Does Topical Minoxidil Actually Work? - Doctor of Pharmacy Reviews
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- Опубликовано: 27 авг 2024
- In this educational video, I discuss the use of topical minoxidil for treating androgenic alopecia (male and female pattern hair loss).
I cover the following topics:
1. Why minoxidil may work for some individuals but not others based on genetic expression of the minoxidil sulfotransferase enzyme in the outer root sheath of the hair follicle. This enzyme catalyses the conversion of inactive minoxidil to active minoxidil sulphate.
2. The mechanism of action of topical minoxidil - simplified version.
3. The efficacy of topical minoxidil 2% and 5% solution and 5% foam in men and women with androgenic alopecia as per a large meta-analysis and systematic review of randomized control trials.
4. Common side effects from topical minoxidil, the cause of these side effects and which require medical attention.
5. A comparison of the foam vs liquid versions of topical minoxidil in terms of efficacy, side effects, cost and convenience.
6. Potential work-arounds for achieving efficacy in topical minoxidil non-responders - these data are from smaller, lower quality studies.
I have created this video based on the latest scientific research so that you can make an informed decision about whether topical minoxidil is right for you.
This video is not medical advice and is for informational purposes only. Please send all personal health inquiries to your healthcare provider.
Thanks and all the best,
Isaac
References
1. www.ncbi.nlm.n...
2. www.ncbi.nlm.n...
3. pubmed.ncbi.nl...
4. pubmed.ncbi.nl...
5. www.ncbi.nlm.n...
6. pdf.hres.ca/dp...
love the breakdown, very refreshing being able to hear a pharmacist's perspective on treatments/medications. It helps provide a much better picture when you hear a medical practitioner's perspective and other people that are highly informed yet not officially educated in the medicine such as derek(not hating at all). Keep up the good work, if have time you should delve into ADHD medications next such as Stimulants vs non stimulants. Differences in MOA and interactions with antidepressants.
A few other tidbits, that I wanted to include:
1. Topical minoxidil is extremely toxic to cats.
2. Topical minoxidil can be added to hair loss treatments that work through other mechanisms of action, such as five alpha reductase inhibitors, for improved efficacy.
3. Topical minoxidil may be effective for other types of hair loss as well, including alopecia, areata, and alopecia from chemotherapy.
4. The most recent evidence suggests that oral five alpha reductase inhibitors, like finasteride, and dutasteride as well as oral minoxidil are more effective than topical minoxidil for treating androgenic alopecia.
5. Topical minoxidil may interact with salicylates, such as low-dose aspirin. Salicylates made downregulate the sulfonyltransferase enzyme rending topical minoxidil less effective.
Thanks for watching!
Isaac
Your info is always partial it’s been proven that minoxidil does not actually need to be applied twice a day because of how long it stays in the body to get the same effect
amazing and very informative video. Keep up the good work. Thank you so much.
thanks, appreciate it!
Does it matter what brand of Minoxidil you use ?
Kx-826 currently seems to be not progressing very well, and perhaps we will continue to use finasteride and minoxidil to retain our hair in the next decade,Thank you for your informative video, doc
Many patients in our alopecia clinic prefer 5% topical minoxidil as part of their medication regimen.
Sup doc. .
Thats all thanks for the vid
Thank you for watching, appreciate it!
Any idea if Minoxidil can be used while having Scalp Micropigmentation procedure or can it be used alongside it?
You can get any one of these without a prescription.
i could listen to you say topical minoxidil for the rest of my life 😭
Idk why my comment didn't go through. Was wondering your opinion on microdosing topical finasteride ( starting with 0.005% per Mazzarella et. al. 1997 = 0.091 mg daily exposure) and then gradually going up to Caserini et. al. (2015) 0.25% solution (0.2275 mg daily exposure) which showed comparable scalp DHT reduction to 1mg oral fin with 3x less systemic DHT reduction.
Note: More interested in reducing the risk of sexual sides than actually saving my hair. Currently Norwood 2ish with some thinning on the side. Also I don't really buy the whole "small percentage" of people getting sides at this point.
Interesting. I believe that there is more evidence for topical finasteride nowadays. The only issue I have with topical finasteride is that there isn’t a standardized formulation. Topical finasteride is usually made on its own at a compounding pharmacy. There could be differences between formulations, there’s no way to ensure that the formulation that you’re applying is the same one that was used in the study. that aside, if you don’t feel comfortable, taking oral finasteride, topical finasteride is definitely a good alternative. And I would say that what you’re suggesting to do is reasonable. And if systemic DHT is suppressed at the very least you’re getting a good psychological benefit.
