Dr Jagdish M jyoti - Cosmetic Surgeon,Apollo Hospitals, Hyderabad, India.

Medical Therapy

Treatment options

Presently, the world over there only two medications for male and one medication for female patients of pattern hair loss which are approved by the US FDA. This approving body has stringent guidelines through which the drugs are approved only after sufficient trials. Minoxidil was the first to be approved followed by Finasteride.


This drug was initially introduced as an oral medication for hypertension. It was observed that it produced hypertrichosis (excessive hair). A topical solution was prepared which could achieve similar benefits.

Minoxidil is applied to the scalp is used to stimulate hair growth in adult men and women with a certain type of baldness. Despite much research over 20 years we still have only a limited understanding of how minoxidil stimulates hair growth. It tends to prolong the growth phase of the hair follicle and thereby reduces hair fall.

A 5% solution of minoxidil is available and clinical investigators have reported it to be considerably more effective than the 2% solution in halting hair loss and stimulating new hair growth in both men and women. At all formulations, women have been shown to have a better response than men to topical minoxidil.

Used as directed, 2% minoxidil has been shown to stimulate hair growth in about 30% of male patients, with a slightly higher rate in females. The response rate is improved with use of 5% solution.

If hair growth is going to occur with the use of minoxidil, it usually occurs after the medicine has been used for several months and lasts only as long as the medicine continues to be used. Hair loss will begin again within a few months after minoxidil treatment is stopped.

How should I use this medicine?

Minoxidil solution is for external use on the scalp only. Do not take by mouth. Follow the directions that come with the product. The hair and scalp should be dry before you use minoxidil solution. You do not need to shampoo your hair before each application. Do not use within 30 minutes of bedtime. After applying minoxidil solution, do not use your hair dryer on the hot or high setting to dry hair. Also, do not swim or exercise for 2 hours after using minoxidil solution. Do not use more often than specified in the directions.

Minoxidil solution must be used on a regular basis for your hair to regrow. It may take 2—4 months of regular use before you notice any improvement. It is important to continue to use minoxidil solution to maintain regrowth of hair. Once you stop using minoxidil solution, the regrown hair will usually fall out within 3 months.

Side effects from using minoxidil

Minoxidil is a safe medication and just like any other drug it has some adverse effects. Uncommon side effects that you should report to your doctor as soon as possible: chest pain, fast or irregular heartbeat, palpitations,difficulty breathing, dizziness or fainting spells, skin rash, blisters, or itching, stiff or swollen joints, sudden weight gain, swelling of the feet or legs, unusual weakness.

Side effects that usually do not require medical attention (report to your doctor if they continue or are bothersome):

  • Headache
  • Redness, irritation and itching at the site of application
  • Unusual hair growth, on the face, arm, and back


Males: 2% and 5% can be used on twice daily basis 1ml in the morning and 1ml in the evening.

Females: Only 2% is approved for use in females and it has to be used similarly on twice daily basis 1ml in the morning and 1ml in the evening.


Finasteride belongs to the group of medicines called enzyme inhibitors. Finasteride works at the molecular level to halt hair loss and stimulate new hair growth. It is a medication that selectively inhibits the activity of an enzyme that converts the "male hormone" testosterone into a form that is active in hair follicles. Testosterone is the most potent of the androgenic hormones. Its actions on hair follicles, skin and prostate tissue is not direct however; these tissues are responsive to a form of testosterone called dihydrotestosterone (DHT); testosterone is converted to DHT by the enzyme 5-alpha-reductase. Finasteride acts by inhibiting the action of 5-alpha-reductase and thus inhibiting the conversion of testosterone into DHT.

Following the lead of finasteride's effectiveness in treating benign prostate enlargement, investigators studied its use in treating MPHL. These studies confirmed that at a dose of 1 milligram per day, finasteride is effective in treating MPHL in some but not all men. The 5-year study showed that 9 out of 10 men treated with finasteride either had gained or at least had not lost hair.

It is important to note that Finasteride for treatment of hair loss should be prescribed only after examination by a doctor/ hair restoration specialist. Finasteride is not approved the use in women, and particularly in women who are pregnant or who become pregnant. The drug has potential for interfering with sexual development of a fetus.

Cyclical Medical Therapy

Cyclical Medical Treatment which stops hair fall, induces new hair growth and medicines used once in three days, reduces cost of medication and guarantees no side effects.

Natural Hair growth cycle is of 4 months. Any therapy must act in one cycle. Cyclical Treatment controls hair fall in 2 months and improves hair growth in 4 months.

With the success of Cyclical Hair Treatment anybody below age of 23 years or not having hairloss beyond Grade III is refused for hair transplant surgery.