What is Minoxidil and Why Do We Use It?
Anyone dealing with hair loss knows a thing or two about trial and error. Even the slightest first sign of a receding hairline, bald patch, or thinning can trigger a frantic search for solutions.
One of the first things to appear in the search results is Minoxidil, the main ingredient in the super popular Rogaine.
It might be the most widely-used hair loss product available, but does it deliver results?
Let’s find out exactly what Minoxidil is, how it’s meant to work, and what outcomes you can expect when adding it to your hair loss regimen.
How Minoxidil Works
While Minoxidil is far from a magical hair regrowth solution, it does have a great deal of legitimate science supporting it.
Classified as a vasodilator, the basic idea behind this drug is to increase the level of blood flow to the target area, thereby stimulating the hair follicle units and promoting growth. More specifically, the drug aims to lengthen the growth stage of the hair cycle, which is commonly thought to shorten with age and a rise in DHT levels. The theory is that if the growth cycle of the follicle unit is elongated, the user will see hair loss slow down and possibly reverse.
However, even experts in the area are uncertain exactly why Minoxidil is effective, and how the underlying mechanisms truly work.
Still, millions of men and women use this drug every year in hopes that they can combat hair loss and see a reversal in fortune.
Minoxidil’s Rise in Popularity
We’ve seen Minoxidil repackaged and marketed in many different ways over the years, but this is not a new drug. It was first introduced in the 1950s as a drug to treat ulcers, but tests showed it to have a better impact on hypertension and related conditions.
By 1963, the drug was named and branded by Michigan’s Upjohn Company, a small pharmaceutical manufacturer that later became part of Pfizer. During continued testing of the drug for high blood pressure, researchers observed a side effect of hair growth. This sparked interest from numerous scientists focused on the project, and a long legal battle ensued to determine patent rights to the formula.
For the next 20 years or so, scientists rigorously tested Minoxidil for its effects on hair regrowth and the prevention of hair loss. A big boost for the drug came when it was approved by the FDA in the 1990s, making it a more legitimate choice for hair restoration specialists and general physicians.
Now, it is the only topical solution approved for androgenetic hair loss, and that reputation carries it far in markets across the world.
With the seal of approval for both men and women, and made available in various formulas and dosages, Minoxidil stands alone as the definitive topical hair loss drug.
Who is Minoxidil For?
Anyone eager to hop aboard the Minoxidil train should know that it is meant to work for only a specific segment of hair loss cases. The medicine is strictly for individuals experiencing male or female pattern baldness as a result of hereditary conditions. That term specifically refers to androgenetic alopecia, which is responsible for more than half of balding cases in the population, for both men and women.
Studies show that Minoxidil is most effective for patients who are in the early stages of hair loss, ideally having experienced thinning and loss for five years or less. That means that long-term hair loss sufferers are unlikely to see the same degree of success with the drug as someone who detected the pattern early on.
There’s also a consensus in the hair-loss community that Minoxidil is most effective on the area to the rear of the vertex, commonly called the “bald spot” at the back of the head. While many users apply the medication to their hairlines, temples, and other parts of the frontal scalp, clinical trials show that growth in these areas is not nearly as likely.
Age does also play a factor here. Minoxidil works best for folks under 40 years of age and is most effective when the first signs of baldness occur.
How to Obtain and Apply Minoxidil
Since Minoxidil is considered generally safe and effective, it is typically available over the counter. In some countries, prescriptions may be required.
While the drug is easy to find and relatively cheap, men and women suffering from hair loss should always consult a physician before trying any new treatment. Not only are there health concerns with any new medication, but doctors may advise another approach to hair loss before they suggest Minoxidil. If you do get the green light from your doctor, make sure you follow the exact instructions and avoid overuse.
The topical solution is fairly quick and easy to apply.
- Thoroughly dry the hair and scalp prior to application.
- Gently rub the prescribed amount into the target area, starting at the center and moving outward to the edges.
