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Over The Counter Treatments
The most popular over-the-counter hair
restoration drug today is Rogaine®, a brand of topical monoxidil
solution by Pfizer Corporation, approved for over the counter sale in 1997 by the Food and Drug Administration (FDA). Monoxidil was originally
used as a blood pressure medication, and then doctors found that it produced the side effect of increased scalp hair growth. Today monoxidil
remains the only FDA approved pharmaceutical topical solution proven to grow hair. In the preliminary studies held in 1985, 55% of men tested
were able to re-grow hair with extra strength Rogaine® (5%
topical monoxidil treatment), although the best results came from those who had been balding for less than 10 years and were bald in a section
of four inches across or less. Another test study compared the results of regular strength Rogaine® (2% topical monoxidil solution) with the extra strength version, and found that
subjects grew 45% more hair with the extra strength Rogaine® than
with the regular strength Rogaine®, and users of both solutions
outgrew the users of the placebo. Only 6% of those tested experienced any type of irritation. Rogaine® works by blocking the production of DHT. Of course there are generic brands of
topical monoxidil solution also on the market. Rogaine® was
originally made only for men’s use, and then a women’s version of the drug was produced. Similar results were achieved with the women’s
version. As with both men’s and women’s versions, users must take note that continuous use of the drug is necessary to maintain the newly
grown hair, as it is a usual reaction for newly growing hair to stop growing and fall out when one ceases to use the drug. As with any drug,
follow all directions and cease to use if irritation or discomfort persists.
Of course many people choose not to use drugs to
treat conditions, because they want to avoid the use of chemicals and their possible side effects. In this case, there are several treatments
in existence that have been found to block the production of DHT and thus work similarly to topical monoxidil products. As mentioned earlier,
Saw Palmetto has been used effectively to block DHT in the treatment of prostatic disease, and is now being explored for its effectiveness in
stimulating hair growth. Traditionally it has been used by herbalists to stimulate hair growth effectively. Nettles, usually taken in the form
of Nettle Root Extract has shown itself to be effective in preventing hair loss as well. More information on these was covered in the section
called Natural Hair Remedies.
Prescription Drug Treatments
While topical solutions such as
Rogaine® brand monoxidil have been used to treat hair loss,
Propecia® brand Finasteride by Merck & Company, Inc. is the
only FDA approved pill approved for the prevention of hair loss and possible hair re-growth. Like Rogaine®, Propecia®
was discovered when its generic equivalent being used for another purpose was found to have beneficial side effects.
Finasteride is the generic name for the drug, which was already in existence for quite some time and had been produced under the name
Proscar® by Merck & Company and used for treatment of
enlarged prostates, a syndrome medically called benign prostatic hyperplasia (BPH). BPH is caused by an overproduction of DHT, which causes
the prostate to grow. Many BHP patients were also suffering with MPB, and when patients began taking Proscar®, they noticed the re-growth of hair also. This sparked new testing and the birth
of Propecia® as a hair restoration drug. The approval of
Propecia® by the FDA was easy to achieve, since it was merely
marketing already approved Finasteride as a hair restoration drug, with a much smaller dosage than that required for BPH.
Propecia® is being prescribed by doctors to some patients as an oral treatment to internally
block the production of DHT. Propecia is an androgen hormone inhibitor only approved for men, and has been clinically proven to grow hair on a
significant percentage of men who suffer with Male Pattern Baldness (MPB) or more properly androgenetic alopecia. Unfortunately, the drug has
not been approved for use by women at this time. This is especially true for women who are pregnant or can become pregnant, because the
process of inhibiting testosterone from being converted to DHT can affect secondary sex characteristics of unborn fetuses.
Propecia® works by reversing the shrinkage of hair follicles that are in the telogen phase,
or last phase of the normal hair cycle. Propecia® works best in
combination with topical treatments of Monoxidil such as Rogaine®. Participants in studies have seen hair grow in as little as six months, whereas those who have seen no results in a year’s time are
reported not likely to see any results from the drug. One round of testing of over 2,000 men with androgenetic alopecia over a four-year
period showed half with reported new hair growth.
Side effects of
Propecia® in a few persons studied include diminished sex drive,
difficulty in achieving an erection, and a decreased sperm production. Side effects were found in less than three percent of participants in
clinical studies. Fortunately when the drug’s use was discontinued, the side effects went away and normal functions resumed. Of course there are some who say that the growth of new hair is worth the cost of a drop in libido. Only you
can decide whether this side effect is worth the personal cost to you. Finasteride is metabolized primarily by the liver, and therefore anyone
suffering with liver disease may not be able to take the drug, and should consult a physician. Additionally, as with Monoxidil, it can mask
PSA levels, thus caution should be used if used by patients with elevated PSA levels, as it may be difficult to read levels properly when
diagnosing potential prostate cancer. Of course proper consultation with your physician will help determine if taking Finasteride treatments
such as Propecia® is right for you.
An interesting phenomena concerning
Propecia® is the dramatic rise in price it caused for Finasteride
when it entered the market as a hair restoration drug. Propecia® is simply a 1mg version of Finasteride, a drug that was already being marketed as Proscar® for BPH by the same company that markets Propecia®, Merck & Company, Inc. Therefore there should not be an increase of any kind
in the cost of production of Finasteride, since it was simply being marketed under a new name at a much smaller dosage. Merck & Company
therefore was prepared to introduce Propecia at the price of $1.25 per pill or $37.50 for a 30-day supply in 1998. However, after
reconsiderations it was decided that Propecia would be introduced at $50 for a one-month supply. This is compared to a 30-day supply of
Proscar® which is 5mg Finasteride being marketed at $55-60.00 for
a 30-day supply. The price was adjusted to be in the range of Rogaine®
Extra Strength. The price of Propecia® today in 2004 is in the range of $130 for a 30-day supply, while
Proscar® prices have risen at a much slower pace, and is now less
expensive than the same Finasteride drug that is 1/5th the dosage. Doctors of course are discouraged by pharmaceutical companies to
prescribe Proscar for cosmetic treatment of androgenetic alopecia. Of course there are always going to be those who find ways to circumvent
this. Therefore, many have been driven to find ways to purchase Proscar® and divide the pill into fourths or fifths instead of paying the
exorbitant prices for the very same Finasteride.
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