Are you losing hair like crazy? Are you tired of using those intensively advertised commercial treatments but all in vain? As hair loss affects millions of women and men across the globe every year, you are not alone. While no complete cure has been found for male- and female-pattern baldness till now, it is possible to stop or slow down hair loss and regrow lost hair to some extent with combination therapy. This includes two well-known drugs – ‘Propecia and ‘Rogaine.’ Let us break down how these two clinically proven treatments can help you treat hair loss successfully.
What is Pattern Baldness?
Our hair grows in cycles, which include a growth phase of 2-6 years followed by a rest phase of several months or years. Shedding is a natural part of the hair cycle where around 50-100 hair fibers fall out daily (1). However, when this growth cycle of hair gets disrupted, hair loss becomes prominent. Pattern baldness scientifically termed ‘Androgenetic Alopecia’ (AGA), is the most common hair loss type. It results from hair follicle miniaturization in which hair follicles constrict and makes it difficult for the hair fibers to grow.
Types of Pattern Baldness
1. Male Pattern Baldness:
Men start losing hair above both temples in this condition, and the hairline recedes over time, creating an ‘M’ shape. The crown area also starts thinning, leading to partial or complete baldness. It usually begins during the teenage and is genetic and closely related to sex hormones. Almost two-thirds of men experience pattern baldness before reaching 35 years, while 85% of them suffer from it by 50 (4).
2. Female Pattern Baldness:
Female pattern baldness is characterized by the overall thinning of hair. Hairline receding and total baldness are not so common in women. Though the actual cause of female pattern baldness is yet to be confirmed, it is believed to be linked to the decreasing levels of female hormones like estrogen, as women generally experience it after menopause. Almost 40% of women suffer from some degree of pattern baldness by 50 (5).
When treating pattern baldness, very few potential options are available that halt or reverse hair follicle miniaturization. They can only manage the problem of hair loss rather than solving it permanently. Propecia and Rogaine are the only two pattern baldness treatments approved by the U.S. Food and Drug Administration (FDA).
What is Propecia (Finasteride)?
Propecia is a brand-name drug known as a highly effective prescription oral tablet used to treat androgenetic alopecia. The generic name for Propecia is ‘Finasteride,’ and it was first coined by the leading American pharmaceutical company ‘Merck.’ Though Propecia is mainly beneficial for men, women suffering from pattern baldness can also gain a lot from this.
Initially, Finasteride was studied and developed as a brand-name drug called ‘Proscar’ to treat the symptoms of engorged prostate glands (benign prostate hyperplasia). During the trials of the FDA-approved drug, Merck discovered its amazing quality of growing hair and developed finasteride as a reliable solution for male pattern baldness.
How Does Propecia Work?
Propecia mainly works by lowering a potent androgen hormone called dihydrotestosterone (DHT) in the body. When DHT binds to the receptors of genetically oversensitive hair follicles, they constrict and turn smaller in size gradually. So, the hair becomes thinner and stops growing eventually. As Propecia prevents the enzyme type II 5-alpha-reductase from converting testosterone into DHT, the hair follicles remain unaffected on the scalp. It slows down hair loss or eliminates the issue and leads to a substantial increase of hair growth on the head too. However, the drug does not stop the progression caused by stress, chemotherapy, certain medical conditions, and specific medication. It also does not influence the growth of hair on other body parts.
Dosage of Propecia
The FDA approved a daily dose of 1 mg. of Propecia with or without food for lowering DHT levels in the scalp by as much as 60%. The effects of the treatment do not stay once the drug is stopped.
Side Effects of Propecia
Even though Propecia has been clinically effective for pattern baldness, it may lead to sexual side effects in men like reduced semen, less sex drive, erectile dysfunction, ejaculation disorder, etc. Some rare side effects of the drug also include excessive hair growth, nipple discharge, enlarged breasts, lumps in breasts, breast tenderness, testicle pain, trouble urinating, allergic reactions (skin rashes, hives, swelling of face, tongue, lips, throat; trouble breathing), depression, and so on. People suffering from liver diseases or prostate cancer should stay away from the drug. Propecia should also not be taken by children, pregnant women, breastfeeding mothers, and premenopausal women. (6)
What is Rogaine (Minoxidil)?
Rogaine is also a brand-name drug that has been used to prevent hair loss for many years. The generic name for Rogaine is ‘minoxidil.’ It was available in the market as a liquid solution for topical use even before Propecia. Nowadays, Rogaine is available as OTC lotions and foams. The FDA approved it as the first and only topical medicine for treating androgenetic alopecia and regrowing hair (7). It is known to be safe and effective in both men and women.
Rogaine was launched in the market as a pill named ‘Loniten’ for treating hypertension. People who used it for regulating blood pressure levels also experienced hair growth in certain areas of the body. It led the researchers to study further and find out whether topical application of the drug can result in hair growth or not.
How Does Rogaine Work?
