Monday, March 30, 2009

Rogaine, Nioxin or Propecia...?

So, you've upped your vitamin intake, checked for potential health issues and you want to take the next step. Deciding on a treatment plan for hair loss can be a bit like deciding on which cheesecake to have from Cheesecake Factory. There are so many choices available and they ALL sound good!
Keep in mind that the key to hair loss treatments are 1. Consistant usage, 2. Patience, and 3. Continued usage. Without any of these three, your results will not be noticible, or long lasting.
Here is a run down of the three most used hair loss treatments. You need to decide what you are actually willing to do each day to help you decide which one is for you.

~Nioxin
Nioxin tends to be the "preventative" measure in most cases. It is designed to take care of the scalp and hair health so that you keep the hair that is currently on your head. There are people who absolutely love this product, and those who are not believers. I think that the truth lies somewhere in the middle. Clearing the sebum from your scalp definately will ensure that you lose less hair! Getting rid of the mites that may be running amuck on you scalp and hair will also help. Perhaps the best option is a two or three pronged approach.
Nioxin has several formulations, one that is likely right for you!
System 1 is for fine, natural hair, normal to thin-Looking (early stages)
System 2 is for fine hair, natural hair noticeable stages of thinning (advanced statges)
System 3 is for early stages of thinning and for treated hair, colored or permed.
System 4 is for chemically enhanced fine hair, noticeable thinning
System 5 is for medium to course hair early stages of hair loss, natural hair.
System 6 is for medium to course hair. for advanced stages of thinning. natural hair.
System 7 is for medium to course normal to thin-looking chemically enhanced hair
System 8 is for medium to course chemically enhanced noticeable thinning hair


