Rogaine (Minoxidil) and Hair Transplants

International Panel of Hair Restoration Specialists Agree: Rogaine (Minoxidil) Can Augment and Optimize the Effectiveness of Hair Transplants

Hair transplant surgery is a definitive treatment for hair loss due to androgenetic alopecia (male and female-pattern hair loss). Transplantation brings hair and hair follicles from donor-dominant areas at the rear and sides of the scalp, where follicles are not susceptible to the conditions that cause androgenetic alopecia, to scalp areas that have suffered androgenetic pattern hair loss. The transplanted follicles continue to grow hair in their transplanted site. Thus, hair transplantation is a permanent solution to the problem of hair loss due to androgenetic alopecia.

The results of hair transplants can often be optimized by ancillary treatment of the scalp with the topical medication minoxidil (Rogaine?), used alone or in combination with the oral medication finasteride (Propecia?). Hair restoration doctors have recognized the value of ancillary minoxidil, and frequently use it to enhance the outcome of hair transplants.

Now, in a recently published scientific paper, a convened panel of international hair transplant specialists reports that the observations of hair restoration doctors and their patients is confirmed by a review of scientific and clinical literature and by their own experience. [Avram R. for the Roundtable Consensus Meeting of the 9th Annual Meeting of the International Society of Hair Restoration Surgery. The potential role of minoxidil in the hair transplantation setting. Dermatologic Surgery 2002; 28:894-900].

The panel reported that the topical application of minoxidil prior to and after hair restoration offers potential benefits of:

• stabilizing existing hair growth and preventing further hair loss in non-transplanted areas of the scalp
• increasing the number of hairs in the anagen (growth) phase, as opposed to those in the telogen (resting) and catagen (shedding) phases, thus contributing to the appearance of a fuller head of hair
• increasing hair weight and density, also contributing to an appearing of fullness
• decreasing post-transplantation shedding of telogen (resting) phase hairs

Where, when, and in what concentration minoxidil is applied is a matter to be determined by the hair restoration physician for the individual patient, the panel agreed. In general, it is preferable to begin minoxidil treatment immediately after the decision to begin transplantation, according to the panel—2 to 4 months before transplantation, if possible, since it usually requires that long to see demonstrable results of minoxidil treatment.

The panel reported that, while topical minoxidil can benefit most hair transplant patients, it may have particular advantages for certain groups of patients:

• women, whose androgenetic hair thinning is typically diffuse and thus can be alleviated by stimulation of new growth to fill in areas of hair loss;
• younger men with diffuse hair loss and a family history of extensive hair loss, in whom minoxidil may slow the loss of hair and maintain a reserve of donor hair for future transplantation
• any patient who wants transplantation to include the “whirl” area at the center-rear of the scalp.

Minoxidil is available in 2% and 5% concentration. The physician hair restoration specialist will recommend the concentration likely to be most effective for the individual patient. Minoxidil may also be used in combination with the oral medication finasteride (Propecia?).

The panel confirmed the recommendation that the use of minoxidil must be continued after transplantation in order to retain the benefits of the medication. A pause or cessation of use will result in loss of all of the hair growth stimulated by the medication.

(Click on About hair loss and Nonsurgical hair loss treatment options for more information on the causes and non-surgical treatments of hair loss).