Hair restoration science has come a long way in the 21st century, with surgical procedures and alternative therapy techniques gaining traction in the mainstream with stellar results.
In terms of prescription hair growth medication, two drugs remain at the top of the field: Finasteride and Minoxidil.
In this article, we’ll be examining the details of each medication with a thorough analysis of their effects, safety, and the best candidates for both types of treatment.
Belonging to a class of drugs known as 5A-reductase inhibitors, Finasteride has long been marketed as one of the most effective and safe prescription medications to treat androgenetic balding, the most common cause of hair loss in 95 percent of men.
Also known by its brand name Propecia, this is a widely popular medication prescribed by doctors all over the world, and has been available in different forms over many decades.
Although it was first researched as a drug for prostate health, scientists discovered its benefits for hair growth and pursued the patent back in the 1970s.
Finasteride works by targeting DHT concentrations in the scalp, aiming to limit the conversion of testosterone into this byproduct molecule that can interfere with the healthy life cycles of hair.
While DHT is a naturally occurring compound, some men are genetically predisposed to having an adverse reaction to high levels, resulting in the male pattern baldness we see in depictions like the Norwood scale.
More specifically, Finasteride works by limiting the production of the enzyme that turns testosterone into DHT, targeting the problem at its source.
While the science is not crystal clear, many doctors in the field agree that Finasteride does have an impact on reducing DHT concentrations and thereby limiting the rate of hair loss.
As far as clinical trials go, Finasteride has an impressive track record. According to a study conducted by the Journal of the American Academy of Dermatology in 1998, Finasteride stimulated hair growth at an average increase of 15% over two years.
Another trial conducted by the Center for Drug Evaluation and Research found that Finasteride helped to slow the speed of hair loss and even stimulate regrowth in key areas along the hairline, where most men begin to see balding occur.
For longer treatments in the five to ten-year range, Finasteride’s effects are also quite promising. A study from the European Journal of Dermatology shows that long-term Finasteride use can significantly reduce rates of balding while sparking growth in low-density areas.
Finasteride is easy to obtain and administer, requiring that patients only take one small 1mg pill per day. While results may not be immediate, many patients begin to see positive changes within three to four months. Results may improve from there, but hair loss is likely to continue at its predicted rate if use is discontinued at any point.
As far as side effects go, most patients are able to take Finasteride without experiencing any negative impacts on their overall health and wellbeing. While some accounts of sexual dysfunction have been reported, other men state that the drug actually boosted their sex drive and performance, so it is difficult to predict the effects on any one individual.
Finasteride should also not be taken by anyone with a history of prostate problems or liver toxicity, and as always, you should consult with a qualified hair restoration specialist before jumping on any sort of prescription meds.
Unfortunately, because Finasteride is designed to manipulate the interaction of male hormones and enzymes, women should not take this medication.
Luckily, Minoxidil offers an alternative solution for women.
More commonly known by its over-the-counter name Rogaine, Minoxidil is a hair loss drug with another great track record and millions of satisfied users worldwide.
Unlike Finasteride, an oral medication that acts on the hormone profile, Minoxidil is a topically administered gel, cream, or foam meant to stimulate hair growth on-site.
Minoxidil is a vasodilator, meaning that it works to widen blood vessels within the skin and increase blood flow to the target area. This allows higher levels of oxygen and nutrients to be transported to the scalp, which may help put the brakes on hair loss or even regrow lost hair.
On a more technical level, Minoxidil works to replace hairs in the telogen phase of growth and replace them with hair in the anagen phase. While telogenic hair is in a state of rest (not growing and eventually weakening), anagenic hairs are in their prime growth phase, meaning they are more likely to spring back to life from that dormant state.
Because of this dynamic, new users of Minoxidil may experience hair loss early on as they test out the drug for the first time. This may be alarming, but doctors urge patients to stick with it for at least a few more months until the anagenic hair is stimulated and begins to grow.
Many clinical trials have been conducted to gauge the effects of Minoxidil, confirming it as the most powerful topical solution for hair restoration.
In a four-month study conducted by the International Society of Hair Restoration Surgery, researchers found that nearly 74% of men saw significant improvements in their hair density, while the vast majority of respondents (93%) stated conclusively that Minoxidil was effective, moderately effective, or very effective.
Minoxidil is great for women as well, who typically experience thinning along the “part” of their hair with age. Clinical trials show that women actually respond better to the drug than most men, and should consider trying a low dose of Minoxidil to test it out.
The side effects of Minoxidil are few, but users need to exercise caution when applying the solution to their scalp. The material can be harmful if it comes in contact with the eyes, nose, or mouth, and any furniture or linens that it touches must be washed thoroughly ASAP.
Administering Minoxidil twice a day can also be somewhat of a hassle for those who lead busy lives since it can take up to ten minutes to fully set and dry without risk. However, most users report that the process becomes easier with time and a normal part of the daily routine.
Accessing Minoxidil is easier than getting Finasteride, but users should still talk with their doctors before picking up a bottle from the store or ordering it online. Only a medical professional will be able to provide the best advice and regimen for proper Minoxidil use, even though some may be tempted to take the “guinea pig” approach.
If users experience any irritation, stinging, redness, or lightheadedness during Minoxidil treatment, they should discontinue use immediately and contact their doctor to figure out an alternative hair restoration game plan.
For men looking to supercharge their hair restoration results, they may wish to take both Finasteride and Minoxidil concurrently. This is a common approach that doctors trust and typically recommend to their patients.
Combined, the mechanisms of Minoxidil and Finasteride can yield impressive results. In 2015, a study from the Indian Dermatology Online Journal found that men taking both drugs report satisfactory increases in the strength and length of their hair, with improved density and population in areas previously impacted by balding.
While surgery is not always the best choice for those suffering hair loss, these drugs can be a major boost after a hair transplant is performed. The combination of drugs is commonly prescribed to patients following procedures such as Follicular Unit Transplant or Follicular Unit Excision.
Since these procedures involve harvesting and grafting units from a donor area and transplanting them to the scalp, patients need all the help they can get in preserving and stimulating the growth of these new follicles.
Both Finasteride and Minoxidil can be helpful tools for limiting hair loss and even sparking new growth, but certain segments of the population are more likely to see results from these drugs.
Studies show that men under the age of 40 have a higher success rate with Finasteride, and the medication is most effective when taken at the first signs of male pattern balding.
Other research tells us that Minoxidil works best on the vertex of the scalp, rather than along the hairline. Younger folks will also likely see better results from early use, so it’s always better to tackle the problem as soon as hair loss begins.
In the world of hair loss drugs, Finasteride and Minoxidil are unparalleled. Until new medications receive FDA approval and show superior results, these are the two medications that should be in your playbook.
Remember to team up with a qualified hair loss pro, and map out a strategy that will keep your hair healthy and strong for the long run.
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