Men searching for hair loss treatments face a number of different options – from prescription medicines, over herbal remedies, laser combs, special shampoos or conditioners, to questionable and outright silly methods, there are many potential options that should, ideally, be able to slow down male pattern baldness or even facilitate growth of new hairs.
However, with many options come many questions, most importantly – how efficient are they in reality?
Here we will try to answer this question by comparing three of the most reliable alopecia treatments currently available on the UK markets.
What’s on this page?
Developed and marketed by Merck Sharp & Dohme pharmaceutical company, Propecia is probably the most successful and efficient hair loss treatment. This prescription-only medicine has a unique mechanism of action rooted in its active ingredient, finasteride. Officially classified as 5-alpha-reductase inhibitor, this pharmaceutical compound reduces and partially inhibits the activity of 5-A-R enzyme, a substance crucial for the transformation of testosterone to dihydrotestosterone (or DHT for short). DHT, in turn, has been identified as a kind of catalyst that facilitates hair loss.
This conversion of testosterone into DHT is completely natural and unavoidable as it will eventually occur in almost all men. Finasteride will slow down this process by lowering the levels of DHT, thus reducing the thinning and shedding of hair, but only as long as the treatment lasts. Once you stop taking Propecia, the levels of DHT will start returning to levels common for your age, and with them, hair loss problems will reappear too, reaching pre-treatment levels in 9 months to one year.
As a prescription-only medicine, Propecia has been thoroughly tested in numerous clinical studies. Its performance has been measured in various different ways, including:
- Conducting a hair count in a representative circular region, 1 inch in diameter
- Visual analysis by certified expert, comparing the users of Propecia and those administered with placebo
- Photographic assessment of Propecia users and placebo users by an independent panel of dermatologists
Measurements of actual hair count serve as a significant indicator of the efficiency of this medicine. The scientists that participated in the study’s execution called the results “significant”, with 107-hair difference within a 1-inch diameter circle between treatment and placebo groups within one year. This difference increased to 138 after two years and 277 after 5 years.
Finally, the researchers published their findings, with the most important conclusions being:
- Within one year, 65% of men experienced increased hair growth (compared to 37% of those using placebo)
- Within two years, this percentage grew to 80% (compared to 47% of placebo users)
- After 5 years, this percentage further increased to staggering 77% while in placebo users it decreased to as low as 15%
Similar statistics can be found in the report made by independent panel of dermatologists which relied on analysing photographic material:
- After one year, 48% of men using Propecia had an increase in hair presence (compared to 7% using placebo)
- After two years, the percentage reached 66% for Propecia users and 7% for placebo
- Finally, after 5 years, 48% of the treatment group showed hair growth, 425 had shown no change and 10% demonstrated hair loss – the placebo group, on the other hand, had different values with 6% experiencing increased growth, 19% with no change and 75% with noticeable hair loss
These studies gathered 1.879 men aged from 18 to 41.
Regaine is, as opposed to Propecia, available as foam or a scalp solution that can be bought over-the-counter (in a lower dose only – 5% solution will still require a prescription). However, probably the most important difference compared to finasteride is the fact that it can also be used by women.
Available in two “strengths” of 2% and 5%, this medicine relies on a mechanism of action that is not fully understood as of now. At the moment, there are some indications that it facilitates increased circulation of blood within the scalp by dilating blood vessels, with hair regrowth being a secondary effect of this medicine. Once when minoxidil was patented, it went through rigorous clinical testing.
The tests were conducted in a manner similar to trials that were focused on Propecia. The participants were divided into three groups – one that used 5% solution, other 2% solution and the third that used a kind of placebo – product that didn’t contain active ingredient at all. Photographic analysis was used as a method and the conclusions were:
- After 48 weeks, 60% of patients in the minoxidil 5% group showed what scientists termed “increased scalp coverage” (23% in the placebo group)
- At the same time, 35% showed dense or moderate regrowth (7% in the placebo group)
- 30% showed no change (as opposed to 60% in the placebo group)
As a result, scientists concluded that 4 out of 5 users of minoxidil 5% can expect regrowth and stopping of hair loss process, as opposed to 3 out of 4 in the test group. So, while Regaine certainly is effective, its efficiency is not as great as is the case with Propecia.
Caffeine shampoo is the most recent addition to hair loss treatments out of the three considered here. While its mechanism of action is not understood in detail, recent studies seem to indicate that it works by protecting the hair follicle against the destructive impact of dihydrotestosterone while at the same time providing a kind of “energy boost” that serves to prolong the hair’s growth phase.
At the moment, detailed research into this treatment option is still significantly lacking, with some encouraging results. As of now, the strongest indicator of efficiency of this approach is the fact that when this substance is applied to hair cultures in a laboratory vessels, it has stimulated growth. However, the legitimacy of these results can be questioned – no one doubt that scientists did produce those results, but the issue is that in vitro studies cannot realistically replicate the use of the shampoo on a human head.
Which one is the best – Propecia, Regaine or Caffeine Shampoo?
It would seem that the greatest advantage of caffeine shampoo is the fact that it can be bought over-the-counter. But, at the same time, it means that it hasn’t been as thoroughly tested in the treatment of male pattern baldness as the other alternatives – in fact, serious studies in caffeine shampoo efficiency are still largely lacking. This is why it is not feasible to objectively compare the clinical success of caffeine shampoo to prescription medicines such as Propecia or Regaine.
At the same time, comparing Propecia and Regaine can also be much more complex than it might seem at the first glance since the former has been tested over the course of 5 years, while the latter only for 48 weeks. With different parameters of analysis and different time frames when the effects are supposed to be noticed, it is not that easy to compare the results.
However, it would seem that with much higher success rate as compared to placebo, Propecia does take the first prize here!