Thank you for your question.
You state in your question that you are applying Rogaine to the scalp at night and you’re
asking does it matter whether you sleep on your back or is it better to sleep on your
side and you have a concern about whether pressure on the head will have an impact on
the effectiveness of this treatment.
Well, I can certainly give you some guidance as to how we recommend management of such
things like going to sleep with the various treatments we offer in our practice. A little
bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island
for over 20 years. I’m also the founder of TrichoStem™ Hair Regeneration Centers,
a non-surgical treatment that we developed for male and female pattern hair loss that
has been very successful and we actually have very specific instructions that we give to
our patients regarding head position when you sleep.
So, I think what’s very important to understand is what kind of impact the position of your
scalp when you are laying in bed would have on the different types of hair loss options.
So to begin with, for example, if you’re taking finasteride, a pill that is a DHT blocker,
it’s a pill that you take daily. It’s irrelevant what position you are in because
this is a systemic drug. It gets absorbed in your circulation. It goes to the hair follicles
via the arteries. Now, when it comes to a topical application, you are applying the
material to the scalp, the minoxidil whether it’s a liquid or a foam. The intention is
that the scalp’s skin absorbs the active ingredients in minoxidil through the vehicle
which is something to break down the outer layer of skin and then it gets absorbed through
the skin and affects the hair follicles.
That being said, I don’t think that a position of the scalp makes that much of a difference.
As long as the scalp is not that wet right when you go to bed and you lay down, because
you could be at risk of just wiping away some of this material that’s being placed. As
long as your scalp is relatively dry about the time you go to bed, then I don’t think
it’s going to make much of a difference.
As an aside, I can mention that we’ve developed a treatment called Hair Regeneration and when
we do Hair Regeneration treatment which is a non-surgical solution for thinning hair.
We do injections under the skin and in the skin, intradermal as well as subcutaneous,
under the skin. We advise our patients to avoid sleeping on their face because we are
concerned about the effect of gravity moving fluid that’s under the scalp towards the
front, towards the face. Now although that’s not dangerous, it can cause some swelling
that is undesirable. So we suggest to our patients to actually sleep with their heads
slightly elevated and understanding that the thinking behind that is that the treatment
is being done in a way where the head position can have an effect on the fluid movement.
It doesn’t have an effect on the therapeutic value of the treatment. The person, whether
they sleep on their face, on their side or on the back, we’re not concerned about that.
It’s not about pressure on scalp. It’s more about what happens inside the scalp.
So again, head position doesn’t specifically have an issue. There are a lot of myths about
different issues whether it’s wearing hats or laying on a particular area of the scalp
on the bed as a cause for hair loss. Those are not really relevant. And the same thing
applies to the treatment. When it comes to legitimate treatment, then head position should
not be an issue. Again, if you’re talking about a treatment like Hair Regeneration or
hair transplant, that’s about the management of moving fluid in the early period after
the treatment.
So I hope that was helpful, I wish you the best of luck and thank you for your question.