Rogaine is a topical treatment for hair loss. It was first approved by the FDA in 1987 for the treatment of androgenic alopecia in men (1).
Three years later the FDA approved it for women. Finally, in the mid-1990s it became available as an over-the-counter treatment.
The company behind Rogaine was Upjohn Pharmaceutical Company. They formed in 1875 and are now part of Pfizer. They initially began testing minoxidil in the 1950s. Though they planned to market it against ulcers, minoxidil turned out to be an effective vasodilator. This led to the FDA approving the drug for the treatment of hypertension.
However, one of the most common side effects patients began experiencing was hair growth. Upjohn patented the drug for hair loss and began developing a commercial product. This would eventually become Rogaine.
The Rogaine brand now belongs to Johnson & Johnson, as a result of the 2006 acquisition of Pfizer Consumer Healthcare. The line of products includes Rogaine Foam, Rogaine Extra Strength Solution for Men, and Rogaine Topical Solution for Women.
How Does it Work?
The active form of the minoxidil molecule is minoxidil sulfate. When the scalp comes into contact with minoxidil upon application, it naturally metabolizes minoxidil to minoxidil sulfate. This happens through the action of a class of enzymes (proteins) called sulfotransferases (2).
Research is ongoing to determine whether some of minoxidil’s hair growth properties are due to its vasodilatory effect (1). Because minoxidil widens the blood vessels, it increases blood flow to the capillaries which supply hair follicles. This could also play a part in stimulating hair growth.
Research over the past three decades shows that around 40% of men experience regrowth of hair on minoxidil (3). This regrowth occurs between three and six months after the start of treatment.
Users must keep applying minoxidil to preserve their results. Once they stop using the drug, any regrown hair will fall out and the baldness will start to progress again.
Minoxidil’s effect on hair growth is partly because it lengthens the anagen phase of a hair’s lifecycle. This is the stage when the hair shaft actively grows. With more hairs in the active growth stage, the result is more hairs that are longer and thicker.
Why Are There Two Forms of the Same Product?
The foam form of Rogaine is a more recent development than the topical solution. It was prompted by complaints about certain side effects of the topical solution. These included the fact that hair sometimes looked and felt greasy.
However, the most serious complaint about the topical solution was that it caused numerous allergic reactions and irritation of the skin. This was not caused by the active ingredient but by a compound called propylene glycol.
The manufacturer includes propylene glycol in the liquid formulation to allow minoxidil to penetrate the surface of the skin. This way, it can reach the hair follicles and stimulate growth. Propylene glycol is a harsh chemical. The Environmental Working Group classifies it as a moderate-level toxin (4).
As a result of this, it became a priority to work on a form of treatment that could work without propylene glycol. The foam version does not contain propylene glycol. This means it is likely to cause skin irritation. In turn, this leads to better patient compliance and hair regrowth.
How to Apply the Foam and Liquid
You apply the liquid solution to thinning areas of the scalp using a 1 ml dropper. Your scalp should be clean of other hair products and dry. After this, you massage the liquid into the skin. This way the minoxidil can penetrate the skin and reach the follicles.
You also apply the foam on a dry scalp that is free from other products. Instead of a dropper, spray the foam directly onto your scalp and massage it with your hands.
Regardless of which version you use, you should wash your hands thoroughly after application. Also, do not apply any other hair product until the minoxidil has completely dried off.
Results
Rogaine will not cure baldness, or come anywhere near that. The application of Rogaine cannot cause new follicles to grow where there are none. For those with advanced alopecia, it will likely be ineffective.
What it can do is kickstart some hair follicles that have become dormant back into their anagen growth phase. It will also slow down the rate of shedding. Balding men often use it in combination with other treatments, such as finasteride, to promote maximum regrowth.
The best chances of significant regrowth are in early-stage alopecia patients. In this stage, hair follicles are less likely to be very miniaturized. Minoxidil can help them get back into a healthy hair growth cycle.
Research done at Duke University Medical Center in Durham, NC, suggests that the foam version is effective against hair loss, and the results are probably similar to the liquid (5). However, the incidence of skin irritation is likely far lower among those who use the foam.
User Friendliness
The studies performed at Duke University also included consumer research. According to Elise Olsen, professor of medicine at Duke University, this research suggests that users find the foam version to be more user-friendly (6). Among its advantages compared to the liquid solution are the following:
- ease of application
- no dripping
- quicker absorption and drying
- fits easier into a daily routine
Summary
Before using either form of Rogaine, it is beneficial to consult your physician. If you are not yet sure what is causing your hair loss, refrain from using it at all.
You should also consider the potential side effects of using Rogaine.
Your physician can advise you on any potential dermatological risks. These may influence your decision to use foam or liquid.
In terms of effectiveness, research has shown both forms of treatment to achieve similar results. The foam is easier to apply, however, and this can significantly affect treatment compliance and overall results.
The liquid treatment also carries a greater risk of provoking skin reactions. If you experience adverse reactions to the liquid, you can consider switching over to the foam version. Though minoxidil is over the counter, when modifying a minoxidil treatment, it is advisable to consult a medical professional.
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