Understanding Minoxidil: Insights from a Trichologist's Perspective
As a trichologist, delving into the complex world of hair treatments, Oral Minoxidil emerges as a prominent agent in combating various forms of hair loss. Its evolution from an unexpected discovery to a household name in hair regrowth is a testament to its efficacy, although with certain nuances that demand understanding and caution.
The Genesis: Unveiling Minoxidil's Journey
In the 1950s-60s, Minoxidil's journey began with an unlikely purpose—researchers exploring treatments for ulcers stumbled upon a fascinating side effect. During clinical trials, it was noted for its ability to induce excessive hair growth (hypertrichosis) due to its vasodilatory properties.
The 1980s witnessed its official debut as "Rogaine," a topical solution, gaining FDA approval as one of the pioneering medications for hair loss. Over the years, it expanded its formulations, catering to both men and women. Fast forward to 2022, the New York Times’ coverage intensified its demand, especially oral minoxidil, for its cost-effectiveness in fostering new hair growth.
Understanding Minoxidil's Functionality
The exact mechanism behind Minoxidil's action isn't fully understood. However, it's believed to extend the anagen or growth phase of hair follicles while enhancing scalp blood flow, facilitating hair regrowth. Note that we are born with a definite amount of hair follicles so while we can not grow new hair, we can definitely help hairs that are not growing for a long enough period of time or that are sitting dormant.
Suitability and Applications of Minoxidil
Minoxidil finds its strength in addressing ongoing hair loss conditions such as Androgenetic Alopecia, Alopecia Areata, and certain scarring hair loss conditions. However, it's less effective for temporary hair loss issues like Telogen Effluvium, which typically resolve without the need for prescription medications. This is why obtaining an accurate diagnosis of your hair loss is a crucial step in finding the right solution for you.
Topical Minoxidil: Utilization and Variations
Minoxidil exists in various topical forms like foams, sprays, and solutions, differing in effectiveness based on their compound agents. Over-the-counter availability and varied concentrations provide choices but don't equate higher concentration with better results. For usage, following manufacturer's instructions or professional guidance is most important. In recent studies, with the data that is available, topical minoxidil 5% solution used twice daily will yield better results than used once a day and even better than using 5% foam once a day.
Side effects in topical application include burning, itching, dandruff, and redness in the affected area. Success rates are often low due to discontinuation by users. It is common to experience a minoxidil induced shedding 6 weeks after using the product topically but do not discontinue the product. It takes at the very least 3 months to see progress. I always say that hair growth is like watching grass grow or paint dry, so give it some time.
Oral Minoxidil: A Deeper Dive
While the oral form offers cost-effectiveness, its prescription-only nature demands caution. Dosages range considerably from 0.25-5mg for hair loss treatment, but it's accompanied by a spectrum of potential side effects, including fluid retention, palpitations, and facial swelling and fluid retention around the eyes, and hypertrichosis. Some women have stated that they begin to grow excess hair on the face. At times, reducing the dosage of Minoxidil has proven to relieve potential side effects. Its also important to note that side effects can occur at any time after starting oral Minoxidil.
With oral minoxidil there was a 24 week long study that proved 1mg yields better results than 0.25mg but we do not have any data after that time frame and dosage range. I have seen prescriptions going up to 5mg so the dosage is very important and can impact one’s potential for side effects and results. We don’t have any studies that discuss the combination of using multiple hair loss treatments at the same time like using Spironolactone or Finasteride while also taking oral minoxidil. We also do not know the long term results of using these types of medications which is crucial as these treatments are meant to be life long as long as someone wants to maintain and prevent their hair loss.
Men tend to exhibit better results, while women, particularly those intending to conceive or during pregnancy, are advised against its use due to associated risks.
Understanding Safety and Research Insights
Studies highlight the safety profile of low-dose oral minoxidil, emphasizing infrequent systemic adverse effects leading to treatment discontinuation in a minority of cases. However, a cautious approach and close monitoring is really key in the safety of using this treatment.
Final Thoughts
As a trichologist, my advice is to use caution and consideration. Minoxidil isn't a quick fix but rather a stimulant that necessitates patience as does any hair loss protocol. Understanding its limitations, potential side effects, and individual suitability is crucial before beginning any treatment. I would consider if this medication is suitable depending on your hair loss diagnosis and speak to a professional if there are other options for treatment to entertain or try beforehand.
Remember, the journey to combat hair loss involves multifaceted approaches and lifestyle changes. Consultation with a dermatologist specializing in hair loss or a trichologist is key.
In conclusion, Minoxidil serves as a valuable tool in the arsenal against hair loss, but its usage demands informed decisions, patience, and photo documentation of its effectiveness to decide if it is suitable for long term use.
References:
Safety of low-dose oral minoxidil for hair loss: A multicenter study of 1404 patients
Adverse effects of low-dose oral minoxidil for androgenetic alopecia in 435 patients
