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Minoxidil baldness. Minoxidil for Hair Loss: Mechanisms, Effectiveness, and Side Effects

by alexxlab

How does minoxidil work to combat baldness. What is the recommended dosage and application method for minoxidil. Are there any potential side effects associated with minoxidil use. Can minoxidil be used for different types of hair loss. How long does it take to see results from minoxidil treatment. What are the differences between liquid and foam formulations of minoxidil. Is minoxidil effective for both men and women experiencing hair loss.

The Science Behind Minoxidil: Understanding Its Mechanism of Action

Minoxidil, a popular treatment for hair loss, has been the subject of extensive research to uncover its precise mechanisms of action. Originally developed as an oral medication for hypertension, its hair-growth-promoting properties were discovered serendipitously. But how exactly does minoxidil work to combat baldness?

Studies have revealed that minoxidil affects hair growth through multiple pathways:

  • Vasodilation: Minoxidil is a potent vasodilator, increasing blood flow to hair follicles.
  • Potassium channel activation: It opens ATP-sensitive potassium channels in cell membranes.
  • Angiogenesis: Minoxidil stimulates the production of vascular endothelial growth factor (VEGF).
  • Cell proliferation: It promotes the proliferation of dermal papilla cells.

One of the key mechanisms involves potassium channels. Research by Shorter et al. (2008) demonstrated that human hair follicles contain two forms of ATP-sensitive potassium channels, but only one is responsive to minoxidil. This selective activation may explain why minoxidil affects hair growth without causing systemic side effects related to potassium channel modulation in other tissues.

Does minoxidil directly stimulate hair follicles? Yes, studies have shown that minoxidil can stimulate mouse vibrissae follicles in organ culture, suggesting a direct effect on hair follicle cells (Buhl et al., 1989). This direct stimulation, combined with increased blood flow and angiogenesis, contributes to minoxidil’s efficacy in promoting hair growth.

Formulations and Application: Liquid vs. Foam Minoxidil

Minoxidil is available in two main formulations: liquid and foam. Each has its advantages and considerations:

Liquid Minoxidil:

  • Typically contains propylene glycol, which aids in drug penetration
  • May cause scalp irritation in some users
  • Can leave a greasy residue on the scalp

Foam Minoxidil:

  • Often propylene glycol-free, reducing the risk of irritation
  • Easier to apply and leaves less residue
  • May be less effective in penetrating the scalp due to the absence of propylene glycol

Is one formulation superior to the other? Studies comparing liquid and foam minoxidil have shown similar efficacy. Gogtay and Panda (2009) noted that the foam formulation provides a new option for those who experience irritation with the liquid form. However, the choice between liquid and foam often comes down to personal preference and individual scalp sensitivity.

How should minoxidil be applied for optimal results? For both formulations, the recommended application is twice daily, typically morning and evening. It’s crucial to apply the product to a dry scalp and allow it to absorb fully before styling hair or going to bed.

Efficacy of Minoxidil: What the Clinical Trials Reveal

Numerous clinical trials have evaluated the effectiveness of minoxidil in treating androgenetic alopecia, the most common form of hair loss. But what do these studies tell us about minoxidil’s efficacy?

A landmark study by Olsen et al. (2002) compared 5% topical minoxidil, 2% topical minoxidil, and placebo in men with androgenetic alopecia. The results were compelling:

  • 5% minoxidil was significantly more effective than 2% minoxidil and placebo
  • Participants using 5% minoxidil experienced a 45% increase in hair count
  • The onset of action was faster with 5% minoxidil

How long does it take to see results from minoxidil treatment? Most studies indicate that visible improvements typically occur after 3-6 months of consistent use. However, individual responses can vary, and some users may notice changes earlier or later.

Is minoxidil equally effective for all types of hair loss? While minoxidil has shown the most consistent results for androgenetic alopecia, some studies suggest it may also be beneficial for other forms of hair loss, such as alopecia areata. However, its efficacy in these cases is less well-established and may vary significantly between individuals.

The Role of Minoxidil in Hair Follicle Cycling

Understanding how minoxidil affects the hair growth cycle is crucial to appreciating its effectiveness. But what exactly happens to hair follicles when minoxidil is applied?

Minoxidil influences the hair growth cycle in several ways:

  1. Prolonging the anagen (growth) phase of hair follicles
  2. Shortening the telogen (resting) phase
  3. Increasing the size of hair follicles
  4. Promoting the transition of vellus (thin, short) hairs to terminal (thicker, longer) hairs

A study by Mori and Uno (1990) on rat hair follicles demonstrated that topical minoxidil could significantly alter hair follicular cycles. They observed an increase in the proportion of follicles in the anagen phase and a corresponding decrease in telogen follicles.

