• The active ingredient in Rogaine is minoxidil.
  • Minoxidil increases the blood flow to blood vessels surrounding hair follicles.
  • Although Rogaine has a proven track record, it does not work for everyone and there may be better alternatives for your hair loss.

Minoxidil was initially used to treat high blood pressure until it was discovered that a side effect of the medication is its ability to stimulate new hair growth. This compound is the active ingredient in the popular hair loss treatment, Rogaine.

Although the evidence is solid for Rogaine’s efficacy in preventing hair loss, the lotion doesn’t work as well for everyone. In certain instances, there may even be better treatment alternatives, depending on the pattern of your hair loss.

Overview

How does Rogaine work?

Much like the 16th-century explorer, Juan Ponce de Leon’s search for the mythological fountain of youth, the quest to find a cure for baldness is just as old and fabled. The ancient Egyptians were convinced that if they lathered a concoction of burnt hedgehog fur onto their scalps, it would stimulate hair growth. The ancient Greek healer, Hippocrates prescribed a lotion of pigeon droppings to cure baldness.

Thankfully, for both men and women suffering from hair loss, modern science has come a long way since the ancients. Minoxidil, a vasodilator that opens up blood vessels has been shown to effectively help regrow hair. New York City dermatologist, Dr. Bobby Buka, explains that minoxidil works by increasing the flow of blood to the blood vessels surrounding hair follicles. ”It is posited that the chemical mechanism in minoxidil relates to the release of nitric oxide, which boosts hair regrowth,” he notes.

Rogaine is the first FDA approved topical medication that helps regrow hair in both men and women. Backed by more than two decades of clinical trials, there are also recent clinical studies that have confirmed the effectiveness of this intervention.

Side Effects

Side effects of minoxidil

It is advised that Rogaine should not be used if the skin on your scalp is cut, irritated or sunburned. It should also not be used anywhere on your body except for the scalp to avoid a toxic level of the ointment being absorbed by your body. Finally, do not use any other topical lotions on your head while using Rogaine, unless otherwise advised.

Because minoxidil is a topically applied medication and is not ingested, it is generally regarded as safe. Commonly reported side effects include redness or irritation of the treated and surrounding area of the scalp as well as itchiness, dry scalp, dandruff and undesired hair growth elsewhere.

Severe side effects are rare and may include tachycardia (increased heart rate), chest pain, dizziness, fainting and swollen hands and feet. If you experience any dizziness, an irregular heartbeat, growth of unwanted body or facial hair, unusual weight gain, swelling of your hands or difficulty breathing, you should stop using the lotion immediately and consult your doctor.

Rogaine use in pregnancy

If you are pregnant, be aware that Rogaine is classified as an FDA pregnancy category C, which means it is unknown whether Rogaine could be harmful to a fetus. Consequently, minoxidil should not be used without consulting your doctor if you’re pregnant or breastfeeding.

Results

How effective is minoxidil?

Although minoxidil provides cosmetically acceptable results, we need to keep in mind that it is only effective in a subset of patients. Specifically, Rogaine in men is only effective in the treatment of male pattern baldness (thinning hair on the crown) and not for the loss of hair at the front of the head or for treatment of a receding hairline. In women, it can be used to enhance hair growth in thinning hair. Other types of hair loss may not benefit from Rogaine. These include patchy hair loss, unexplained hair loss or pregnancy-related hair loss.

It is also important to remember that the effectiveness of topical minoxidil only lasts for the duration of continued application. In other words, this medication must be used indefinitely to maintain continued hair growth or halt further hair loss. An older study concluded that cessation of topical minoxidil treatment results in the reduction of hair weight and follicle number count after 28 weeks.

An article citing a review of the studies on Rogaine notes that the effectiveness of topical minoxidil in treating hair loss has been primarily demonstrated in men who are between the ages of 18 and 41 years. Also, they concluded that minoxidil’s effectiveness is higher in men who have been experiencing hair loss for less than five years.

 

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Minoxidil combined with finasteride before and after

Can minoxidil be used on beards?

The short answer is Yes.  Minoxidil has been used to grow hair anywhere on the body where there are hair follicles, including head, face, eyebrows, arms, and chest. However, everyone is different and it is important that you give it up to 3 months to see results.

Recent clinical studies on Rogaine

The International Society of Hair Restoration Surgery highlights a one-year observational study by dermatologists in 2004 of 984 men with male-pattern hair loss. The study evaluated the effectiveness of a 5% minoxidil topical solution in halting hair loss and stimulating new hair growth. The researchers concluded that areas of the scalp suffering from hair loss were reduced in 62% of the patients, remained unchanged in 35.1% and grew larger in 2.9% of study participants.

