for Men® ( Minoxidil )
Go Here for Rogaine
(updated for 2012)
Minoxidil is the main ingredient of the brand name drug
Rogaine, a topical lotion that was the first drug to
be approved by the FDA for the treatment of androgentic
alpecia (genetic hair loss). Available in varying degrees
of strength from 2 to 5 percent, minoxidil requires
twice a day applications. The rate of effectiveness
varies between the 2 percent formula and 5 percent formula.
Rogaine manufacturer, Pfizer, claims that their new
5 percent foam version can regrow hair in about 85 percent
of the men who use it. A smaller degree of success with
minoxidil has been reported for treating frontal hair
Clarification: Rogaine should not be confused
with Regain (a questionable hair loss product trying to
capitalize on the Rogaine's name), Progain (a shampoo marketed
by Rogaine maker Pfizer trying to capitalize on their own
brand name by making it sound similar to Rogaine). Minoxidil
is sometimes misspelled and spelled differently in other
countries as: Minoxidal, Minoxedal, Minoxidel, and even
Minoxidile. In the United Kingdom, Europe and Asia Pacific,
it is marketed under the brand name Regaine, eerily similar
but unrelated to Regain, mentioned above.
Back Story: When it first came out onto
the market in the late 1980s, minoxidil was a revolutionary
new drug promising some or partial hair growth in men. First
looked at for lowering high blood pressure, the manufacturer
(Upjohn) noticed that it also produced an interesting side-effect
in some men: new hair growth. Until that time approximately
20 years ago, the Food and Drug Administration had not approved
any treatment for male pattern hair loss. With the internet
still in the future, mail order hair loss treatment scams,
without legitimate scientific research to back their claims,
were being advertised and sold through classified ads in
newspapers and mens' magazines.
And although they are still not 100 percent sure to this
day how it works, topical minoxidil was the first FDA approved
medical treatment to break through the barrier of hair loss
scams and accepted as medical treatment for hair loss in
men and women when it was marketed under the brand name
According to the International Society of Hair Restoration
Surgeons: "Some media stories implied it was a
"miracle drug". However, Rogaine users, and
doctors who prescribed it, quickly found the hype did not
match the results. (2)
With only the regular strength 2 percent Rogaine available
at the time, early research indicated it produced moderate
hair regrowth in 26 percent of men and minimal hair regrowth
in 33 percent of men after 4 months of use. At the time,
the research indicated that those who rubbed 1mL of minoxidil
on their scalp twice a day was only effective on those with
vertex or crown hair loss.
During the 1990s, Rogaine came out from behind the counter,
upped in strength to 5 percent, a version was developed
for women, and cheaper generic versions became available.
In 2002, researchers compared minoxidil 2 percent with
minoxidil 5 percent and concluded:
In men with AGA, 5% topical minoxidil was clearly
superior to 2% topical minoxidil and placebo in increasing
hair regrowth, and the magnitude of its effect was marked
(45% more hair regrowth than 2% topical minoxidil at week
48). Men who used 5% topical minoxidil also had an earlier
response to treatment than those who used 2% topical minoxidil.
In other words, the 5 percent formula grew 45 percent more
hair, and hair growth started earlier, over the 2 percent
However, even with the improved efficacy of the 5 percent
solution, applying liquid minoxidil on your head twice a
day - wasn't very convenient for most men. As a man gets
ready for his day and prepares to go to work, the application
of a 1ml of liquid to one's scalp wasn't very practical
since it took time to dry - time that many men didn't have
in the morning. Styling one's hair for work, and sopping
liquid on their balding crown, proved inconvenient and impractical.
In 2006, Rogaine maker Pfizer solved this problem with
the introduction of Rogaine Foam, in 5 percent. This now
made it easier for Rogaine to be used on a wider basis since
the foam could be easily applied and dried quickly.
Crown, Frontal, and Temple Hair Loss
For nearly a decade, no sufficient evidence existed that
showed it was effective in treating frontal hair loss -
the most common form of hair loss in men worldwide. However,
this would change.
