Many manufacturers of hair loss products criticise prescription hair loss treatments; however Nanogen always recommend patients try prescription treatments in addition to any other therapy as they have been proven to be very effective for the majority of patients. Note that despite other people's claims, there are only 2 fully approved medications. The two approved treatments work in different ways, and are available in different formats. Finasteride is a tablet taken orally to inhibit DHT, Minoxidil is a topical formulation thought to work to increase blood circulation, both are discussed in more detail below.

Finasteride

A potent oral and therefore systemic DHT inhibitor, Finasteride works well to stop hair loss in many patients, and there have been numerous reports of it actually re-growing hair in some particularly responsive cases. Interestingly, Finasteride was first discovered as a hair loss treatment by accident, when men taking it to cure prostate cancer saw a reversal in hair loss.

Unfortunately, Finasteride is only available to men, and shouldn't even be touched by women as it can cause serious harm and birth defects. Finasteride also has a wide range of side effects reported, some quite severe, including impotence, loss of libido, excess hair growth all over the body, acute pains, and nausea.  

Finasteride is available as the well-known Propecia^® and the standard dose is 1mg, although many men prefer to take lower doses to avoid the above side effects whilst still preserving some of the positive effects on DHT and Androgenetic Alopecia.  

For more information on DHT and its role in hair loss, please read an earlier summary "DHT and Androgenetic Alopecia."

Minoxidil

Also discovered by accident, Minoxidil was originally an oral treatment for high blood pressure. Now more commonly found as a topical hair loss treatment, Minoxidil prevents increases the Anagen growth phase of hair. Minoxidil also increases blood flow in the scalp, providing more nutrients that the hair needs to grow, and may be in short supply in people with thinning hair. Minoxidil also has several reported cases of hair re-growth.

How Minoxidil actually works as a thinning hair treatment is not known, but it is thought to be a Nitric Oxide donor, this would cause increased blood flow through widening the blood vessels, a process called vasodilation.

Minoxidil is much safer and more pleasant to use than Finasteride, and safe as a treatment for female hair loss as well. There are few reported side-effects apart from the, "Shedding," temporary hair thinning caused by Minoxidil which corrects itself. The main issue with Minoxidil is it is alcohol based, and so dries and damages the scalp with long term use, causing irritation and dandruff.  

Minoxidil is available in a range of concentrations, normally recommended as 2% for female hair loss and 5% for male thinning hair treatment. There are 12.5% concentrations available from certain clinics, however due to the high alcohol content needed to produce such as solution the effects and side effects are unproven, and so we recommend 5% as the maximum concentration of Minoxidil at the moment.  

An alternative to increasing concentration of Minoxidil may be to increase penetration. Nanosomal technologies show promise, but currently aren't approved for use as they could have dangerous side-effects when used with Minoxidil. Another option is to use a Scalproller to increase Minoxidil penetration through the epidermis, therefore it would be possible to use a lower dose of Minoxidil with a similar overall effect, but with less alcohol and so less drying and irritation.