Have small oral doses of minoxidil been revealed as a solution for moderate hair loss? Discovering a cure for one of the most difficult medical problems in the world will surely have many men in their thirties and fourties storming through the doors of their medical hair restoration clinics to request minoxidil right away?

Minoxidil is not a well-kept secret though. It is an old, inexpensive drug best known by the brand name Rogaine and has been accessible since the late 1980’s. The drawback of minoxidil is that it lacks the support of the pharmaceutical industry; therefore there are no TV advertisements or other forms of direct-to-consumer advertising. While it is known about in the broader public, it is not as widely known as it could be. But there’s no doubt that the hair loss community is aware of it.

Among those of us who care for people with hair loss, it’s a medication we frequently use and have been for a very long time. Over the past ten to fifteen years, doctors have become more aware of the risk versus benefit debate, with the danger being the potential negative cardiovascular and other effects of taking minoxidil orally versus the benefit of hair growth. If given in sufficient doses (25-100mg daily), it would cause hair to grow everywhere on persons who took the oral form for cardiac issues. If you administer lesser doses of up to 2.5 to five milligrams daily, you can significantly increase hair regeneration while maintaining good safety levels. As a result, we are utilizing it more regularly and have grown accustomed to it. If anything has been revealed, it is not that this increases hair growth, but rather that it is a safe product to use.

Patient 1 before Minoxidil Patient 1 after Minoxidil 3 months

Minoxidil is an effective treatment for hair loss and it works for a variety of hair loss concerns. According to the best data we have, minoxidil performs better when taken orally than when applied topically, and it is comparable to or even superior to many other treatments. The efficacy claims are supported by both clinical experience and the published evidence. The ironic thing about minoxidil is that, despite growing hair, we still don’t fully understand how or why. We can point to other medications that we have that have a particular mechanism of action for promoting hair growth. With minoxidil, some speculate that it may have an effect on the vascular system of the hair as well as the hair cell cycle. There are other alternative hypotheses, but they haven’t quite been tested the way some of the other drugs have.

Response to treatment with minoxidil varies from person to person and not all patients can tolerate the drug. While taking the medicine, some patients may experience palpitations, oedema in their lower extremities, dizziness or light-headedness. Other patients, especially women, may experience hair growth that is excessive where it is not desired and subpar where it is desired. Therefore, the effect this drug has on your scalp may or may not be worth it if you’re a woman taking it and you suddenly notice you’re sprouting hair on your chin.

We utilize an enormous number of pharmaceuticals off-label as doctors, and the drugs we use off-label the most frequently are older ones like minoxidil. These medicines have been used for a very long time. The pharmaceutical industry has little interest in conducting randomized controlled trials, which are typically how we obtain medications for indicated treatments. A non-industry financed clinical trial that might provide precise statistics and information for patients attempting to make judgments about this would be fantastic if it were funded by the NIH or a comparable institution.

However, the lack of data does not imply that the medicine does not function. There is a ton of observational data. Those of us who care for individuals with hair loss concerns have undoubtedly witnessed numerous success stories. However, we are constrained in that we cannot provide you with precise statistics, risk-benefit ratios, or other data of the sort. Hair loss has been generally dismissed as a cosmetic issue.

In contrast, hair loss has a significant impact on your mental health and your ability to decide how you want to present yourself to others in this world, whether you have experienced it yourself or know someone who has. Things don’t always need to be life or death to be valuable.

Having a consultation and assessment with your hair restoration doctor will determine whether or not minoxidil is a suitable treatment option. When beginning minoxidil therapy or using any other systemic hair loss medication, there are generally two things to keep in mind. The first is that the sooner you begin the better. The second is that preventing hair loss goes hand in hand with promoting hair growth. When you start using minoxidil, you have a little bit more grace since it helps you grow new hair and enhances the quality of the hair you already have. Therefore, it’s best to address your concerns regarding hair loss sooner rather than later.

However, you are trading off the fact that these are not antibiotic-like treatments that you take for a two-week period. Only when you take them do they function. They will either grow new hair or keep the hair you already have. The new hair you have grown will shed if you stop taking your meds. It doesn’t make things worse for you or cause more hair loss. But you can’t be careless. You must feel very strongly about your commitment. Additionally, it takes between six and nine months before you begin to notice a significant difference. These medications work slowly. Early is preferable if you’re prepared to make the commitment, but even if it takes some time to get there or if you’re a little late seeing the doctor, you might still benefit.

The challenge in treating hair loss all boils down to the science. The molecular mechanisms, inflammatory mechanisms, hormone effects, and stem cells involved in follicular biology have all been the subject of extensive research. We take for granted the thousands of hairs that cover our bodies. However, each one is a unique organ system with its own stem cells, immune system, cholesterol coating, and other components that help your hair know when to begin growing and what colour it will be.

We don’t even give it a second thought because it’s just a routine part of our lives whether we shave our faces every day or cut our hair every month. Hair, however, is a remarkably complicated organ with its own set of laws and workings. People have been working on this and progressing, and they are aware of the fundamentals of biology. But there isn’t just one easy thing you can stop doing or one easy thing you can do to remedy it. Many of these issues appear insurmountable, but one day we will have an extremely successful, widespread, and effective treatment—even more so than minoxidil—that will feel like an overnight success despite taking 40 years to develop.

Source: https://nymag.com/intelligencer/2022/09/is-minoxidil-really-a-miracle-cure-for-baldness.html