How does this translate to visible hair growth? As more follicles enter and remain in the anagen phase, and as existing follicles enlarge, users typically experience an increase in hair density and thickness. This effect is particularly noticeable in areas of thinning hair, where miniaturized follicles are prevalent.

Does minoxidil create new hair follicles? While minoxidil does not generate new follicles, it can revitalize dormant or miniaturized follicles, effectively “waking them up” and stimulating them to produce thicker, more visible hair.

Vascular Effects of Minoxidil: Enhancing Blood Flow to Hair Follicles

One of the key mechanisms by which minoxidil promotes hair growth is through its vascular effects. But how exactly does minoxidil influence blood flow to hair follicles?

Minoxidil’s vascular effects include:

  • Vasodilation of small arteries and arterioles
  • Increased capillary permeability
  • Stimulation of angiogenesis (formation of new blood vessels)

A study by Sakita et al. (1999) found that topical minoxidil application induced increased fenestration in the perifollicular capillary wall. This enhancement in capillary permeability likely contributes to improved nutrient delivery to hair follicles.

Furthermore, research by Lachgar et al. (1998) demonstrated that minoxidil upregulates the expression of vascular endothelial growth factor (VEGF) in human hair dermal papilla cells. VEGF is a potent stimulator of angiogenesis, and its increased expression may lead to the formation of new blood vessels around hair follicles.

How does improved blood flow benefit hair growth? Enhanced blood supply to hair follicles means increased delivery of oxygen and nutrients, which are essential for robust hair growth. This improved nourishment may help to reverse miniaturization of hair follicles and promote the growth of thicker, healthier hair.

Minoxidil for Women: Effectiveness and Considerations

While much of the research on minoxidil has focused on male pattern baldness, it’s also approved for use in women experiencing hair loss. But how effective is minoxidil for female pattern hair loss?

Studies have shown that minoxidil can be beneficial for women with androgenetic alopecia:

  • A 2% concentration is typically recommended for women
  • Some studies suggest that 5% minoxidil may be more effective, but with a higher risk of side effects
  • Women may see results more quickly than men, often within 3-4 months

Are there any special considerations for women using minoxidil? Women should be aware that:

  1. Minoxidil should not be used during pregnancy or while breastfeeding
  2. It may cause increased facial hair growth in some women
  3. Hormonal fluctuations (e.g., during menopause) may affect treatment efficacy

Can minoxidil be used for other types of hair loss in women? While primarily studied for androgenetic alopecia, some research suggests minoxidil may be helpful for other forms of hair loss, such as alopecia areata or traction alopecia. However, its effectiveness in these cases may vary, and consultation with a dermatologist is recommended.

Side Effects and Precautions: What Users Should Know

While minoxidil is generally considered safe and well-tolerated, it’s important for users to be aware of potential side effects and precautions. What are the most common side effects of minoxidil?

Common side effects include:

  • Scalp irritation, itching, or redness
  • Dry, flaking skin on the scalp
  • Increased hair shedding in the first few weeks of treatment
  • Unwanted hair growth on the face or body (more common with higher concentrations)

Are there any serious side effects to be concerned about? While rare, more serious side effects can occur, including:

  1. Rapid heartbeat
  2. Chest pain
  3. Swelling of the hands or feet
  4. Sudden, unexplained weight gain

Users experiencing any of these severe side effects should discontinue use and seek medical attention immediately.

Can minoxidil interact with other medications? Recent research by Goren et al. (2018) suggests that low-dose daily aspirin may reduce the efficacy of topical minoxidil in androgenetic alopecia patients. This highlights the importance of discussing all medications with a healthcare provider before starting minoxidil treatment.

Are there any groups who should avoid using minoxidil? Minoxidil is not recommended for:

  • Pregnant or breastfeeding women
  • Individuals with a history of heart disease or hypertension (without medical supervision)
  • Those with scalp conditions or open wounds on the scalp
  • Individuals under 18 years of age (efficacy and safety not established in this group)

How can users minimize the risk of side effects? To reduce the likelihood of adverse reactions:

  1. Start with the lower concentration (2%) and gradually increase if needed
  2. Apply minoxidil to a clean, dry scalp
  3. Avoid exceeding the recommended dosage
  4. If irritation occurs, consider switching to the foam formulation or using a lower concentration

By being aware of potential side effects and taking appropriate precautions, users can maximize the benefits of minoxidil while minimizing risks.