~Rogaine (Minoxidil)
Originally developed as a blood pressure medication, Rogaine, was the first FDA approved medication for the treatment of hair loss. Rogaine is a topical solution that is applied directly to the scalp. It can be purchased without a prescription and in generic formulations in concentrations of 5% (for men) and 2% (for women).
It was observed that patients who were taking minoxidil began growing body hair and it was reasoned that applying minoxidil directly to a bald scalp might cause hair to grow in this area as well. Studies showed that this was indeed the case, although the growth was generally modest.The original studies on Rogaine were performed on the crown, so there is a misconception that it only works in this area. Although minoxidil usually works best in the crown, it also works to a lesser degree in other areas, such as the front of the scalp, as long as there is some fine (miniaturized) hair in the area. It does not work when the area is totally bald. The greatest benefit from the medication is seen from 5 months to 2 years (remember, PATICENCE!), with a gradual decrease in effectiveness after that. Users of minoxidil long-term will continue to lose hair, but at a somewhat slower rate. The exact mechanism by which minoxidil works is not known, but the drug is felt to increase the duration of the hair follicle growth cycle (called anagen). This improves the quality of the hair by increasing the diameter and length of fine (miniaturized) hair. The simultaneous use of minoxidil and Propecia, which directly inhibits the formation of DHT, may have some synergistic benefit in the treatment of hair loss, although the latter medication is significantly more effective. Minoxidil should be applied to the scalp twice a day. The medication only works if it is in direct contact with the scalp (not the hair) and only works in areas where it is applied. Therefore, it is important to use the medication in the front part of the scalp if this is an area of thinning. The 5% formulation is twice as effective as the 2% solution, but contains propylene glycol, a compound that can irritate the scalp and can make the hair feel sticky and difficult to manage. If this is a problem, you should consider using the 5% solution at bedtime and the 2% solution (which is alcohol based and less sticky) in the morning. When using minoxidil, it may take 6-12 months before any results are seen. The majority of patients who see an effect from minoxidil experience a delay, or decrease, in the rate of hair loss. The drug also serves to thicken already existing hair. It will not grow any new hair on a bald scalp. Rogaine Foam is a new form of 5% Minoxidil in a glycerin and alcohol base. The foam technology is a convenient way of delivering minoxidil to the scalp without the sticky and often irritating effects of propylene glycol, the delivery compound used in the original 5% solution. When released from the canister, the new product seems like a shaving foam, but it rapidly "melts" when it reaches skin temperature. Applying Rogaine as a foam allows convenient application to the scalp without dripping or running down the forehead or neck, and without leaving a sticky residue in the hair. Once a day topical use of Rogaine (topical minoxidil 2% and 5%) seems to be almost as effective as using it twice a day. The reason is, that although minoxidil has a relatively short half-life of several hours when given orally, when topically applied, it has a half-life of 22 hours in the skin. This suggests that once a day dosing is a reasonable option. It is important to realize that Pfizer, the company that now makes Rogaine, specifically states that it will be less effective if used only once a day.If minoxidil is discontinued, the effects of the drug wear off within three months and the previous pattern of hair loss resumes. When minoxidil is restarted, one generally does not regain the hair that was lost, so it is best not to stop and start the mediation, but to use it regularly. Minoxidil has been prescribed (off-label) in conjunction with other medications, such as topical retinoic acid (Retin-A), to enhance its penetration into the skin, increasing its effectiveness. This combination of medications, however, can greatly increase the absorption of minoxidil into the bloodstream and may increase the risk of potential side effects, including changes in blood pressure and severe scalp irritation that has led to scarring. The 2% concentration of minoxidil is approved for use in women. Women are generally more sensitive to the side effects of minoxidil in decreasing blood pressure (hypotension) and may get light-headed from the medication. Women also have an increased risk of developing allergic skin reactions (contact dermatitis). An annoying local reaction that women sometimes get from topical minoxidil is the development of facial hair. Although the facial hair slowly resolves when the medication is discontinued, at times the hair may need to be removed. Carefully trying to avoid the medication dripping down onto the temples and forehead seems to reduce, but not totally prevent, this problem. There is a significantly greater incidence of these side effects if the 5% solution is used.
Rogaine
Alternative names - Regaine, Minoxidil
Consistency is the key to success since stopping the application of Rogaine will cause the hairs gained to be lost in about 6 months. On the other hand the results from Rogaine can diminish over time, some doctors believe there is a tolerance that is built up over many years of use. One way of remedying this tolerance concern is to take a week or two off the treatment every 3-4 months. However it is not recommended to do this until you have been using it consistently for at least 12 months.Rogaine and DHTRogaine unfortunately does not reduce or remove DHT which is the cause of Androgenic Alopecia. However this can be remedied by using a DHT inhibitor in combination with Rogaine. In fact some dermatologists recommend using Rogaine in conjunction with Propecia, and there have been studies that have show that these two drugs work synergistically and give far better results than using either drug on its own. Pharmacia, the manufacturers of Rogaine actually hold a patent for using Rogaine with a DHT inhibitor, or Anti Androgen.
Side effectsSide effects are not common, but some people can experience a contact dermatitis or irritated skin from the alcohol in the Rogaine. Excessive doses can cause a rapid heartbeat or dizziness but is very uncommon with normal use.

~Propecia
Propecia is the only once-a-day pill approved by the FDA for the treatment of certain types of male pattern hair loss in men. Propecia reduces DHT, a key cause of hair loss and clinical studies have shown visible results.
For best results, take Propecia every day for 12 months, however, you may need to take it daily for 3 months or more before you see a benefit from taking it. If Propecia has not worked for you within 12 months, further treatment is unlikely to be of benefit.
Once again, Propecia can only work over the long term if you continue taking it. If you stop taking it, you will likely lose any hair you have gained within 12 months of stopping treatment.
Propecia was developed to treat mild to moderate male pattern hair loss on the vertex (top of head) and anterior mid-scalp area (middle front of head) in MEN ONLY. There is not sufficient evidence that Propecia works for receding hairlines at the temples.
Propecia is for the treatment of male pattern hair loss in MEN ONLY and should NOT be used by women or children. This is a prescription medication, so you will have to talk with your doctor to ensure that it is right for you.
In clinical studies for Propecia, less than 2% of men experienced side effects. Since this is a family blog, I won't go into graphic details, but make sure you know what the possibilities are before you take that pill!.
Although results vary, generally you will not be able to grow back all the hair you have lost.

1 comment:

  1. Thank you very much for this comprehensive review. I'm starting to see some evidence of hair loss on my scalp (no longer just my comb, which is not new) and don't know what, if anything, to do about it.

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