- Allow the solution to dry naturally on the area for at least four hours before showering, going to bed, wearing a hat, or taking off clothes over the head.
- Do not blow-dry the area or use a fan to accelerate drying.
- Spend at least 20 seconds washing hands after application and ensure the liquid does not spill over to any clothes, furniture, towels, or bed sheets.
If you accidentally let some of the solution touch linens or clothes, immediately wash the items by themselves in the washing machine.
Only about 1 milliliter of the solution is necessary per application, and most doctors recommend applying twice a day, once in the morning and once in the evening. Do not double-dose if you miss an application. Simply skip the dose and resume use at the next designated time. Minoxidil will not have the prescribed effect if more solution is applied.
The key to applying Minoxidil is caution and care. The solution is not to be ingested or applied to any area other than the targeted area of hair loss.
Minoxidil Results
So we know who should take Minoxidil, as well as what it aims to do, but what results can someone with pattern baldness expect from use?
Many experts continue to reference the landmark trial that put the drug on the map back in 1987. In this study, 40 percent of the men tested showed moderate to dense regrowth on affected areas on the crown of the head. More trials have also been done over time, showing similar results.
According to a 2015 study from Dermatological Therapy titled “Clinical utility and validity of minoxidil response testing in androgenetic alopecia,” 62 percent of men saw hair regrowth in the span of 3 to 6 months.
These results are pretty consistent across the board for trials on male pattern balding, and positive outcomes are even more likely for men who make positive lifestyle changes as a part of their programs.
The research showed that results for women were also very promising. The trial saw that 60 percent of women who tested Minoxidil saw improved rates of hair growth, compared to the 40 percent in the placebo group.
Women tend to experience hair thinning along the middle part of their hair, rather than in a circular bald spot or a receding hairline. This aspect of androgenetic alopecia is considered to be more closely related to blood flow and its effects on the hair cycles, which means that women can see great results from Minoxidil.
Some doctors also say that age has less of an impact on the results of Minoxidil for women, suggesting that they can achieve meaningful results from the drug even if they are over 40 years old.
It is rare to see the immediate effects of Minoxidil, as consistent applications are necessary to let the medicine act over time on the scalp.
If hair loss continues after two weeks of use, you should stop the regimen and seek alternatives. It’s entirely possible that Minoxidil is simply not an effective treatment for some men and women, which is why guidance from a hair loss expert is especially important.
Possible Side Effects of Minoxidil
Just like any other medical treatment, you’ll want to closely monitor the status of your hair, as well as your overall health, while taking Minoxidil daily. While the side effects of this drug are not very common, they can be serious if you go overboard with dosing or simply have a natural adverse reaction to the compounds. The most widely reported side effect of Minoxidil is continued itching or skin rash in the affected area.
Upon application, it is typical to experience a bit of a sunburn sensation or some tingling. As long as you follow the prescribed dose amount, this is generally nothing to worry about if you experience this. If you experience irritation like this for more than a week or two, you will want to contact your doctor and consider changing course.
In some rare cases, the side effects of Minoxidil can be more severe, and give a clear signal to the user that they should stop the application immediately.
Since the drug was originally designed for the purposes of treating hypertension and high blood pressure, it is especially important for users with these underlying conditions to seek consultation with a doctor before using Minoxidil, as well as during use.
Stopping Minoxidil Use
As previously stated, Minoxidil is not for everyone, and if you aren’t getting the results you want from the medication, it’s probably smart to discontinue use.
You will know if the medication is effective within less than four months of the first application, provided you are sticking closely to the prescribed usage. Unless you are highly satisfied with your progress, there is no real reason to keep applying daily and hoping for better outcomes. It is not a wise use of time, money, and effort.
If you and your specialist do decide it’s time to discontinue Minoxidil, there are some things you should keep in mind.