Minoxidil and its use in hair disorders: a review

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Minoxidil Topical: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

Minoxidil solution and foam are used to help hair growth in the treatment of male pattern baldness. It is not used for baldness at the front of the scalp or receding hairline in men. The foam and 2 percent minoxidil solution is also used to help hair growth in women with thinning hair.Minoxidil belongs to a class of drugs known as vasodilators. It is not known how minoxidil causes hair growth. This medication is not used for sudden/patchy hair loss, unexplained hair loss (for example, if you have no family history of hair loss), or hair loss after giving birth.Do not use this product if you are 18 years old or younger.

How to use Minoxidil Solution, Non-

Read and follow all directions on the product package before using this product. If you have any questions, ask your doctor or pharmacist.

Clean and dry the scalp area before applying the medication. You may apply this product to damp hair. To use the solution, fill the applicator with 1 milliliter of medication (to the 1 milliliter line), or use 20 drops. Part your hair in the area of thinning and apply the solution evenly to the affected area of the scalp. Gently rub in. Allow the solution to dry completely before using other styling products (such as gels, mousse) or before going to bed.

To use the foam, rinse your hands in cold water and dry well. Apply about 1/2 capful of foam to the scalp and rub in gently. Allow the foam to dry completely before styling or going to bed.

If scalp irritation is a problem, you may need to avoid using minoxidil on the same days that you have your hair colored or chemically treated (for example, permed).

Do not use on other parts of the body unless directed by your doctor. Do not use on skin that is red, painful, irritated, scraped, cut, or infected. Wash hands thoroughly after application. Avoid getting the medication in your eyes. If this occurs, rinse your eyes with large amounts of cool water.

Do not use this medication more often, apply more of it than as directed, or apply it to an irritated or sunburned scalp. Doing so can cause the drug to be absorbed into your body and result in serious side effects. This product may contain alcohol and can be irritating and drying to the scalp. Ask your doctor or pharmacist how to use this product safely.

It takes time for hair to regrow. Most people need to use this medication regularly for 4 months to see benefit. This medication must be used continuously to maintain hair growth. If your condition does not improve or worsens after using this medication for 4 to 6 months, or if you think you may have a serious medical problem, tell your doctor.

Side Effects

Burning, stinging, or redness at the application site may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

If your doctor has directed you to use this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Rarely, this medication can be absorbed through the skin and cause side effects. Stop using this medication and tell your doctor right away if you have any serious side effects, including: unwanted facial/body hair, dizziness, fast/irregular heartbeat, fainting, chest pain, swelling of hands/feet, unusual weight gain, tiredness, difficulty breathing especially when lying down.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before using minoxidil, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

If you have any of the following health problems, consult your doctor or pharmacist before using this product: diseases of the scalp (such as eczema, infection, cuts), heart problems (such as chest pain, heart attack, heart failure), kidney disease, liver disease.

During pregnancy, this product should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug include: drugs for high blood pressure (such as guanethidine), drugs that interact with alcohol (such as disulfiram, metronidazole).

Does Minoxidil Solution, Non- interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: dizziness, drowsiness, fainting, flushing.

Keep all medical and lab appointments.

If you miss a dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from heat. This product is flammable. Keep it away from fire, and avoid open flame after treatment until the medication has completely dried. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Minoxidil for hair, the benefits and harms of minoxidil

Androgenetic alopecia most often develops in the stronger sex and leads to male pattern hair loss. This is due to the peculiarities of the hormonal background, in which the endocrine system produces an excessive amount of the male sex hormone – dihydrotesterone, which negatively affects the quality of the hair, causing hair loss, thinning and growth retardation.

It is worth noting that Minoxidil is mainly suitable for men. For the fair sex, androgenic baldness is very rare, in exceptional cases. And as an option, you can use 2% Minoxedil. A big plus of the drug is the absence of smell.

Minoxidil FAQ:

Ingredients Minoxidil

Supplied as a spray or foam. Active ingredient concentration: 2–15%. The drug is suitable for any form of hair, even for the most complex hairstyles.

The most popular minoxidil brands on the market are Rogaine and Alerana.

Rogaine consists of minoxidil, purified water and a combination of citric and lactic acids. Other components include stearic alcohol and glycerol. Alerana, in addition to the usual minoxidil and purified water, contains ethyl alcohol and propylene glycol.

Analogues

There are situations when there is an allergic reaction to one of the components of the drug. Then, for the treatment of hair loss, the doctor may prescribe other drugs with a similar effect. Active analogues of minoxidil are preparations based on nanoxidil (Spectral DNS), aminexil (Vichy Dercos) and stemoxidine (Vichy Dercos Neogens).

