Q I am a 45-year-old woman. I was prescribed a 5 per cent minoxidil (Rogaine) lotion for my hair loss problems and have been using it for about two years now.
I understand that once anyone starts on minoxidil, she must continue using it. Otherwise, she will lose the regrown hair.
However, the lotion has not significantly improved my hair growth. Can I safely stop using minoxidil?
A Minoxidil is a common topical agent prescribed for hair loss and is usually available in concentrations of 2 per cent and 5 per cent.
It is approved for use in male- and female-pattern hair loss, but is also used off-label in other hair loss conditions. This means that the product is used to address conditions other than those for which it is officially sanctioned.
Although the use of topical minoxidil may result in some degree of hair regrowth, it works mainly by maintaining and thickening pre- existing hair.
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Hence, its effects may be geared towards slowing down further hair loss and preserving hair density, rather than a significant increase in hair growth.
Minoxidil should be used for at least six months as it can take several months to see the results.
To maintain the effects of minoxidil, you will need to use it over the long term. A withdrawal of the medication, as you are rightly concerned about, can result in the loss of minoxidil-dependent hair within three to six months.
As female-pattern hair loss is thought to be caused by a combination of genetic and hormonal factors, treatment options include oral medication such as spironolactone, which blocks the action of androgen hormones on the scalp.
Spironolactone can be prescribed off-label for use in female-pattern hair loss. However, the patient may have to go for regular blood tests to monitor her kidney function and potassium levels, which may go up with spironolactone use.
It is also important to note that all topical or oral treatments work only as long as they are used continuously.
Surgical options such as hair transplantation may also be suitable for some patients.
Although female-pattern hair loss is the most common cause of gradually thinning hair, other factors such as iron deficiency and thyroid disorders also need to be ruled out.
You may want to see a dermatologist for an assessment, to rule out reversible causes of hair loss.
The dermatologist may discuss your treatment goals, as well as the risks and benefits of the options, should you feel that your current treatment is ineffective.
- Dr Yeo Yi Wei, Associate consultant at the department of dermatology, Singapore General Hospital.