What Is Minoxidil?
Most of you look up minoxidil on the internet to find out how effective this medication is to treat hair fall but minoxidil was introduced to the world first as a medication to treat hypertensive patients or high blood pressure patients and was found to be quite effective. And till date, many doctors still prescribe the oral form of minoxidil to patients with high blood pressure. Once minoxidil was tested on as an antihypertensive medication, researchers found out that a common adverse event or a reaction to this was hypertrichosis. This means that there was excessive growth anywhere on the body in men and women. It was this discovery that led researchers to dig deep into minoxidil and how it works in treating alopecia or hair fall.
It was only in 1987 that scientists were assured that topical or externally applied minoxidil is suitable for treating hair loss in men and women. Studies have also shown that minoxidil hair regrowth treatments are more than 60% effective in treating little advanced stages of hair loss that are up to stages 4-5, provided you also maintain a healthy lifestyle and keep a check on the diet.
To date, minoxidil in the form of topical application is the main treatment to treat pattern hair loss and off-label used in treating other hair loss disorders like Alopecia Areata, for beard enhancement, chemotherapy-induced hair loss, eyebrow enhancement, loose anagen hair syndrome and telogen effluvium.
Minoxidil As FDA-Approved Treatment For Androgenetic Alopecia
Apart from Finasteride, also called Propecia, Minoxidil is the other drug that has been approved by the Food and Drug Administration (FDA) to treat hair loss in males. Some brands also combine both Minoxidil and Finasteride together to treat hair fall more effectively.
Androgenetic alopecia also called pattern hair loss is a hair loss condition where hair falls out in a particular pattern. This pattern is different when it comes to males and females. Hair loss occurs as a receding hairline in men gradually as the stage progresses in men while females experience more and more scalp visibility and not a receding hairline. The main reason behind this hair fall is a genetic aspect, where a genetic sensitivity to the hormone DHT - dihydrotestosterone is seen. But this genetic sensitivity is triggered by severe stress, lack of sleep, nutritional deficiencies, and many other factors.
Minoxidil is most effective when hair loss is treated at the early stages. Stages 1-4 are when hair loss is still at its prime and the follicles are still active. This is why treating the internal factor behind hair fall, maintaining a healthy diet, and regular application of minoxidil can easily regrow hair within a span of 5-6 months. Once the hair loss starts progressing beyond stage 5, then even minoxidil cannot help to regrow hair. At this point, since the follicles are more or less sealed and not active at all, only severe surgical treatments like Platelet Rich Plasma Therapy or a Hair Transplant can only bring back new regrowth.
Factors That Trigger DHT And Cause Androgenetic Alopecia
Lack Of Sleep
The Circadian cycle also called the sleep-wake cycle plays an important role in hair health. This is why sleep is of utmost importance when it comes to literally any organ activity. Irregular sleeping patterns also aggravate stress and cause hair thinning. A hormone called melatonin is released during sleep which is also essential for the smooth functioning of the hair cycle. This also works against DHT - the main hormone responsible for hair fall which causes DHT to unbind from the hair follicle receptors. Lastly, if melatonin is not produced in equal amounts due to not getting proper 8 hours of sleep, this can hamper the cycle and cause hair thinning in men.
Low Energy Levels
The body's ability to convert the food we eat to energy is what determines how much or how less energy we have. This is called metabolism. A good metabolism is required for the body to break down nutrients from food and supply them through the blood to the follicles. If the metabolism is slow that means most of the body's energy is being utilized to break down nutrients and supply them to other parts of the body other than hair. This is when hair gets neglected and causes DHT to carry out its regular activity of causing hair thinning in men.
Hair needs food too. Biotin, iron, zinc, etc as in all macro and micronutrients are required by the hair for it to grow in an ideal manner. This means that when any of these nutrients fall short in the body, it aggravates the hormone DHT and the excess of it has a negative effect on the hair strands and reflects as hair thinning along with looking dull, and lifeless.
How Does Minoxidil Work To Regrow Hair?
