Does Minoxidil really work? This is a question that many people ask, especially those looking for a solution to androgenetic alopecia. Although the answer may seem obvious, given that Minoxidil is one of the main stimulators of hair follicle growth , approved along with finasteride by the Food & Drug Administration (FDA) as an official therapy, it is important to delve deeper into some aspects.
Despite its proven effectiveness, the question “Does Minoxidil work?” continues to arise frequently among those suffering from baldness. That is why Andro Genetic has prepared a complete guide that explores all the main features of this treatment, to clarify doubts and offer an in-depth analysis.
Historical Notes on Minoxidil
The history of Minoxidil begins in the late 1970s, when it was developed by the American pharmaceutical company Upjohn Company . Initially created as a drug to treat hypertension, its beneficial effect on hair growth was later discovered. In 1999 , Upjohn merged with another company, becoming part of the Pharmacia Merger group . Subsequently, in 2003 , the pharmaceutical giant Pfizer acquired the entire group, further consolidating the presence of Minoxidil as one of the main treatments for baldness.
Initially, Minoxidil was used as an antihypertensive drug. Thanks to its powerful vasodilatory properties , it was able to reduce blood pressure and was administered orally under the trade name of Loniten . However, many patients reported an interesting side effect: episodes of hypertrichosis and hair regrowth. This led to considering its possible use for the treatment of alopecia .
However, oral administration of the drug in subjects without hypertension caused serious side effects . It was therefore decided to try a topical application, directly on the scalp, to reduce systemic absorption and the associated risks.
Several studies conducted since the early 1980s confirmed the effectiveness of topical Minoxidil in stimulating hair regrowth. Over time, the use of Minoxidil for the treatment of hypertension lost relevance, as more effective drugs were introduced for this purpose.
Today, Minoxidil is much more well-known for its use in hair regrowth than as a drug for high blood pressure. You could say, then, that it works better for hair than for blood pressure! Andro Genetic provides all the up-to-date information on this amazing treatment.
Minoxidil: How Does It Work?
As one of the very few FDA-approved medications for the treatment of hair loss, it is clear that Minoxidil works . Its effectiveness has been proven through numerous studies and has been confirmed by millions of users worldwide for over 30 years .
Initially , it was thought that the beneficial effects of Minoxidil on hair and fur were due exclusively to its vasodilatory properties. This action is linked to its ability to open intracellular potassium channels present in the smooth muscle cells of the peripheral arterial system. This effect is common to several hypotensive drugs, which are powerful but often accompanied by numerous side effects. As already mentioned, Minoxidil was initially developed as a drug to lower blood pressure.
The vasodilatory effect, with increased blood circulation, explains why oral intake of Minoxidil caused hypertrichosis and hirsutism in patients. A 1992 study showed that, even when applied topically as a lotion or foam, Minoxidil opens potassium channels, relaxing vascular smooth muscle and allowing more blood to flow to the hair follicles in the area of application. This directly stimulates the dermal papilla and matrix, keeping the entire follicle healthy.
However, Minoxidil ‘s effectiveness in promoting hair growth is not only due to increased blood circulation. Other more modern and powerful vasodilators have no effect on hair regrowth. So, why does Minoxidil work?
Its mechanism of action involves the regulation of the biological cycles of the hair, prolonging the Anagen growth phase and minimizing the passive Telogen and Catagen phases . This was explained in a study published in the Journal of Dermatological Science in June 2011. By stimulating the production of Beta-Catenin in the follicular dermal papilla, Minoxidil synchronizes the hair cycle, forcing the Anagen phase , in which the hair grows and increases in diameter.
The vasodilatory action also contributes, providing more nourishment to the follicle which remains active in Anagen , but it is not the main factor in regrowth.
What is Induced Fall?
Precisely because of this cycle synchronization effect, the so-called induced hair loss may appear at the beginning of therapy . This phenomenon occurs approximately one month after the beginning of treatment and can last up to the third month. During this period, the hair that is in the Telogen and Catagen phases falls out to be replaced by new hair in the Anagen phase .