@isaacwadepharmd3969 Since roughly half of individuals lack the enzyme needed to convert Minoxidil to Minoxidil Sulfate, why isn't there a product to simply just apply Minoxidil Sulfate topically (so that everyone could benefit, even those without the needed enzyme to convert)?
Great question! It seems the main reason is that minoxidil sulfate is extremely unstable and degrades quickly. A minoxidil sulfate product would likely have a very short shelf-life. Another issue is that minoxidil sulfate is a bigger molecule compared to regular minoxidil and may have a harder time penetrating into the scalp to exert its effect. However, there seems to be some (low quality) clinical evidence for minoxidil sulfate 10% solution and it may be worth seeing if you can find a pharmacy that can compound the drug for you + a provider.that could prescribe it. Apparently minoxidil sulfate solution is relatively common in Brazil.
@@isaacwadepharmd3969MinoxidilMax if I’m not mistaken
Thoughts on microdosing topical finasteride? I'm considering using the 0.005% concentration as suggested by Mazarella et al. (1997) (equivalent 0.091mg daily exposure) and then working my way up to 0.25% (equivalent 0.2275mg daily exposure) (Caserini et. al (2015) showed comparable scalp DHT reduction with oral 1 mg fin but 3x less systemic DHT production reduction).
Note: I'm more interested for avoiding sexual sides than losing hair and don't really buy the "small percentage" of people getting sides statistic. Currently norwood 2ish with some thinning on one side of my head.
Interesting. I believe that there is more evidence for topical finasteride nowadays. The only issue I have with topical finasteride is that there isn’t a standardized formulation. Topical finasteride is usually made on its own at a compounding pharmacy. There could be differences between formulations, there’s no way to ensure that the formulation that you’re applying is the same one that was used in the study. that aside, if you don’t feel comfortable, taking oral finasteride, topical finasteride is definitely a good alternative. And I would say that what you’re suggesting to do is reasonable. And if systemic DHT is suppressed at the very least you’re getting a good psychological benefit.
@@isaacwadepharmd3969 I definitely agree that formulations especially from companies like Hims or Keeps (who add way too much fin) often vary. My bet is to just make my own solution with oral fin diluted with the vehicle of my choice (likely alcohol) and making sure to keep it away from any women. Rob English has a pretty good article about topical fin on his perfect hair health website which basically goes into more detail of what I noted and also a calculator on making topical fin which is useful. Additionally other youtubers like Haircafe and Let's Get Hair also made their own vids on making topical fin (Matt also goes into microdosing).
I guess the question then becomes how do I go about progressing? Should I start with my 0.091 daily exposure 1x a week and increase frequency until its basically everyday (as in the study), then move up a dose incrementally and increase frequency (rinse and repeat) until I get to 0.2275mg daily exposure as I suggested? My aim is to avoid PFS (whether real or not) with the least amount of fin exposure possible so if I ever feel symptoms like low libido, ED, watery semen, etc., I'll just drop it.
Also side note: forgot to mention I'm 24 with a Norwood 2. Also slight TMI, I've tried a Ketoconazole/Saw palmetto shampoo with a pumpkin seed oil conditioner which I think kinda killed my morning wood (no controls for other variables so not sure) but no ED thankfully. hence the apprehension with fin. I know you're not giving medical advice and I definitely will talk to my docs about things before I even begin this microdosing experiment but thought I'd get your thoughts if you'd like to share them. No biggie if not. Have a good day
Thanks for thé vidéo ! I use minoxidil since a year now with good résults until april/may of this year, i don't know why but m'y haïr get worse week After week since april even with thé minoxidil daily.. thiner but realy ...
I added finasteride 2 months ago, i Hope good résults cause i have a great shedding since weeks now 😅😂
But i don't understand, why minoxidil efficacy suddenly stopped in my case ? I mean, i Lost a lot of hair density in 3 months without any change in my routine
Not sure why it stopped in your case as everyone is different. There’s a good chance you will see some great improvements from oral finasteride after 3-6 months. Good luck! Isaac
Its effectiveness reaches its peak after 1-2 years of use and then deteriorates
Lol bro you just missed the new minoxidil booster that came out from Jupiter wellness🤣
What minoxidil booster? Lol
@@isaacwadepharmd3969 look up Jupiter wellness
@@isaacwadepharmd3969only things that I found to make you a responder are either pre coating the scalp with tretinoin or hydrocortisone cream .a lot of those telemedicine companies have that in their topical formulas
Say topical minoxidil one more time…
😅
well,lets hope i don't grow a moustache