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Minoxidil baldness. Minoxidil for Baldness: Comprehensive Review of Mechanisms and Efficacy

by alexxlab

How does minoxidil work to combat hair loss. What are the different formulations of minoxidil available. What is the efficacy of minoxidil in treating androgenetic alopecia. What are the potential side effects of using minoxidil for hair growth. How does minoxidil compare to other hair loss treatments.

The Science Behind Minoxidil’s Hair-Growth Promoting Effects

Minoxidil, originally developed as an antihypertensive medication, has become a widely used treatment for hair loss, particularly androgenetic alopecia. But how exactly does this drug work to promote hair growth?

Potassium Channel Activation

One of the primary mechanisms of action for minoxidil is its effect on potassium channels in hair follicles. Shorter et al. (2008) discovered that human hair follicles contain two forms of ATP-sensitive potassium channels, with only one being sensitive to minoxidil. This activation of potassium channels is believed to play a crucial role in stimulating hair growth.

Vascular Effects and Angiogenesis

Minoxidil also appears to have significant vascular effects that contribute to its hair-growth promoting properties. Sakita et al. (1999) observed that topical minoxidil application led to increased fenestration in the perifollicular capillary wall. This enhancement of blood flow to the hair follicles may contribute to improved nutrient delivery and overall follicular health.

Furthermore, Lachgar et al. (1998) found 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 better vascularization of the hair follicles. Yano et al. (2001) demonstrated that VEGF-mediated angiogenesis plays a crucial role in controlling hair growth and follicle size.

Cell Proliferation and Hair Cycle Modulation

Minoxidil has been shown to have direct effects on hair follicle cells. Buhl et al. (1989) demonstrated that minoxidil stimulates mouse vibrissae follicles in organ culture, suggesting a direct proliferative effect on follicular cells. Mori and Uno (1990) observed that topical minoxidil application affected hair follicular cycles in rats, potentially prolonging the anagen (growth) phase of the hair cycle.

Formulations and Applications of Minoxidil

Minoxidil is available in various formulations, each with its own advantages and considerations. What are the different ways minoxidil can be applied for hair loss treatment?

Topical Solutions

The original and most common formulation of minoxidil is a topical solution. Tata et al. (1994) studied the influence of ethanol and propylene glycol cosolvents on the deposition of minoxidil into the skin, highlighting the importance of the vehicle in drug delivery.

Foam Formulations

More recently, foam formulations of minoxidil have been introduced. Gogtay and Panda (2009) described minoxidil topical foam as a “new kid on the block,” offering potential advantages over traditional solutions. Purnak et al. (2011) compared liquid and foam formulations of minoxidil, suggesting that the foam version may have improved cosmetic acceptability and potentially reduced side effects.

Efficacy of Minoxidil in Treating Androgenetic Alopecia

Numerous clinical studies have evaluated the effectiveness of minoxidil in treating pattern hair loss. What does the evidence say about its efficacy?

Dosage Comparisons

Price et al. (1999) conducted a study comparing the effects of 5% and 2% topical minoxidil, placebo, or no treatment on hair weight and hair count in men with androgenetic alopecia. The study found that both concentrations of minoxidil were effective in increasing hair weight and count, with the 5% solution showing superior results.

Olsen et al. (2002) performed a randomized clinical trial comparing 5% topical minoxidil, 2% topical minoxidil, and placebo in men with androgenetic alopecia. The study concluded that the 5% solution was significantly more effective than the 2% solution or placebo in increasing hair count and improving patients’ assessment of hair growth.

Histological Changes

Abell (1988) and Headington and Novak (1984) conducted histologic studies of male pattern baldness treated with topical minoxidil. These studies revealed changes in hair follicle morphology and cycling, providing further evidence for minoxidil’s efficacy at the cellular level.

Pharmacology and Pharmacokinetics of Minoxidil

Understanding the pharmacological properties and metabolism of minoxidil is crucial for optimizing its use in hair loss treatment. What do we know about how minoxidil is processed in the body?

Metabolism and Sulfation

Anderson et al. (1998) studied the sulfation of minoxidil by multiple human cytosolic sulfotransferases. This process is critical for the activation of minoxidil, as the sulfated form is believed to be the active metabolite responsible for its hair growth-promoting effects.

Systemic Absorption

Lowenthal and Affrime (1980) reviewed the pharmacology and pharmacokinetics of minoxidil, including its systemic absorption when applied topically. While minoxidil is primarily used as a topical treatment for hair loss, understanding its potential for systemic effects is important for assessing safety and potential side effects.

Potential Side Effects and Interactions

Like all medications, minoxidil can cause side effects and may interact with other drugs. What should users be aware of when considering minoxidil treatment?

Common Side Effects

Rossi et al. (2012) reviewed the use of minoxidil in dermatology, including its side effects. Common side effects of topical minoxidil can include scalp irritation, itching, and dryness. In rare cases, systemic effects such as changes in blood pressure may occur, particularly if excessive amounts are applied or if the user has a compromised skin barrier.

Drug Interactions

Interestingly, Goren et al. (2018) found that low-dose daily aspirin may reduce the efficacy of topical minoxidil in androgenetic alopecia patients. This highlights the importance of considering potential drug interactions, even with over-the-counter medications, when using minoxidil for hair loss treatment.

Comparing Minoxidil to Other Hair Loss Treatments

While minoxidil is a widely used and effective treatment for hair loss, it’s not the only option available. How does it compare to other treatments?

Finasteride

Finasteride, an oral medication that inhibits the conversion of testosterone to dihydrotestosterone (DHT), is another FDA-approved treatment for male pattern baldness. While both minoxidil and finasteride can be effective, they work through different mechanisms. Finasteride specifically targets the hormonal aspect of androgenetic alopecia, while minoxidil promotes hair growth through various pathways.

Combination Therapies

Some studies have explored the use of minoxidil in combination with other treatments. For example, combining minoxidil with finasteride or with low-level laser therapy may provide synergistic effects, potentially leading to better outcomes than either treatment alone.

Future Directions in Minoxidil Research

As our understanding of hair biology and the mechanisms of action of minoxidil continues to evolve, what new developments might we see in the future?

Novel Delivery Systems

Research into improved delivery systems for minoxidil is ongoing. This could include nanoparticle-based formulations or other technologies that enhance penetration and reduce systemic absorption, potentially improving efficacy and reducing side effects.

Personalized Treatment Approaches

Future research may focus on identifying genetic or physiological markers that predict responsiveness to minoxidil. This could lead to more personalized treatment approaches, allowing clinicians to better tailor hair loss treatments to individual patients.

In conclusion, minoxidil remains a cornerstone in the treatment of androgenetic alopecia, with a wealth of scientific evidence supporting its efficacy. Its multi-faceted mechanism of action, involving potassium channel activation, vascular effects, and direct stimulation of hair follicles, makes it a versatile option for many patients experiencing hair loss. As research continues, we may see even more refined and effective ways to harness the hair-growth promoting properties of this remarkable drug.

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 .