Don’t worry if you notice a worsening of hair loss during the first months of treatment: this is a normal and temporary phase. Avoid panicking and do not stop applications abruptly, as sudden interruptions can compromise the results.
Suspension of treatment
It is common to find in the main industry forums, both Italian and international, warnings regarding the importance of paying attention when deciding to permanently suspend Minoxidil or to interrupt the treatment for long periods .
Sometimes you may come across desperate requests for help from people who have carelessly made the “insane act” of stopping the use of Minoxidil and find themselves having to deal with uncontrolled hair loss.
If you want to stop or quit Minoxidil , it is certainly possible, but it is essential to follow certain methodologies to avoid unpleasant surprises.
To learn more about this topic, I refer you to the article in which I explain how to stop taking Minoxidil WITHOUT experiencing a major breakout.
Minoxidil 2 or 5%?
There are commercially available formulations with concentrations of both 2% and 5% , and many wonder which percentage is more effective in treating male pattern baldness.
A clear answer to this question is provided by the study published in 1984 in the Journal of the American Academy of Dermatology .
The study involved a sample of 393 people affected by androgenetic alopecia, divided into three groups for a period of 48 weeks :
- 157 people used 5% minoxidil applied twice daily.
- 158 people used 2% minoxidil in the same way.
- 78 people received a placebo , again in two daily applications.
Efficacy was assessed by examining a specific area of the scalp and periodically monitoring progress in terms of hair count and speed of response. At the end of 48 weeks , the group using 5% minoxidil showed 45% more hair regrowth than the 2% group , with significantly faster response times to therapy.
It is important to note, however, that the 5% group had a higher incidence of irritation and itching, probably due to the greater amount of glycol needed to stabilize the solution. Despite this, the drug was well tolerated, with virtually no systemic absorption effects.
Today, 2% minoxidil is recommended for women and men in the early stages of androgenetic alopecia, while 5% minoxidil is recommended for more advanced cases. There are also preparations with higher concentrations, up to 15% . However, in addition to not being approved by the FDA for the treatment of androgenetic alopecia, they have not shown significantly better results than 5% , accompanied by a higher incidence of side effects.
Existing Formats
To date, the formulations available on the market are the following:
- Industrial lotion : this is the most traditional format, consisting of liquid preparations that use propylene glycol as a carrier and preservative.
- Minoxidil foam or foam : this is a spray foam format that simplifies and speeds up the application, particularly useful for those with very thin or shaved hair. However, for those with a good hair density, it can be quite uncomfortable. An important feature of the foam version is the absence of glycol, making it ideal for those who cannot tolerate this carrier. Among the most popular brands we find Rogaine Foam and Kirkland Foam , easily found in the main online stores.
- Galenic preparations are made by specialized pharmacies on the instructions of the prescribing physician. These preparations may also include additional compounds, such as antiandrogens and hydrocortisone , and, above all, allow for the production of minoxidil free of propylene glycol , a carrier that can cause irritation on sensitive skin. It is important to note that a medical prescription is required for this type of preparation , as previously indicated.
Minoxidil Price: How Much Does It Cost and Where to Buy It?
As you can imagine, until 2015, the 5% formulation of minoxidil was a prescription drug and , consequently, in Italy it was available exclusively in pharmacies .
Today, however, industrial preparations can also be purchased on online sites such as eBay, where the most readily available brands are Rogaine , from the Johnson & Johnson group, and Kirkland .
While in Italian physical pharmacies it is easier to find Minoximen from the Menarini group , Aloxidil from IDI Farmaceutici , Biorga or Carexidil , the prices are significantly less competitive than in the aforementioned online stores.
However, progress continues and today the most important traditional pharmacies are organized and have real e-commerce , where it is possible, comfortably from home, to obtain significant savings compared to standard prices.
Minoxidil How to Use?
As mentioned above, if you still have a good amount of hair, it is advisable to use lotions , since the pipette allows you to apply the product directly to the scalp, avoiding excessive waste on the hair itself. On the contrary, foam is more suitable for those with very short or shaved hair.
The amount of product to use depends on the size of the area to be treated; therefore, do not get stuck on the classic milliliter. For example, to cover the entire head, especially now that I have a good amount of hair, I use about 3 ml for adequate coverage.
