in 3 stages: Anagen, Catagen, and Telogen.
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    The most common type of hair loss in men and women is androgenic alopecia or patterned hair loss.
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    Minoxidil and finasteride are FDA-approved to treat androgenic alopecia but have several side effects.
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    Minoxidil has side effects, including rash, chest pain, rapid heart rate, dizziness, and weight gain.
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    Finasteride's side effects include erectile dysfunction, decreased sex drive, ejaculation problems, breast lumps, and nipple discharge.

Minoxidil and finasteride are FDA-approved to treat this type of hair loss, but may have some serious side effects. Knowing the benefits and risks can help you make an informed choice about the best treatment for you.

How does hair grow?

Hair growth is an intricate process that varies depending on the hair type, such as scalp or eyelash. The entire process is influenced by your genetics, your current state of health, and your medications. Hair growth occurs in 3 stages.

  • Anagen. The anagen phase is the growth phase of hair. It can last up to 5 years and varies depending on the hair type. Scalp hair has a longer anagen phase than eyebrow hair. About 90% of your scalp hairs are in the phase at any time;
  • Catagen. The catagen phase is a transition phase. It lasts approximately 10 days. During this phase, the hair follicles shrink, and the hairs separate from them;
  • Telogen. The telogen phase is sometimes divided into 2 phases: resting and shedding. The resting phase lasts about 3 months, and the shedding phase can last up to 5 months. It is normal to lose about 100 hairs per day. The loss of hair is necessary to make way for new ones to grow.

What is patterned hair loss?

There are many types of hair loss, but the most common form is male and female-patterned baldness, also known as androgenic alopecia. This type of hair loss usually runs in families. Male patients present with hair loss on the top of their heads, affecting the frontal hairline. Female patients experience hair loss on the top of their heads and sides of their temples, with the preservation of the frontal hairline.

What causes male and female patterned baldness?

Patterned baldness or hair loss is a multifactorial process. It involves the interplay of genetics, hormones, stress, free radicals, external factors, and inflammation. The best results come from combination treatments that treat the different aspects of hair loss.

What is minoxidil?

Minoxidil, also known as Rogaine in the US and Regaine in the UK, is FDA-approved to treat patterned hair loss in men and women. Now available over the counter, it is a vasodilator thought to increase blood flow to the scalp and prolong the anagen phase. This increased blood flow will help bring more nutrients to the scalp and increase hair growth. It comes in solution and foam that is applied twice a day. It can take several months to see the full effects, and it must be used forever to keep the hair from falling out.

What are the side effects of minoxidil?

There are a number of side effects of minoxidil.

  • Redness. May also present with itching, swelling and burning;
  • Dermatitis. Either irritation dermatitis or allergic contact dermatitis.

Many times this rash is caused by other ingredients in the product that irritate the scalp, not the minoxidil. Some people have found that the solution can irritate, while the foam does not. More severe side effects include weight gain, dizziness, swollen hands and feet, chest pain, and rapid heart rate.

Who should not take minoxidil?

Always discuss starting any new medications with your doctor first. Patients with a known allergy to minoxidil, should not use it. Also, patients that are pregnant or nursing, on certain medications, or have a disease of the liver and kidneys should avoid minoxidil.

What is finasteride?

Finasteride, also known as Propecia, is an FDA-approved medication to treat patterned hair loss in men, and it is only available with a prescription. It prevents the conversion of the hormone testosterone into DHT, which is responsible for destroying hair follicles. Originally, finasteride was approved for the treatment of an enlarged prostate, but it was later discovered that it helps hair grow. It can take several months to see the full effects and must be taken forever to keep the hair from falling out.

What are the side effects of finasteride?

Finasteride can cause several unpleasant side effects.

  • Sex. It has been associated with lower sex drive, difficulty getting an erection, and ejaculation problems;
  • Swelling. Swelling of the tongue and lips;
  • Depression. Feelings of sadness, anger, and sleep issues;
  • Breasts. Lumps in the breast, as well as a rash and nipple discharge.

Who should not take finasteride?

As with any drug, you need to discuss taking finasteride with your doctor. Finasteride is not for everyone. Patients with liver disease, prostate cancer, pregnant, breastfeeding, or premenopausal women should not take it.

What other treatments can regrow hair?

While minoxidil and finasteride can help with hair loss, they do have some serious side effects. It also takes several months to see the full effects of hair growth, and they do not work for everyone. Also, the treatments must be continued indefinitely to keep the hair from falling out again. Other treatment options for patterned hair loss may have fewer side effects. These include:

  • Low-level laser therapy;
  • PRP/PRF;
  • Micro-needling;
  • Neutraceuticals;
  • Hair transplantation.

Patterned hair loss is a chronic, progressive disease that will affect most men and women as they age. It is a multifactorial process that can be difficult to treat. Minoxidil and finasteride are both FDA-approved to treat patterned hair loss, but may have serious side effects. They may also not be appropriate for all patients. It is best to discuss your options with your doctor first before starting any treatments. If you are suffering from hair loss, see your doctor right away.

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