There are presently two medications that are FDA approved for male pattern hair loss:
Propecia is the first and only oral medication that is FDA-approved for the treatment of male pattern hair loss in MEN ONLY. It is only available by prescription, comes in 1mg tablets and is taken once a day. Propecia has shown efficacy in patients who had hair loss in the vertex and anterior mid-scalp area. Efficacy in the bitemporal areas has not been established. If the patient stops taking Propecia, any benefits gained on therapy are lost over the next year. Propecia has an excellent safety profile. Patients should not judge the results of Propecia until after at least one year of taking the medication. Propecia directly affects dihydrotestosterone (DHT), a key factor in male pattern hair loss in those with a genetic predisposition. Propecia specifically inhibits Type II 5a-Reductase, the enzyme that converts testosterone to DHT, thus lowering DHT, mimicking the natural human model that does not show hair loss. Lowering DHT appears to inhibit further miniaturization of hair follicles and helps return miniaturized hairs into normal terminal hairs.
Initially, 2% Minoxidil was available by prescription only, now both 2% and 5% solutions are available over-the-counter. The 2% Minoxidil solution is approved for use in both men and women, whereas the 5% Minoxidil is approved for use in MEN ONLY. Minoxidil has shown efficacy in patients who had hair loss in the vertex. Efficacy in the anterior scalp and bitemporal areas has not been established. If the patient stops using Minoxidil, any benefits gained on therapy is lost over the next year. The Minoxidil ( in solution form) should be applied twice daily to the scalp. Patients should not judge the results of Minoxidil until after they have used the product for at least one year. It is unknown how Minoxidil causes hair growth. Studies have shown the 5% Minoxidil causes more hair growth than the 2% Minoxidil solution, but the side effects are also more common with the higher concentration. Side effects are primarily dermatologic: dandruff, irritation and redness of scalp, and less commonly, there may be hair growth in undesired areas.
Occasionally, physicians will have the pharmacist add retinoic acid or azelaic acid to the Minoxidil solution in hopes of increased efficacy. There are no other medications on the market that can claim that their product causes clinically significant hair growth. There are other medications that have been shown to cause hair growth in dermatologic studies, however the side effect profile was too high or the results were not good enough for the companies to seek FDA approval. Be wary of the Gimmick Treatments that try to fool you into thinking that their products cause hair growth.
There are products from Glaxo-Welcome and Upjohn that are presently in clinical trials that are showing significant promise. For more in-depth information on the medical treatments for hair loss, please visit our web site at www.HairMeds.com.