BEFORE WE BEGIN...
The information provided in this article is for information purposes only and should not be considered as a substitute for medical advice. Please read our disclaimer at the bottom of this page for more information.
Medically Reviewed by Professor V. Jolliffe
As we outlined in Understanding Hair Loss - there are many different causes of hair loss. In this article we will briefly go through the treatment options for one of the most common types of hair loss - Androgenetic Alopecia or Pattern Hair loss.
The aim of treatment here is two-fold. Firstly to ‘put the brakes on’ the process and limit its progress, using antiandrogens such as Finasteride. Secondly we aim to ‘fatten up’ the fibers which you have by keeping them in the active growth phase, anagen for as long as possible. This is achieved using a hair growth stimulant such as Minoxidil.
When starting to treat pattern hair loss your first step should be to consider one of the two licensed treatments for hair loss - Finasteride and Minoxidil.
WHAT IS MINOXIDIL?
Minoxidil is a topical treatment, available in both foam and liquid format, which helps to improve blood and oxygen flow to the scalp and as a result is believed to prolong the Anagen phase of the hair cycle. One commonly known brand name for Minoxidil is Regaine but there are a number of generic brands now available.
Originally an oral medication used to treat blood pressure in the 1950’s, researchers found that it had a positive effect on hair growth and Minoxidil was first launched as Regaine Topical Solution 2% in the UK in 1988. In 1990 the drug's licence was extended from men- only to women with hair loss. It is one of the most-used medications for hair loss in men and women today.
There are a number of Minoxidil preparations available, with the 5% strength (foam) being considered most effective and licensed for both men and women.
HOW DOES MINOXIDIL WORK?
While the exact mechanism of action in Minoxidil is unknown, this drug is a vasodilator, meaning it could actively combat hair loss by expanding the blood vessels in your scalp, promoting healthy blood flow.
With this increased blood flow, it is believed that the starved hair follicles in your scalp are fed a greater amount of oxygen and nutrients so applying it to your scalp can potentially improve hair density and increase the rate of growth.
HOW LONG DOES MINOXIDIL TAKE TO WORK?
Minoxidil will start to work immediately but its effects are usually noticeable after 6 months, peaking at 12 months.
ARE THERE ANY SIDE EFFECTS WITH MINOXIDIL?
While side effects are rare, they include temporary increased shedding of hair, fine facial hairs and scalp irritation.
Many people worry that if they stop using minoxidil they will lose hair. Whilst discontinuing minoxidil will result in a loss of its benefits on hair thickness and length, it will not make your hair thinner than if you had never used it. Your hair will just revert to where it would have been if Minoxidil had never been used
Costs: Typically between £20 - £35 per month
WHAT IS FINASTERIDE?
Originally used to treat the symptoms of enlarged prostate (benign prostate hyperplasia), Finasteride is the generic version of a more well-known medicine called Propecia. This is licensed for use in male pattern hair loss as a 1mg daily tablet and designed to halt hair loss on the head and, in some cases, stimulate regrowth. It has been clinically proven to be an effective treatment for male pattern hair loss.
HOW DOES FINASTERIDE WORK?
One of the main factors involved in male pattern hair loss (Androgenetic Alopecia) is the activity of DHT (dihydrotestosterone) on the hair follicles. DHT activates a receptor in the hair follicle which causes the growth phase of the hair cycle to gradually decrease. This results in finer, shorter hairs until the growth phase is so short that the hairs do not grow from the scalp at all.
Finasteride stops the production of DHT by inhibiting the enzyme which converts testosterone into DHT (an enzyme called 5 alpha reductase). As a result less DHT is present in the scalp and further hair loss is halted.
HOW LONG DOES FINASTERIDE TAKE TO WORK?
You should start to notice reduced hair loss and/or the regrowth of your hair after about three to six months. The best results appear after 12-24 months of continuous treatment.
ARE THERE ANY SIDE EFFECTS WITH FINASTERIDE?
1-2 % of men taking finasteride report changes in their sexual function. This includes symptoms such as erectile dysfunction, decreased libido and ejaculatory dysfunction. Stopping treatment usually leads to the resolution of these symptoms in over 99% of patients.
A complete list of side effects is available in the Patient Information Leaflet enclosed with your medication, which you should always read before taking it for the first time. We also cover this further in our article - A Guide to Finasteride.
Costs: If you opt for the brand Propecia this can be £45+ per month, with generic Finasteride starting at £15+
While there are several medications produced by the pharmaceutical industry to manage hair loss, effectiveness between individuals varies. Minoxidil and Finasteride are the only UK licensed MHRA approved treatments and have been used as hair loss treatments for a number of years. They are widely prescribed by medical professionals globally and considered as the first-line treatments to manage hair loss.
Why not find out more about your first stage treatment options by reading the following guides;
While our aim is to provide you with uptodate and relevant information, drugs affect each person differently. As such we can not guarantee that this information includes all possible side effects and this information is not a substitute for medical advice. Always discuss treatment options and possible side effects with a healthcare professional who knows your specific medical history.