Minoxidil in its liquid form is applied directly over the areas of the scalp undergoing hair loss. Originally it was indicated for the treatment of severe hypertension, and when patients reported slowing of the progression of hair loss and actual growth of new hair the research started for its use in hair loss. Its mechanism of action is dilatation of the local blood vessels of scalp and speculated direct activation of hair follicle growth. It is available in three concentrations 2%, 5% and 10%. Minioxidil is to be applied at night before going to sleep. It can be applied twice daily also but not more than 2 ml should be applied in 24 hrs. Few patients can have burning sensation, eryhtema, palpitations and headache with the use of minoxidil. Once started, it has to be used for indefinite period and it takes 4 months for the results to become apparent. In women, the minoxidil can be used in 2% concentration to prevent further hair loss and occasional hair regrowth can be achieved. Consult your doctor during pregnancy and lactation.
Some physicians recommend the use of minoxidil after hair transplantation. Application of minoxidil to the grafted areas once a day can shorten the time interval between the hair restoration procedure and the growth of transplanted hair by around one month.
Finasteride (Propecia) on the other hand has more direct action on the hair growth as it is 5-alpha reductase inhibitor and blocks the conversion of testosterone to DHT, the hormone most responsible for hair loss in men. Finasteride is taken in the dosage of 1 mg once a day orally to prevent further hairloss. Some physicians also prescribe it in the dosage of 2mg once a day on the alternate days.
Post hair transplantation finasteride use potentially increases hair growth over the anterior and middle scalp areas. It also causes minimizing and even reversing the miniaturization process of hairs in the back of the scalp. Finasteride can also increase the density of transplanted hairs leading to improvement of the surgical results. The most common side effects of finasteride are reduced libido and erection. They are not very common and are almost totally reversible on cessation of the medication.