Rogaine was the first medical drug in history approved by the US Food and Drug Administration (FDA) for treating hair loss. By now it has been approved and is available as a cure for hereditary hair loss in many other countries of the world. Its main active ingredient is minoxidil, a vasodilator that was initially used in the form of the oral drug Loniten to treat high blood pressure. Minoxidil is a hair growth stimulant but its exact mechanism of action is not known. Since Loniten has long come off patent, generic minoxidil is widely available in drugstores at a very reasonable price and in most countries it does not require a doctor's prescription.
Both Rogaine and generic minoxidil solutions come in concentrations of 2% for women and 5% for men but many experimental, generic hair loss remedies use concentrations of up to 20%. Minoxidil is often blamed for causing negative side effects. Since it has become the most commonly used medicine for treating baldness, its side effects are very well documented and they happen to be often largely exaggerated. In less than one percent of patients they include an irregular or fast heart beat, decreased blood pressure, blurred vision, swelling face and ankles, numbness in the hands, etc. These symptoms are directly related to minoxidil being a vasodilator. In addition, minoxidil can cause undesired hair growth on the face and other parts of the body. This is due to its ability to stimulate hair growth. But some side effects that minoxidil is often blamed for are not caused by minoxidil itself. They include inflammation, itchiness and redness of the scalp, dandruff and allergic reactions. These side effects can be attributed to the chemical vehicles used in the solution, such as propylene glycol and isopropyl alcohol (propanol). Many hair loss sufferers have discontinued their minoxidil treatment because of scalp problems, although minoxidil rarely causes such negative reactions.
Furthermore, many generic, minoxidil based lotions contain supplementary substances that are supposed to enhance their overall effectiveness, such as azelaic acid, retinoic acid, herbal extracts, etc. These ingredients, especially the herbal extracts, are known to be allergenic to many people. It is advisable to try several different minoxidil based remedies, for instance, those that do not contain propylene glycol, in order to test their tolerability for your scalp. A more expensive product, e.g. the original formulation - Rogaine solution - is not necessarily a better option than a less expensive generic mixture. However, Rogaine foam, though relatively expensive, is typically very well tolerated. Anti dandruff shampoos, e.g. Nizoral, can, in the majority of patients, be employed successfully to treat scalp inflammations, itchiness and dandruff caused by the use of minoxidil based topical products.
By Dody Gasparik M.Sc.
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