A study published in 2017 that investigated 36 women treated with oral minoxidil daily for six months noted hair growth improvement within three months. Another study published in 2015 concludes that a significantly higher proportion of participants in the minoxidil group showed greater hair growth than the placebo group. In this study, both study investigators and patient self-reports reached the same consensus. Likewise, a 2014 study published in The Journal of Drugs in Dermatology attests that minoxidil shortens the telogen phase in hair (i.e. when hair follicles enter a resting state and fall out) thus ensuring more hair growth.

Expert opinions

What dermatologists recommend

Drs. Gary and Kristina Goldenberg, dermatologists in New York City recommend Rogaine to their patients. But they believe that the best approach to reversing hair loss is a combination of treatments. ”These may include over-the-counter vitamins, as well as vitamin injections; correction of internal abnormalities, such as hormonal imbalance; as well as in office treatments such as PRP [platelet-rich plasma] and stem cell injections; and light-based devices.”

The Goldenberg’s also insist that starting treatment at the first sign of hair loss is crucial. Since most types of hair loss is progressive, often the best outcome is merely keeping the hair that you still have. For this reason, they also note that managing patient expectations is essential to avoid any unrealistic hopes for treatments.

Managing hair loss in women

Hollywood, FL dermatologist, Dr. Todd Minars, says he recommends Rogaine – but only for women whose hair is thinning. ”I tell women the following. First, get the 5% [solution] even if the packaging is labeled for ’men.’ And second, use it nightly (not twice a day) – once seems fine and realistically, no one wants to put anything on their scalp even one time per day let alone two. Just make sure it is not right before bed because we don’t want Rogaine to get on a pillow and then onto your face, resulting in unwanted hair growth,” he cautions.

Alternatives to Rogaine in men

For men, Dr. Minars suggests Propecia. ”It’s a pill, and so the compliance is much higher than a medication you must apply to your scalp. It is a prescription that is approved for male pattern hair loss. I do not prescribe it for women but I do know many dermatologists who do,” he informs.

Although Dr. Buka recommends Rogaine, in his opinion finasteride is a more effective option. ”It works by blocking the conversion of testosterone to DHT, or dihydrotestosterone. DHT is the active metabolite of testosterone that is most responsible for shrinking hair follicles. For 40% of patients, blocking DHT results in new hair growth. For another 40%, it helps keep the hair they have. Then for 20%, it doesn’t work at all,” he explains.

Rogaine wrap up

So, the good news is: it works for most people with thinning hair on the crown. If you start using this lotion, however, there are a few key points to remember.

Once you start, don’t stop or hair loss may resume. If you decide to use Rogaine, be careful not to deviate from the instructions for use. That means making sure your hair and scalp are free of moisture before applying the recommended dosage to areas of your scalp affected by thinning hair. Rogaine is usually applied twice per day – once in the morning and once at night.

Some dermatologists recommend Rogaine for use in women, stipulating that application once-a-day at night is enough to produce results. Remember to wash your hands before and after application, and avoid applying Rogaine on areas of your skin where you do not want to stimulate new hair growth. Never apply more than of 2 ml of Rogaine per day as it could trigger unwanted side effects.

Finally, if you do experience any side effects, stop using it and contact your doctor immediately.

About The Author

Articles by

Gary D. Breslow, MD, FACS is a highly regarded board certified plastic surgeon in New Jersey, known by both patients and peers as a problem-solver with a warm, engaging personality, and an instinctive ability to identify and truly understand the goals of his patients and the patients, themselves.

Originally from Long Island, New York, Dr. Breslow graduated from Brown University with a Bachelor of Science degree and received his medical degree from New York University School of Medicine.

Following medical school, Dr. Breslow spent 6 years training at the Hospital of the University of Pennsylvania’s nationally renowned Integrated Plastic Surgery Residency Program. There he received extensive training in both cosmetic and reconstructive surgery from some of the nation’s top practitioners. After leaving Penn, he returned to NYU Medical Center to spend one year as the Microvascular Reconstructive Fellow at NYU’s prestigious Institute of Reconstructive Plastic Surgery.

Dr. Breslow is Board-Certified by the American Board of Plastic Surgery. He is a member of the American Society of Plastic Surgeons, a Fellow of the American College of Surgeons, and is licensed to practice plastic and reconstructive surgery in both New Jersey and New York.

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