Originally a treatment for hypertension, today Minoxidil is marketed as a hair loss treatment. The most well-known brand Minoxidil product is called Rogaine. It’s alleged to be medically proven in treating hair loss in both men and women.
When testosterone interacts with the enzyme, 5-alpha-reductase, it creates Dihydrotestosterone (DHT). This hormone runs rampant throughout the body. When it contacts with androgen receptors in the scalp, it causes the hair and follicles to shrink. This leads to the pattern baldness most commonly found in men.
Available in drug stores in two concentrations, 2% and 5%, minoxidil is probably the most common treatment for hair loss. It’s also available in a much higher concentration of 12.5% from some hair loss clinics.
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But does it actually work?
100% of patients showed some hair regrowth, although this peaked at 12 months
The first clinical trial on the effect of topical minoxidil on hair loss was carried out in 1987 at Stanford University. The effects of 2 – 3% topical minoxidil was studied on 72 male patients with androgenic alopecia (AGA). The study lasted for 30 months, but 13 patients dropped out during the first year. In the first four months, 100% of patients showed some hair regrowth, although this peaked at 12 months. 70% of patients who applied Minoxidil to their scalps for the full 30 months had 50% more hairs than when they started the trial. A small subset of patients even managed to sustain increases in hair regrowth after 12 months.
In a disappointing turn of events, hair regrowth had returned to baseline levels by week 104.
A clinical trial carried out over 48 weeks in 2002 on 393 men with AGA concluded that 5% topical minoxidil was more effective than 2% in regrowing hair. A similar trial in 2004 carried out on 381 women reached a similar conclusion on the higher concentration.
In 2003, a trial by Pfizer lasting 16 weeks was carried out on 352 male patients. Half received 5% Minoxidil foam, while half received a placebo. Neither group knew what they were receiving, nor in fact did the researchers. The results showed a significant statistical difference in hair regrowth between the groups. The 5% minoxidil group returned 21.0 hairs/cm² after week 16, while the placebo group returned 4.3 hairs/cm² in the same duration.
More recently a 2016 clinical trial evaluated the effects of 5% Minoxidil foam on frontotemporal and vertex AGA in men over 104 weeks. The most significant hair regrowth was found during assessments between weeks 52 and 76. In a disappointing turn of events, hair regrowth had returned to baseline levels by week 104.
These trials seem to show that minoxidil works for more AGA patients than not. Further, the higher the concentrations the greater the hair regrowth. Minoxidil only continues to work while it is still being applied, peaking at one year’s use with a slow decline in regrowth after that. A 5-year follow-up of 31 minoxidil patients in 1990 reached this conclusion. Further, as a 2015 review suggested, cosmetically acceptable results are only achieved by a small subset of patients.
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