Rogaine is an FDA approved hair loss treatment, and the most popular topical treatment in the world. However, results do not come overnight.
This post will introduce Rogaine, including how it works and what you can expect from its use. It will also discuss how long it may take to see results, and how you may be able to speed up the process and enhance growth.
Who Is Rogaine For?
Rogaine can be used by both men and women who have thinning or receding hair. Men who use it are most likely to be suffering from Androgenetic Alopecia (AGA).
This is the term used to describe the hair loss that affects the temples and crown of the head in men and is sometimes referred to as male-pattern baldness. It is caused by the action of DHT (a by-product of the hormone testosterone) on the hair follicles.
How Does Hair Grow?
In order to understand how minoxidil works, you will need to understand how hair grows normally and what is different in people with a genetic susceptibility to losing their hair.
There are three different phases in the life cycle of every hair, whether it is growing on your toes or on the top of your head (1). These three phases are:
This is the phase your hair is in most of the time. It is the ‘growing’ phase which sees the hair on your head grow about half an inch a month, though this is faster in the summer than in the winter.
This phase is the longest of all and can last three to five years before it enters the next phase.
This short phase occurs at the end of the anagen phase and lasts approximately 10 days. It is the transition phase between anagen and telogen.
This is the phase where the hair falls out. Luckily, this happens gradually so that each hair falls out at a different time. The average person sheds 80 hairs a day.
This period of three months occurs after the telogen phase and ends when the next anagen phase starts, repeating the cycle again.
These phases occur in normal healthy people and are not usually disrupted. However, it is important to note that the body can react to stresses, such as extreme dieting or other pressures, by entering telogen effluvium, which means your hair sheds at a faster rate.
If you have androgenetic alopecia, the hair follicles will become smaller and smaller, making the hair that grows during the anagen cycle thinner and weaker.
They will fall out more easily and will appear much finer before you eventually lose the hair for good.
How Does Minoxidil Work?
Though no one is sure exactly how minoxidil works, it is thought that it allows more oxygen and nutrients to get to the follicles where the hair grows. This may be due to the fact that it is a known potassium channel opener but, more likely its role as a vasodilator (2).
Minoxidil was originally developed as a vasodilator, but it was during initial studies that the drug was discovered to have hair growth-promoting properties (3). This characteristic helps the hair grow back thicker and healthier than before, and this improves with each hair cycle of continued minoxidil use (4).
As you already know, AGA is caused by the gradual narrowing of the hair follicles which makes the hair frailer, less visible, and more likely to fall out. Minoxidil reverses this process.
By increasing blood flow to the scalp and, as a result, the flow of oxygen and nutrients, the process of follicle miniaturization can be reversed.
What Can I Expect If I Use Rogaine?
If you use Rogaine according to the manufacturer’s instructions, you will need to apply it to a dry scalp, twice per day. That is the case for both the foam and the solution.
One of the more startling effects of using Rogaine is that you will experience a phenomenon called ‘shedding’ in the first two weeks (5). This means the hair is falling out to make way for new, thicker hair.
It may take up to four months before you see the new hair growth and, even then, this hair may be colorless and fine. This is due to the action of hormones on your hair follicles, which makes them smaller. It aims to reverse this, but it may take some time to get your hair back to its original state. It is expected that hair will get thicker as time goes on.
If you have not seen any improved hair growth after four months it is recommended that you stop treatment.
How Much Hair Will I Grow?
A study published in 2014 looked at the impact of using 5 percent minoxidil (which is the concentration Rogaine comes in) on people with AGA (6). The results of the study showed that while 40 percent of users had some hair regrowth this typically took three to six months to take effect.
Earlier studies published in American Family Physician showed that those who used the product for two years had significant terminal (thick and long) hair growth, demonstrating the length of time it may take to see optimal results.
That review study also showed that it could, in fact, take up to six months to see any results which is significantly longer than the four months suggested by the manufacturer.
It also found that 50 percent of men who used Minoxidil for two-and-one-half years could grow hair of moderate to dense thickness (8). Actually, 32 percent of these men needed that hair to be cut and 36 percent felt that it was worth the time and money to continue treatment (9).
However, you should note that the effectiveness of the product varied depending on where the thinning was on the head. The ideal candidate had been bald for fewer than five years, with a bald patch that was fewer than 4 inches (0r 10cm) in diameter, and located on the vertex.
The chart below shows how the ideal candidate for Minoxidil treatment scores between III-V vertex on the Hamilton chart.
While men who have a greater level of hair loss may still try to use Rogaine, satisfaction with the results drops off for men who score higher than a V on the Hamilton chart. Men who stopped using minoxidil showed a rapid loss of the hair that was gained during therapy. Three months after discontinuation of therapy, hair counts were at or below baseline hair counts (10).
This means that Rogaine needs to be used permanently. Androgenetic alopecia (one of the main causes of hair loss) is due to the action of hormones that are always being produced by the body. Even if you get good effects with Rogaine you are going to need to continue to use it, or the hair growth you may have experienced will be lost.
What Are the Side Effects?
All medicines have some risks associated with them, and Rogaine is no different. While this product is relatively well tolerated, it can cause dandruff and dryness of the scalp (11). Some even get contact dermatitis from it, which is a bit like eczema.
Dandruff can contribute to hair problems so if this is something you suffer from while using it, stop immediately.
Some people can be allergic to the chemical and end up with breathing difficulties and tachycardia. This is rare, but usage would need to be stopped immediately.
Tricks To Make Rogaine More Effective/Work Faster
You are wondering about how long this topical treatment takes to work, but did you know there are a few simple tricks that make it work more effectively? The first one is to use something called a dermaroller.
