Health A-Z

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If you begin to lose hair in a hereditary pattern, you may be able to slow further hair loss by using minoxidil (Rogaine) or finasteride (Propecia). Minoxidil can be used by both men and women, while finasteride usually is used just for men.

Minoxidil is a solution, now available over the counter. It is applied to the scalp twice daily. It can help to slow further hair loss in some people, and within four to eight months there may be some hair regrowth. In men a higher strength (5%) works best. In women there seems to be little difference in effect of the 2% strength and the 5% strength, and there is the risk of development of facial hair with the 5% strength. One caution: If you stop using minoxidil, you probably will lose any hair that may have been retained or restored by the medication.

Finasteride is a prescription-only pill that blocks the formation of the type of testosterone that affects hair growth. Higher strengths of the same medication are used in men to stop non-cancerous (benign) growth of the prostate gland. Studies suggest that finasteride helps to prevent hair loss in up to 99% of men with hereditary-patterned baldness, and that two-thirds experience some new hair growth. As with minoxidil, any benefits from the medication are quickly lost once it is discontinued. In addition, a small number of men develop difficulty with sexual function.

Finasteride does not appear to prevent hair loss in women. It also may cause birth defects, and should not be used by any woman who could possibly get pregnant. However, other types of hormonal treatment, such as certain types of birth control pills, may help the small number of women with hair loss that have elevated levels of male hormones.

In some people, hair loss may be caused by certain hair treatments (straightening, coloring), hairstyles (tight braids) or hair pulling. These do not cause hereditary-pattern baldness, but they may contribute to hair loss and should be discontinued.

A variety of other creams, oils, lotions and herbal remedies for hair loss are regularly advertised. However, only minoxidil and finasteride have been proven useful.

Some over-the-counter scalp treatments can cause irritation or harm and worsen hair loss.

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From Health A-Z, Harvard Health Publications. Copyright 2007 by the President and Fellows of Harvard College. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.

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