It's the only treatment FDA-approved for female pattern baldness, or androgenetic alopecia. While it's effective at stopping hair loss, women need to know about this drug's potential side effects.
Women who have female pattern baldness, or androgenetic alopecia, lose about 150 hairs a day — more than the 50-100 hairs that women without thinning hair lose daily. And unfortunately, once those hairs are lost, it takes a long time to grow them back, so getting hair loss treatment early is the best strategy.
The telltale sign of androgenetic alopecia is an overall thinning of your hair. For many women, hair loss happens on the top or the front of the head.
Fortunately, minoxidil (Rogaine) can help stop the hair loss in its tracks. In some cases, it can even help regrow new hair. But there are disadvantages to using the medication, which comes as a topical lotion or foam, especially for women.
Who May Need Minoxidil and How It Works
Minoxidil applied topically to the scalp only works if your hair loss is a result of female pattern baldness and not some other condition, says Clarissa Yang, MD, a dermatologist at Brigham and Women’s Hospital in Boston.
Normally, hair grows about half of an inch each month. Each hair grows for up to six years, then it stops growing, rests for a while, and eventually falls out and is replaced by a new hair that grows for six years. If your hair is growing normally, about 85 percent of it is growing at any given time and 15 percent of it is resting.
But if you have female pattern baldness, your hair follicles get smaller and smaller over time, Dr. Yang says. The smaller they are, the shorter the amount of time your hair grows. Eventually, when strands of hair fall out, they’re not replaced with normal new hair, but instead by thinner, finer strands of hair.
Doctors think that, among other possible causes, aging, genetics, and a change in the level of male hormones, or androgens, after menopause may be part of what brings on female pattern baldness. (That’s why female pattern baldness is also called androgenetic alopecia).
Minoxidil is the only drug which is FDA-approved to treat female pattern baldness. It works by prolonging the growth phase of the hair follicles, Yang says. It’s recommended that women use minoxidil 2%, while men can use the 5% formula.
Minoxidil: Pros
In most women, minoxidil slows down or stops hair loss. And in up to a quarter of the women who take it, minoxidil can actually encourage new hair to grow. It works best when you use it as soon as you notice that you’re losing hair, Yang says.
It’s available over the counter, so you don’t need a prescription from a doctor to get it. However, Yang encourages everyone to see a primary care doctor or a dermatologist before beginning treatment, because there could be a medical problem that’s causing the hair loss, such as thyroid dysfunction or nutritional abnormalities.
Minoxidil: Cons
There also are some disadvantages to taking minoxidil as a hair loss treatment. These include:
- It’s expensive. Buying Rogaine for women can cost about $30 for two ounces, but a generic form of minoxidil 2% costs almost half the price. It’s also something you have to continue using indefinitely because the results go away if you stop the medication, Yang says.
- It can be inconvenient. You have to apply it to the scalp two times a day.
- It can cause unwanted hair growth. Some women may experience facial hair growth when they use minoxidil. That can happen if the medication trickles down onto your face or simply as a side effect when you apply it only to your scalp. The risk is lower for women who use the 2 percent concentration of the drug, as opposed to the 5 percent concentration that’s designed for men.
- It can cause more hair loss at first. You may notice an increase in hair loss during the first two to four weeks of using minoxidil, Yang says. That happens because some of the old hairs are being pushed out by new ones, she says.
- It can take months to see results. You have to use it for at least four months — and possibly a year — before you see results. Even then, only about one in five women will have moderate hair regrowth, with a larger percentage noticing only that their hair loss seems to slow down or stop.
- It can irritate your skin. You may experience some irritation, flaking, and redness.
It’s not easy knowing you may never have the same long locks or hairstyles you had when you were younger, but minoxidil is a relatively easy, safe way to fight the loss of your hair.
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