To enhance the effect, in addition to taking medications, the doctor may recommend taking vitamins and microelements, the composition of which is selected specifically for hair, and not for general action. Also a good recommendation is mesotherapy and PRP/Price

The cost of the drug directly depends on the percentage of minoxidil in its composition. The most popular solutions are those containing 2% and 15% minoxidil. Accordingly, the first option will cost $13–15, while a five percent solution will cost $18–50.

The drug belongs to the conditional category “cost above average”, and due to the active appreciation of the dollar against the Russian ruble in recent days, its purchase may feel even more expensive. However, the price of the drug is fully justified, since minoxidil is one of the most effective substances for the treatment of hair loss, regardless of whether it is caused by a genetic predisposition or is one of the post-covid syndromes.

Instructions for use

It is best not to use Minoxidil as soon as a problem of hair loss is discovered, but to consult a trichologist. And especially not to use every day. Alcohol-containing solution often leads to flaking of the scalp. The maximum safe frequency is every other day for the night!

The daily dose of the drug – 1 ml of solution – is equal to seven injections on the scalp. In general, it is determined by the attending physician, but these are standard values. If the drug is supplied in the form of a foam, then 1 ml of the solution is approximately equal to half the vial cap.

Use of the product is as follows:

  1. First, the scalp is cleaned.
  2. The preparation is then gently rubbed into the skin.
  3. Leave on for several hours, the main thing is not to wash it off.

Regular use of the drug is implied, short-term use will not give the desired effect.

Contraindications
  • pregnancy;
  • breast-feeding;
  • allergic to minoxidil and other components of the drug;
  • skin lesions of the head;
  • diseases of the cardiovascular system, liver, kidneys;
  • Minoxidil is likely to be incompatible with other hair loss medications, we strongly recommend that you consult your doctor about additional contraindications.
Side effects

Rare but should be known in advance:

  • dizziness;
  • burning eyes;
  • allergy in the form of itching and rash;
  • swelling of the tongue, lips and throat;
  • lowering blood pressure;
  • palpitations; dyspnea.
Why is Minoxidil dangerous?

The appearance of side effects is possible both on the part of the hair and the body as a whole. Minoxidil is a crystalline powder that is dissolved in alcohol, which is quite drying to the skin and can cause seborrhea, dryness, tightness, and flaking. Harm from the use of Minoxidil can also be manifested from the side of the cardiovascular system – such manifestations as dizziness, tachycardia and chest pain are possible. An allergic reaction is also possible.

Action of minoxidil against baldness, against hair loss and for hair growth

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Learn more about how Rogaine

® Foam with Minoxidil 5% works.

Foam Regaine contains a 5% solution of minoxidil 1 , which is considered the first line drug in the treatment of hereditary baldness – androgenetic alopecia 7 . Exactly how minoxidil works when applied topically is not completely known. According to the instructions for medical use of the drug, minoxidil in the foam Regaine ®1 :

  • dilates the blood vessels of the scalp and improves blood flow around the hair follicles;
  • promotes the formation of vascular endothelial growth factor, a substance that is believed to increase the permeability of small vessels, which indicates a high metabolic activity in anagen – the phase of active hair growth.

Rogaine Foam ® , indicated for the treatment of androgenetic alopecia 1 , is clinically proven 2,3,4 . Nine out of ten men 4 and 81.5% of women 5 note that with regular external use of minoxidil, hair loss stops within two months, and new ones appear in place of vellus and previously lost hair 4.5 . The best effect of the drug is noted at the initial stage of the disease and with moderate androgenetic alopecia 1 .

How to use Regaine®

The drug is approved for use from 18 years of age and has contraindications 1 – it is important to consider them. Therefore, before using Regaine ® , read the instructions for its medical use and consult a specialist. How to use Rogaine®? 1

  • Apply Rogaine ® Foam with clean, dry hands to dry scalp, not hair. This can increase the effectiveness of the drug, as it will be easier to reach the hair follicles.
  • Since the foam may dissolve on contact with warm skin, rinse your fingers with cold water and dry them before squeezing it out.
  • Spread the foam evenly over the areas of baldness and use your fingertips to gently rub it into the skin.

Men are recommended to perform the procedure twice a day (morning and evening), women – once a day. If you use the product more often, this will not affect the result of treatment 1 .

Within 4 hours after application of Rogaine ® Do not wash or blow dry your hair. You can comb during treatment as usual. However, before styling, you must wait until the foam is completely dry, and then use styling products 1 .