*Updated November 22, 2017*
|Hair loss drug||Propecia||Rogaine|
|How it's taken||Oral tablet||Topical form|
|For men/women||Men only||Men and women|
|Directions||Take one tablet daily||Men: apply twice daily
Women: apply once daily
|Common side effects||Dizziness, headache, weakness, runny nose, skin rash, breast tenderness, testicular pain||Itching, rash, skin irritation, fatigue|
|Serious side effects||Erectile dysfunction, loss of sexual desire, decrease in amount of semen ejaculated||Unwanted facial hair, chest pain, irregular heartbeat, fainting|
|How it works||Lowers levels of DHT, the primary culprit in hair follicle shrinkage||Reinvigorates hair follicles, hopefully encouraging new hair growth|
|Prescription/OTC||Prescription only||Available OTC|
|Evaluation by American Hair Loss Association||First line of defense against male pattern hair loss||Recommended for men if Propecia doesn't work; only option for women|
|Longevity of results||Effects last only as long as drug is taken||Effects last only as long as topical solution is applied daily|
|Typical prices for month-long supply||$115 to $165||$25 to $35|
If you’re losing the battle to keep your hair, you’re probably in the market for a product that can turn the tide in your favor, allowing you to keep the hair that you’ve still got and promoting the growth of new hair to replace all that you’ve lost.
You no doubt have heard of the two FDA-approved medications — Propecia and Rogaine — that are designed to help combat hereditary hair loss, but you don’t know which one is the most effective or best suited for you.
Propecia Gets Top Recommendation
The American Hair Loss Association, a California-based organization dedicated to improving the lives of all those affected by hair loss, confidently proclaims finasteride — the active ingredient in Propecia — the first line of attack for all men interested in treating their male pattern baldness.
However, the AHLA believes that minoxidil, Rogaine’s active ingredient, still has an important role to play, particularly for those who have not had satisfactory results from Propecia or would like to add another product to their treatment regimen.
While Propecia appears to have a definite edge over Rogaine in the views of many hair loss specialists, you owe it to yourself to learn more about how each works, its side effects, and the long-term commitment that’s involved in using either or both of these products. To help you in that endeavor, what follows is a profile of both drugs.
The Rogaine Story
Originally marketed as an oral drug to treat high blood pressure, minoxidil — the active ingredient in Rogaine — first attracted the attention of hair loss researchers because of one of its distinctive side effects: hair growth, often in unexpected places. Many users of the anti-hypertensive drug experienced increased growth and/or darkening of fine body hairs, as well as the growth of hair in such unlikely places as cheeks and foreheads. This prompted researchers to study the drug’s effect on hair growth when applied topically to the scalp.
In studying the hereditary hair loss process, scientists have discovered that age, heredity, and hormones work in combination to cause a shrinking, or miniaturization, of your hair follicles that eventually results in a shortening of the hair’s growing cycle.
Enlarges Hair Follicles
Although the precise mechanism of minoxidil’s hair-growing properties is not fully understood, Rogaine’s website indicates that topical minoxidil enlarges hair follicles and reduces the miniaturization process. This, in turn, lengthens the hair cycle’s growth phase, allowing your hair to become longer and thicker.
First brought to market in the late 1980s, Rogaine today offers its product in different versions for both men and women. Men can buy Rogaine as a 5 percent minoxidil foam or a topical solution to be applied to balding areas of the scalp. Rogaine for women is available only in 2 percent minoxidil topical solution form.
Results Come Slowly
With Rogaine, users may have to wait up to four months before they can detect visible hair regrowth. Once the product is in use and hair regrowth has been established, the user must continue to use Rogaine regularly or risk the loss of all new hair.
Rogaine’s side effects are generally mild and tend to disappear after a short time. They include burning, stinging, or redness at the application site. Users who experience rare but more serious side effects such as chest pain, dizziness, fast or irregular heartbeat, fainting, swelling of hands or feet, and difficulty breathing should immediately stop using the medication and contact their doctor.
Like minoxidil’s beginnings as an oral blood pressure medication, finasteride, the active ingredient in Propecia, was first introduced as an oral medication for the treatment of enlarged prostate, a condition known as benign prostatic hyperplasia, or BPH. As with minoxidil, men who participated in early drug trials of the BPH drug experienced unexpected hair growth, which prompted the drug’s manufacturer to study the possibility of marketing finasteride as an oral medication to combat hair loss.
Although generally prescribed as a 5-milligram tablet for treatment of BPH, the FDA-approved dose of finasteride for hair regrowth is a 1-milligram tablet. In one five-year study of finasteride’s efficacy on the hair growth front, two out of three men taking a daily dose of finasteride regrew some hair, while all of the men who took no finasteride lost hair.
Works at Hormonal Level
While Rogaine targets the hair follicle itself, Propecia works at the hormonal level to combat hair loss. Propecia’s 1-milligram dose of finasteride inhibits 5-alpha-reductase, an enzyme that converts testosterone into a powerful androgen known as dihydrotestosterone, or DHT. Men who take Propecia regularly reduce their scalp levels of DHT by up to 60 percent. In terms of hair loss, this is significant because DHT is the culprit responsible for shrinking or miniaturizing the hair follicle, a process that eventually leads to baldness.
Unlike Rogaine, which is available to women in a reduced-strength topical solution, Propecia is available to men only.
As with Rogaine, hair regrowth experienced while taking Propecia is likely to disappear once regular use of the drug is discontinued.
Propecia’s Side Effects
Side effects of Propecia may include a decline in sexual desire and/or ability. However, only a small percentage of users have reported experiencing this unwelcome side effect. Men who experience breast enlargement or tenderness, nipple discharge, a lump in the breast, pain in the testicles, or an inability to urinate should immediately discontinue use of the drug and contact their doctor.
So there in capsule form are the basic facts and figures about these two hair regrowth medications. Which still leaves you with the question about which is likely to work better for you.
If you are going to use only one of these drugs, as you’ve already seen, the preponderance of the evidence seems weighted in favor of Propecia.
AHLA Views on Both Drugs
As you’ve already seen, Propecia has received the AHLA’s stamp of approval as the most effective of the two drugs, a view it bases on its conviction that the only truly effective medically proven way to arrest hair loss is to lower DHT levels. Previous studies have indicated that regular use of Propecia can reduce DHT levels by up to 60 percent.
AHLA notes that because minoxidil has no effect on the hormonal process of hair loss, its results tend to be temporary and disappointing over the long run. However, the organization still recommends minoxidil for those who would like to add another product to their regimen as well as for those who have had no luck with finasteride. AHLA acknowledges that minoxidil is an effective treatment for a small percentage of its users, presumably some of whom are women who cannot take finasteride.
A Turkish study, published in a 2004 issue of “Dermatology,” also found that finasteride was slightly more effective than minoxidil in treating male pattern baldness, also known as androgenetic alopecia. However, researchers in that 12-month study concluded that both drugs were safe and effective in the treatment of mild to severe male pattern baldness.
Don Amerman is a freelance author who writes extensively about a wide array of nutrition and health-related topics.