Rogaine does not affect the hormonal process of hair loss. Instead, it works as a vasodilator that widens the blood vessels to increase blood flow in the body. When applied directly to the balding areas of the scalp, Rogaine can stimulate follicular hair matrix cells, thereby delivering more oxygen and nutrients to them. This results in significant hair growth. But the result is solely dependent upon the scalp condition and the extent of hair fall in the patient. The positive effects of Rogaine in treating alopecia areata or hair loss linked to chemotherapy are yet to be confirmed. It also cannot treat issues like postpartum thinning of hair.
Dosage of Rogaine
According to the FDA, a dose of 1 ml. of liquid Rogaine solution should be applied to the scalp twice daily (morning and night) for treating pattern baldness. However, the effects of the drug are temporary, and hair loss starts again if you discontinue its usage.
Side Effects of Rogaine
Rogaine is pretty safe to use as a hair loss treatment. Some potential mild complications of the drug that people may experience are contact dermatitis, facial hair growth, temporary hair shedding, low blood pressure, possible fetal development impairment, allergy symptoms, headaches, rapid heart rate, burning, stinging, itching, acne, nausea, vomiting, dizziness, fainting, changes in hair texture or color, etc. (8). Ensure that you are not taking diuretics, guanethidine, or hypotensive medications as they may interact with rogaine. Pregnant women, breastfeeding mothers, and premenopausal women should also steer clear of this drug.
So, Which Should You Use?
Propecia and Rogaine are two different treatments with the same goal. They not only work differently but also address different aspects of pattern baldness. While Propecia blocks DHT production to stop hair loss as its source, Rogaine combats it at the topical level by nourishing the hair follicles and encouraging hair growth. You may certainly choose the right solution based on your unique lifestyle and requirements. But experts recommend a combination therapy to treat androgenetic alopecia in the best possible way.
Propecia-Rogaine: The Combination Therapy
Combining Propecia and Rogaine has been found to treat pattern baldness most comprehensively. The efficacy of these two drugs increases when used together than separately (9). Studies have revealed that the oral intake of 1 mg dose of Propecia and the topical application of 3% of Rogaine per day can help in managing hair loss and boosting hair regrowth significantly.
How Safe is the Combination Therapy?
Unlike most medications that interact with each other, Propecia and Rogaine are perfectly safe to take together. As they work through different mechanisms and in different parts of the body, there is no risk involved in bringing them together for treating pattern baldness.
Pattern baldness or ‘Androgenetic Alopecia’ (AGA) is caused by hair follicle miniaturization. It is known as the most common type of hair loss that affects both men and women. There are only two FDA-approved treatments for this purpose – Propecia (Finasteride) and Rogaine (Minoxidil). Propecia works by lowering DHT levels in the body, which slows down or eliminates hair loss and increases hair growth on the head. On the other hand, Rogaine works as a vasodilator that stimulates and nourishes hair follicles to promote significant growth of hair. Studies have found that a combination of 1 mg of Propecia and 3% of Rogaine per day can help in managing hair loss and boosting hair regrowth even better than the individual drugs. This combination therapy is also risk-free as Propecia and Rogaine do not interact with each other due to different mechanisms.
Frequently Asked Questions (FAQs):
Is Rogaine More Effective than Propecia?
Rogaine and Propecia have different mechanisms. But Propecia, being a hormonal medication, works at the source level of the hair loss problem while Rogaine works on it externally. Hence, Propecia is recommended as the first line of attack for pattern baldness. However, Propecia has no significant impact on hair regrowth, while Rogaine has shown great results.
Does Propecia Work If you are Already Bald?
Propecia is not an effective way to regrow lost hair. Hence, it may not work properly for a person who is already bald. This is more reliable as a protection against further hair loss or baldness.
Does Biotin Stop DHT?
Biotin is vitamin B7, which has no impact on hormones. Hence, it cannot stop DHT.
Will Minoxidil Regrow Hairline?
No, minoxidil is not capable of regrowing hair and reversing the receding hairline.
Does Rogaine Work on Bald Spots?
Though Rogaine helps regrow lost hair, it is ineffective in producing hair in bald spots or patches on the scalp.
- “Hair Loss: Tips for Managing”, AAD.org
- “Androgenetic Alopecia”, MedlinePlus.gov
- “Baldness: How Close are We to a Cure?”, MedicalNewsToday.com
- “Men’s Hair Loss”, AmericanHairLoss.org
- “Demographics of Women with Female Pattern Hair Loss and the Effectiveness of Spironolactone Therapy”, NCBI.nlm.nih.gov
- “Finasteride, Oral Tablet”, Healthline.com
- “Women’s Rogaine (5% Minoxidil) Topical Aerosol”, AccessData.FDA.gov
- “11 Side Effects of Rogaine for Women”, Healthline.com
- “Combined Treatment with Oral Finasteride and Topical Minoxidil in Male Androgenetic Alopecia: A Randomized and Comparative Study in Chinese Patients”, OnlineLibrary.wiley.com