Hair Loss & Restoration Article: More About Minoxidil (Rogaine) For Hair Loss

More About Minoxidil (Rogaine) for Hair Loss

You have probably heard about Rogaine (minoxidil) because it has been in clinical use for about 15 years—first only by prescription and later over-the-counter. Some of your friends or family members may have used it to treat male-pattern hair loss (MPHL) or baldness.

Minoxidil (Rogaine® ) tends to be more effective in women than in men. The reason for this is not well understood. Only the 2% solution of Rogaine® is approved by the FDA for marketing to women, but there is substantial evidence from hair counts and photographic before-and-after evaluation that the 5% solution has additional benefit for women just as it has for men [ Olsen EA. Female pattern hair loss. J Am Acad Dermatol 2001; 45:S70-S80].

Minoxidil is a drug that was developed for one medical use (to lower blood pressure), but turned out to have another unexpected but valuable application (to stimulate growth of hair in people with MPHL). The effect of minoxidil on hair growth was not predictable on the basis of its vasodilating action (relaxing blood vessels to lower blood pressure). Neither is minoxidil known to have any effects on androgens, the male hormones associated with androgenetic alopecia (See About hair loss for more information about androgens and androgenetic alopecia).

What minoxidil did turn out to have is a direct effect on the cellular structure and cellular activity of scalp hair follicles. By way of its activity in relaxing blood vessels, it also appears to improve blood flow in scalp hair follicles. While the reason for these effects is not fully understood, minoxidil is proven to slow or stop hair loss and to stimulate the growth of normal, healthy hair in scalp hair follicles that have ceased functioning normally due to androgenetic alopecia. The effects of minoxidil vary from individual to individual and usually cannot be predicted.

The effect of minoxidil on scalp hair follicles was observed first when the drug was given orally (in pill form) to treat high blood pressure [Zappacosta AR. Reversal of baldness in a patient receiving minoxidil for hypertension. N Engl J Med 1980; 303:1480-1481].

The effect on scalp hair follicles was maintained when minoxidil was prepared in topical solution for direct application to the scalp. The topical solution has been shown over a period of 15 years of clinical trials and patient care to be a safe and effective treatment for hair loss due to MPHL. It is effective in about 30% of persons who receive the treatment. For reasons not yet understood, women have a higher response rate than men to topical minoxidil.