"Results at 48 weeks (study conclusion) show
that visible, photographically evident improvements were
seen in the frontal scalp regions of 51 percent of men
using 5 percent minoxidil, 42 percent using 2 percent
minoxidil, and 13 percent of placebo users. Among these
men, moderate to great increases in hair growth were seen
in the frontal scalp regions of 19 percent of men using
5 percent minoxidil, 10 percent using 2 percent minoxidil,
and 3 percent of placebo users." - Dermatology
Times, 2003 (4). [Unfortunately, this study is no longer
available online. DT has been swallowed up, and the information
is locked behind a registration requirement.]
Translation of the conclusions: Although half of the men
saw improvement in their frontal hair growth, this could
mean anything from mild to moderate to significant. It goes
on to state further that of the entire study, 1 in 5 saw
moderate (mid-level) to great (pretty good) regrowth in
the frontal region. The other 1.5 men out of 5 only saw
mild regrowth, while the balance of 49 percent saw no further
loss, or further loss, depending on how minoxidil worked
According to the International Society of Hair Restoration
Surgeons, minoxidil is often more effective in improving
hair growth in central areas of the scalp than in frontal
areas. It is often effectively used by physician hair restoration
specialists to complement hair transplantation, contributing
to an appearance of "fullness" in scalp hair.
(2). See map below.
Doctors and research concur that minodixil
is most effective in treating bald spots on the top (vertex)
or crown (back top) portion of the scalp.
How Effective is Rogaine (minoxidil)?
According to Rogaine.com, ROGAINE® Foam
regrew hair in 85% of men after 4 months when used twice
daily. (1) However, I have not found a copy of this study.
The 2 percent version was reported to regrow
hair, mostly on top or on the crown, in 6 out 10 men with
minimal to moderate hair regrowth after 4 months.
A 2004 study from Turkey found that 5 percent
minoxidil produced new hair growth in half of the men tested
after 12 months. This study compared Minoxidil 5 percent
to Finasteride 1 mg, and the finasteride proved the winner
with 80 percent new hair growth. It should be noted this
study only included 25 men for the minoxidil study, and
40 men for the finasteride treatment. Strangely enough,
this study was conducted by the medical school of a military
academy. Apparently, the Turkish Army doesn't want their
soldiers going bald. (5)
Results of Study comparison between 2 percent and 5 percent
minoxidil age 18 to 49.
|Moderate / dense
||Loss of hair
If you add up the minimal and moderate changes
for both the 2 and the 5, the 5 wins by 54 percent compared
to 38 percent for the 2 percent.
Dermatologists and medical professionals recommend
using minoxidil as early as possible, since it is easier
to regrow thinning spot of hair that is recently lost, compared
to a wide area of lost hair that disappeared years ago.
Thus, early use of minoxidil is indicated
to prevent progression of small areas of male or female
pattern hair loss. Physician hair restoration specialists
sometimes use minoxidil to slow hair loss in young patients,
delaying hair transplantation for several years in order
to conserve the supply of hair that will be needed later
for transplantation. - ISHRS
Still Some Negative Chatter
Despite it's advancement in strength and delivery
system, the Rogaine 5 percent foam still get's some, not
a lot, but some negative feedback on internet message boards.
The complaints mostly stem from first time users who report
that Rogaine sped up their hair loss in the first months
Pfizer and dermatologists agree that some
men will experience increased hair shedding during the month
or two. This is explained that minoxidil merely sped up
the hair growth cycle for some hairs, sending them into
the Telogen phase. According to Rogaine.com, this is a good
sign and necessary development.
ROGAINE® stimulates hair follicles
to shift from the resting phase to the growth phase. Thus,
it is not uncommon to see a temporary increase in shedding
during the first 2 weeks using ROGAINE®. This occurs
in some people as the new hair pushes out the weak hairs,
when the hair follicle shifts into the growth phase. It
is very much like losing baby teeth to make room for adult
teeth. This increase in shedding is only temporary and
should subside within a couple of weeks with continued
treatment. Please note, however, if increased shedding
continues for longer than 2 weeks, you should consult
your doctor to rule out other possible medical problems.
Some users note that these hairs would have
fallen out anyway under the normal hair growth cycle, and
the Rogaine merely sped up the process.