First, it takes less than three months after stopping Minoxidil to see hair return to its previous state. That means that any progress made on Minoxidil, whether it be reduced loss rate, increased thickness, or growth, will be reversed. This does not necessarily mean that hair loss will occur at a faster rate than usual after the medication stops working, just that patients should expect a return to normal.
Since maintaining the benefits of Minoxidil means using it for life, some patients are discouraged from continued use. Even if you are skeptical about lifetime use of the drug, physicians often suggest that you try it for three months and see if you like the results, especially if you are a good candidate for use.
If and when you do decide to stop using Minoxidil, there are a few things you can do that may help you hold on to some of those gains.
The first is essential oils, which help to maintain a healthy scalp while strengthening the roots of the follicles, in some cases. Since Minoxidil works to boost the strength of existing hair on the scalp, oils such as lavender, peppermint, or tea tree can help to support that strength.
Healthy changes are also highly recommended when coming off Minoxidil if you haven’t yet already made them. Healthier eating, lower stress, and a good exercise regimen can ensure that strong blood flow continues to the scalp.
Minoxidil as Part of a Hair Restoration Regimen
While many men and women can see satisfactory results from Minoxidil use alone, hair restoration specialists often suggest using the drug as a part of a broader strategy to stop hair loss and stimulate regrowth.
The drug most commonly paired with Minoxidil is a 5-alpha reductase inhibitor known as Finasteride. This oral medication is prescribed to target and reduce DHT levels in the scalp, which are thought to be the main contributor to pattern baldness.
Since DHT is a derivative of the male sex hormone testosterone, doctors do not prescribe Finasteride to women. Luckily, women tend to still benefit from Minoxidil alone, so additional medication is rarely necessary for them to see good results.
Minoxidil is also commonly prescribed by doctors who perform hair transplants such as Follicular Unit Strip Surgery of Follicular Unit Excision.
In these procedures, healthy follicles are harvested from a donor area, typically on the back of the neck or the side of the head, and grafted on to the top of the crown or hairline where most patients have suffered losses.
Although hair transplants cost more upfront and require more planning than picking up a couple medications, hair restoration surgeries are known for giving patients impressive transformations, and have a high satisfaction rate.
As these new grafts take root on the scalp, Minoxidil can be very effective to ensure that the follicles remain strong and further hair loss, namely on the vertex. It is important to wait until the affected area is completely healed and that the grafted hair has fully taken root before applying Minoxidil. Patients recovering from hair transplant surgery will be advised by their doctors in the post-op stage as to when they can start topical treatment.
Since the recipient area of the scalp is particularly sensitive in the weeks and months following hair transplant surgery, patients using Minoxidil need to keep a very close eye on their progress with the drug. Side effects of Minoxidil such as acne, swelling, and headache tend to be more common during the surgical recovery phase because of the increased permeability of the skin cells on the scalp.
Conclusion
If you haven’t yet considered Minoxidil and you are experiencing thinning hair on the top of the crown, this is definitely a medication to consider.
Once again, the drug is most effective for younger people who are noticing the first signs of balding, so these tend to be the best candidates for Minoxidil.
With that said, Minoxidil has occasionally shown results for patients outside of this particular group, and considering the low-risk factor of the drug, it is worth trying if you meet the requirements to be a good candidate.
While many people choose to purchase Minoxidil in stores or online, it is always recommended that people suffering from hair loss connect with a medical professional before using it.
A hair restoration expert will give you a thorough explanation of your hair loss and allow you to make more intelligent, informed decisions about the best way to handle it. Only a licensed physician can give you the best insight on hair loss and provide you with the best-recommended game plan.
If you are interested in seeing hundreds of detailed Minoxidil case studies and learning more about this medication in general, be sure to check out our blog, the Daily Journal of Hair Loss Information. Also, sign up for our email newsletter if you want to receive updates about our clinic and the many hair restoration services we offer!
Sources:
https://www.healthline.com/health/does-rogaine-work
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691938/
https://www.mayoclinic.org/drugs-supplements/minoxidil-topical-route/description/drg-20068750
