Medications

     There are presently 2 medications that are FDA approved for male pattern hair loss:

     1.Propecia
     Propecia is the first and only medication that is FDA approved for the treatment of male pattern hair loss in men only . It is only available by prescription, comes in 1 mg 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 area 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 1 year of taking the medication. Propecia directly effects dihydrotestosterone (DHT), a key factor in male pattern hair loss in those with genetic predisposition, Propecia specifically inhibits Type II 5- alpha 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. Propecia is generally well tolerated. Common side effects of reported studies were decreased libido and increased erectile dysfunction, which usually have been mild and generally have not required discontinuation of therapy.

     2.Minoxidil (Rogaine )
     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, where as 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 are lost over the next year. The solution 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 1 year. It is unknown how Minoxidil causes hair growth. Studies have shown the 5% Minoxidil cause more hair growth than 2% Minoxidil solution, but 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 will be hair growth in undesired areas.