Use A Dermaroller
This is a small roller device covered in tiny metal pins. The pins penetrate the dermal layer just deep enough to wound the skin and increase collagen production, stimulate blood flow, and reduce calcification (12).
Studies have shown that using a dermaroller in combination with minoxidil is much more effective than minoxidil use alone (13).
Just look at the graph below:
After 12 weeks the dermaroller + minoxidil combination went from a hair count of 226 to 317 which is an increase of 91. The group to receive minoxidil by itself went from a hair count of 201 to 218 which is only an increase of 17.
The best place to use the dermaroller (also known technically as microneedling) is along the hairline, where it can be used to directly stimulate hair growth. Never share a dermaroller.
Scalp Massage & Exercises
Scalp massages and exercises are an effective way to regrow hair! They even work without using any topical treatments such as minoxidil.
The goal of the exercises/massages is to detach the scalp from the cranial bone, reduce calcification, increase blood flow, and make the scalp more flexible, elastic, and soft (15). These are all conditions that make new hair growth much more likely.
Just look at someone with a bald head and you will see how stiff, shiny, and thin the scalp is. This is what causes hair follicle miniaturization in the first place.
Combining Rogaine with these techniques makes the product so much more effective.
You can learn some scalp massage techniques here.
Rogaine Reviews from REAL Users
Whether you are on the fence about using Rogaine, or you wonder whether the pros and cons you have experienced are common, it does not hurt to consider the reviews offered by real users.
In summary, here are some PROS and CONS as offered up by REAL users of Rogaine products:
- It slowed hair loss
- It regrew lost hair (in newly-balding areas)
- It improved hair’s overall quality
- Be prepared to use for several months before results become obvious
- Shedding, aka “dread shed”, is a very common occurrence
- It can cause itching and general irritation, especially in the beginning of treatment
Of course, the results will vary from person to person. This means the only way to know if the solution will work for you is to try it yourself.
Does Generic Minoxidil Provide the Same Results?
Rogaine is the most popular brand product to contain minoxidil. However, many other hair loss products do, too. But do the generic brands provide the same results as Rogaine?
If you use a generic minoxidil product with 2 percent minoxidil, the results should be quite similar to if you had used 2 percent Rogaine. This is because, even though the inactive ingredients differ from brand to brand, the active ingredient is the most important part of the formula. As such, any two products with the same active ingredient should work similarly.
Of course, there may be some differences between the products, including how it applies and the side effects experienced.
For example, some users claim that the Kirkland brand minoxidil is quite greasy, while others say that the Rogaine brand product dries out their scalp. This all comes down to inactive ingredients (especially in relation to the presence of alcohols).
Liquid or Foam?
A major question you may find yourself asking is whether you should go with the liquid or foam formulation.
Rogaine topical solution was the first to be developed and approved by the FDA, and it has been in use since 1988 (16). As far as symptoms go, Rogaine liquid solution was causing a number of irritations. These include itching, flaking, redness, and dryness. As research continued, it was discovered that minoxidil was not the issue. Instead, an ingredient found in Rogaine liquid – propylene glycol – was the culprit.
In response, researchers worked to develop a Rogaine solution without propylene glycol. This is where Rogaine foam comes in (17).
As a liquid, Rogaine topical is absorbed into the scalp much more fully. This can mean better hair growth results which is why Rogaine topical solution is typically recommended to be used in smaller doses (especially for women). On the other hand, Rogaine foam does not penetrate the scalp as deeply. In fact, Rogaine foam 5 percent is approved for female use, and this goes to show that much less of the foam actually absorbs in comparison to the liquid.
If you have a sensitive scalp, or you would like to work with a product that is easier to apply, choose the foam.
However, if you are interested in faster results, the liquid would be the way to go.
2 Percent vs 5 Percent
Rogaine and other minoxidil-containing products come in two concentrations: 2 percent and 5 percent. Which one is best?
Will a Higher Concentration Increase Results?
While a stronger dose may work for individuals who did not respond to minoxidil 2 percent, you will not necessarily see 2.5 times more growth when you switch from 2 percent to 5 percent.
This is because dose response – a pharmacological occurrence – does not increase directly in line with dose increase (18). As such, you may experience improved results, but not necessarily 2.5 times what you would have experienced from using a 2 percent minoxidil formula.
Is There an Increased Risk of Side Effects?
Alongside dose response is a concept known as the law of diminishing returns. That is, side effects increase without enough of a benefit return.
This may not necessarily happen with the 5 percent formula – after all, many individuals use it without ill effects – but as dose increases, so too does risk of side effects. This is especially true in female users of the product, as studies show them to be more sensitive to minoxidil’s systemic effects (such as hirutism).
Results and Expectations
One reason that some users of Rogaine find themselves less-than-pleased with the results is because they do not know what to expect. With any hair loss treatment, it is important to go in with a clear understanding.
First, you must know that Rogaine does not work for everyone.
Second, you should know that shedding is very common at the beginning of treatment. This is known as “dread shed,” and while it may be unsettling it is normal and should stop after the first few months of use.
Third, Rogaine takes time. This is not an overnight cure, and it is not a product you can use inconsistently. To determine if Rogaine really works for you, you must use it consistently and for at least six months.
There is no doubt that Rogaine can contribute significantly to hair growth. However, this does not mean that Rogaine is the right treatment for everyone.
The only way to know if Rogaine will work for you is to give it a try. But you may also want to combine it with the other techniques – including microneedling and scalp massages – mentioned above.