Propecia (finasteride): The drug Propecia (FDA approval in 1997) has shown to be effective at slowing down or halting the process of hair loss caused by male pattern baldness. It does do by inhibiting an enzyme called 5-Alpha Reductase, which is responsible for the conversion of testosterone to dihydrotestosterone, or DHT. The working theory is that most, if not all, hair loss due to male pattern baldness is a result of DHT binding to its receptors on susceptible follicles and inhibiting their growth. Since DHT receptors are mostly found on follicles on the top of the head, this is the area where the DHT causes the hair to fall out. Propecia lowers the total body DHT levels, thereby reducing the inhibition caused by DHT (double negative equals a positive). The end result is less hair loss for most males.
Propecia is available by prescription, and is safe and well tolerated by men. It is taken once daily, and side effects are rare. The most frequent side effect is a possible decrease in libido. Studies have shown this to occur in less than 2% of patients taking the medicine, and these effects disappear when Propecia is stopped. Although this medication has been marketed as a hair regrowth solution, it is the opinion of RMHRI that the practical usage for this medication is to prevent further hair loss. Regrowth of lost hair is rare, but the reduction of hair loss is usually substantial.
Rogaine (minoxidil): Rogaine (FDA approval in 1988) is the only other medication which has gained FDA approval for the treatment of hair loss. It is available as a clear liquid solution, and more recently as a mousse-like foam, which is applied directly to the scalp twice daily. This medication has proven to be safe and well tolerated. Minoxidil was used to treat hypertension prior to its use as a treatment for hair loss. Its ability to reduce hair loss and grow small hairs was subsequently seen as a side effect. After this discovery, it began being marketed as a hair growth medicine in its topical form. While minoxidil can stimulate increased blood flow to the scalp, this is unlikely to be the mechanism by which it grows hairs. The more likely scenario is that it activates some cellular receptor which still remains a mystery. Unfortunately, the hairs which may grow as a result of applying minoxidil are usually very small and have a tendency to shed soon after the medication is stopped. On a more positive note, minoxidil can be used to treat female hair loss in addition to male pattern baldness.