Rogaine (topical minoxidil) is approved by the FDA to treat androgenic alopecia, also known as pattern baldness, which is caused by hereditary factors. However, an article published by the American Academy of Family Physicians in 1999 regarding the effectiveness of Rogaine in early clinical studies indicates that around half of the men who used this topical treatment for male-pattern baldness did not experience substantial hair regrowth.
Rogaine & Male Pattern Baldness
Before Rogaine was used for hair loss, it was prescribed in oral form to treat hypertension, says the American Hair Loss Association. During clinical trials of oral minoxidil, it was noted that some of the side effects included hair growth on participants' body parts, such as the forehead, cheeks and hands. Minoxidil was subsequently adapted for topical use to address androgenic alopecia. Mayo Clinic experts describe the way Rogaine works as "unknown," cautiously noting that topical minoxidil can stimulate hair regrowth in adults of both genders who suffer from a "certain type of baldness."
2 Percent Minoxidil
In their 1999 AAFP report, "Medical Treatments for Balding in Men," doctors Dean Thomas Scow, Robert Nolte and Allen Shaughnessy found that in the late 1980s 50 percent of participants who used 2 percent topical minoxidil noted regrowth of moderate to dense thickness. The studies defined "ideal candidates," however men who had experienced male pattern baldness for less than five years whose area of baldness was located in the vertex of the head--the area between the crown and back of the head where the skull slopes. Areas of baldness successfully treated did not exceed four inches in diameter. Rogaine resulted in very little or no regrowth when used to stimulate regrowth in the frontal area, such as the hairline.
5 Percent Minoxidil
In "Medical Treatment for Male Baldness," Scow, Nolte and Shaughnessy cite two studies examining the effectiveness of Rogaine with 5 percent minoxidil, a stronger solution, compared to the original 2 percent formulation approved by the FDA. One study indicated that men who used 5 percent topical minoxidil noted a 55-percent increase in hair regrowth after five months of use, while only 25 percent using 2 percent topical minoxidil noted increased hair density. The authors also state that a second study revealed that men using Rogaine with 5 percent minoxidil noted more regrowth of terminal hairs (by count) and also experienced a marked change in how much hair growth covered the scalp.
Rogaine vs. Oral Finasteride
Rogaine was once viewed as a revolutionary treatment for male pattern baldness. Yet one study conducted in the late 1980s indicated that only 36 percent of men who'd used Rogaine for more than two years felt it was worth the money and time to pursue continued treatment. When comparing the effectiveness of Rogaine to oral finasteride, the AHLA advises men to use Rogaine only when the latter option cannot be tolerated.
The AHLA describes the effectiveness of Rogaine as extremely modest and ultimately disappointing compared to prescription Proprecia, which is currently approved by the FDA to treat hair loss only in men. In clinical trials, 65 percent of male participants noted a substantial increase in hair regrowth, says the AHLA. Additionally, Scow, Nolte and Shaughnessy point out that Proprecia is effective on both the vertex and anterior midscalp. Men with mild to moderate frontal thinning may notice slight improvement in regrowth, although regrowth is not noted around the hairline or temporal area. The argument for choosing Proprecia over Rogaine, claims the authors, is that it appears to be the best method to prevent future hair loss in men who are in the earliest stage of androgenic alopecia.