Standard therapy involves two daily applications: one in the morning and one in the evening. This is because minoxidil has a half-life of about 6 hours , thus ensuring more uniform coverage throughout the day. Furthermore, all studies were conducted taking into account these two applications.
However, many trichologists at SiTri , including Dr. Paolo Gigli, who treats me, believe that even a single daily application may be sufficient. In fact, the therapy I have been following since July 2014 involves applying the 5% minoxidil lotion only in the evening, and the results are evident.
Some factors to consider when applying minoxidil:
- Dry Skin : It should be applied to dry skin, as moist skin may increase systemic absorption, increasing the likelihood of side effects.
- Affected areas : The application should be carried out exclusively in the areas affected by baldness, since, due to its hair growth stimulating properties, application in healthy areas could cause the appearance of unwanted hair.
- Avoid waste : It is advisable to apply it directly to the scalp as much as possible. The dropper pipes usually provided are very useful for this purpose. Of course, if you wet your hair, nothing serious will happen, but you will simply have wasted some of this expensive lotion.
Does Minoxidil Work? When Can You See the First Results?
As with finasteride , consistency in application and patience in waiting for results are essential in minoxidil therapy. Unlike Propecia , where you just take a pill every morning, I can confirm that applying the lotion daily can become stressful. However, consistency is essential to avoid problems related to withdrawal.
Also, don’t get anxious when, after the first 3-4 weeks , the induced shedding period begins, as explained above. In the following two months, you may notice a further worsening.
It is important to wait at least 6 months to evaluate the first results; within a couple of years you will reach the maximum peak to be maintained by continuing the treatment. For an accurate evaluation, it is always advisable to contact a competent doctor who can monitor your progress scientifically.
Can it be used to thicken the beard?
Although this approach is still considered experimental and supported by a limited number of scientific studies , it seems that, in some circumstances, the use of this active ingredient may prove effective in making beard hair thicker .
Minoxidil: Contraindications
Contraindications are mainly related to the characteristics of the antihypertensive drug and the composition of the topical preparation :
- Hypersensitivity to the components : Intolerance or allergy to the active ingredient is generally rare, while it is more common to find irritation due to the propylene glycol present in industrial preparations, used to transport the active ingredient into the first layers under the skin. If hypersensitivity to the glycol occurs, it is advisable to suspend treatment and opt for galenic preparations that use other carriers (such as trascutol ).
- Subjects with heart disease, hypertension and arrhythmias : Since minoxidil can cause a drop in blood pressure , its use in patients with these problems must be carefully evaluated by a doctor .
- Pregnancy and breastfeeding : Although the 2% formulation can be prescribed to women for other types of alopecia, it is advisable to avoid its use during these periods.
Minoxidil: Side Effects
In general, the use of topical minoxidil at the officially approved percentages for androgenetic alopecia does not cause problems with systemic absorption , making side effects extremely rare and attributable to those listed in the contraindications section.
It is important to stop treatment if the following occurs:
- Chest pain , irregular heartbeat, weakness or dizziness .
- Sudden water retention or swelling in the hands and/or feet.
- Redness and irritation of the scalp with the appearance of dermatitis .
- Unwanted hair growth if you are not precise with the application.
Minoxidil: Prescription Needed or Not?
Until 2015 , in Italy minoxidil was considered a cosmetic for concentration percentages lower than 5% and did not require a medical prescription . However, for the 5% formulation , which has proven to be more effective for androgenetic alopecia , a prescription issued by a doctor was required.
Currently, even industrial preparations of 5 % minoxidil , although classified as Class C drugs (at the citizen’s expense), can be purchased without a prescription.
However, the obligation to prescribe on a white prescription remains in case it is necessary to obtain a galenic preparation from the pharmacy, with different dosages or excipients.
To the initial question of this article, that is, whether minoxidil works in the treatment of androgenetic alopecia, we can certainly answer that after finasteride it is the most important weapon currently at our disposal and undoubtedly gives a boost in the growth of miniaturized hair recovered from the anti-DHT action of propecia and similar, allowing us to attack baldness on multiple fronts .