Minoxidil is used as a topical treatment for hair loss in both men and women. It has been on the market for many, many years and is used by Dr. Elliott in nearly all cases. It is particularly effective for women, but also in men when combined with finasteride. It exists as 2% and 5% concentrations and is applied to the scalp twice a day. There are no common side effects but some patients may develop itch, rash or flaking. This almost always represents scalp irritation, rather than allergy to minoxidil and is solved by changing the solution formulation. A small number of patients (1 in 15) may also experience increased hair shedding 2-5 weeks after starting treatment. This shedding represents growth of new, stronger hair that pushes out some of the weaker hair and always resolves over a number of weeks. Minoxidil is also used by Dr. Elliott in treating some non-genetic causes of hair loss including telogen effluvium and alopecia areata.
Dr. Elliott has been using minoxidil since 1997 and it has helped save his hair.
Finasteride is on the market in Canada as both Propecia (for treatment of male pattern hair loss) and Proscar (for treatment of benign prostate enlargement). Both can be used to treat hair loss, though Proscar is taken at a dose of 1/4 tablet per day. It is not used in women who may become pregnant. The medication acts by blocking 5 alpha reductase type II, which is an enzyme in the body that converts testosterone to dihydrotestosterone (DHT). DHT is unnecessary once a male passes puberty and when you start treatment with this medication, your DHT levels drop by about 70%. This results in cessation of hair loss in approximately 90% of males, most of whom will also go on to experience some re-growth. Side effects are rare and reversible. Less than 2% of men will experience a drop in sex drive or difficulty getting an erection. This resolves in most without stopping the medication. Worst-case-scenario you stop the drug and the side effects go away. Unfortunately many men have been denied the benefits of this medication because of fear of side effects that rarely occur.
Dr. Elliott has been on this medication since 1995 and it has saved his hair.
Dr. Elliott firmly believes in the benefits of combination treatment. There is no doubt that patients benefit more than when they are on a single treatment. There is a synergistic effect where the benefits exceed the sum of each individual modality. Think of the benefits of finasteride as being a 2 and minoxidil a 1, but if you use them together, you get a 4. Low Level Laser Therapy adds benefit on top of this.