Here’s how minoxidil helps in hair regrowth. Unlike Finasteride which is a DHT blocker, minoxidil works like a vasodilator. This means it increases the diameter of the blood vessel and pushes oxygen and nutrient-rich blood flow through the blood vessels that then reach the hair follicles. This helps to increase the diameter of hair follicles and promotes thicker and stronger regrowth than before. Topical minoxidil when applied directly to the head in the form of a spray, foam, or even a solution, gets converted to a salt form with the help of the scalp enzyme called sulfotransferase. This salt form is then known as minoxidil sulfate. This works by speeding up the telogen phase or hair shedding phase of the hair cycle and prolongs the next incoming phase which is anagen or the active hair follicle growing phase. One can also note that since minoxidil does not cross the blood-brain barrier (BBB). Apart from this, 95% of minoxidil is also filtered out through a person’s kidney within a span of 4 days. It is however recommended to use minoxidil religiously for 8-10 weeks or one might not notice any difference in regrowth.
How Is Minoxidil Available?
Since minoxidil is a common medication prescribed for hair regrowth treatment, it is easily available in the market. Topical solutions of minoxidil are available in either 2% concentrations or 5% concentrations. 2% is generally given for women’s application while 5% minoxidil is prescribed to men. This topical minoxidil is available under the brand names Rogaine or Theroxidil as well. Apart from the regular topical minoxidil solution, minoxidil is also available as a foam booster, a spray solution, and even oral medication. In a study conducted in 2019, minoxidil solution was compared to minoxidil foam. It was seen that the foam minoxidil had easier penetration of minoxidil and increased the delivery of the active ingredient. It was also observed that this also helped to reduce irritation to the scalp.
How To Use Minoxidil?
Using topical minoxidil is not as tough as you think it is. It is simply like how you use a serum. You have to basically clean and dry the scalp area or hairline that is experiencing this hair loss, before applying the topical minoxidil solution. Always fill the solution to the indicator up to the mark of 1 mL of the line or simply use 20 drops. Part your hair when the scalp or rather hairline is affected with no growth. Apply the solution and use your fingertips to gently rub the solution over a wider area. Now allow the solution to dry up and absorb into the scalp. Make sure to never use a gel or any kind of hair mask or mousse immediately after applying minoxidil.
Minoxidil foam application is very easy to apply. First, wash your hands thoroughly with water and make sure to dry them well. Then apply around half a cap of the foam to the scalp area or hairline where you need regrowth to take place and using the fingertips again gently rub it in circles. Now, allow the foam to dry up and absorb before using any other products or before directly jumping into bed. Also make sure to avoid applying minoxidil to the scalp on the days you have colored or chemically treated your hair, even as basic as a perm. This is because sometimes combining the application may cause scalp irritation and can give you a rash.
What Do You Need To Know Before Using Minoxidil?
Most people start off by using minoxidil expecting their hairline and hair to regrow magically in a span of 1 week but that’s not true at all. So if you’re someone newly trying to use minoxidil, mind you, it won’t help to regrow hair in a week, and in fact, nothing can. Every hair strand has a life cycle of 4 phases including anagen or the actively growing phase, catagen or the transition phase, telogen the resting phase, where the hair comes out of the follicle and is still resting on the scalp waiting for a trigger so that it falls off, and lastly the exogen or the final shedding phase. Let’s look at each individual phase to make it less complicated.
- Growth Phase: About 90% of the hair on the scalp is in the active growth phase of the hair cycle. In this phase, the hair acquires all the necessary nutrients from the blood supply with the help of the dermal papilla region of the follicle for it to actively grow. In a month, a hair strand is said to grow 1 cm in length. This entire phase lasts between 4-7 years.
- Transition Phase: Hair now starts to transition from an actively growing phase to a resting phase. Here is when hair detaches from the follicle and the blood supply is cut off. This phase is considered the shortest of all phases as it lasts anywhere between 3-4 months.
- Resting Phase: 8-10% of the hair on the scalp falls under this phase. After it has been detached from the follicle in the last phase, it is literally just hanging on the head and waiting for an external factor as simple as combing your hair for it to fall off.
- Shedding Phase: Here the hair falls off completely from the follicle. However, the follicle is still not empty. By this time, hair follicle regrowth takes place when a new hair begins to actively regrow in the same follicle where the previous strand fell off. This is why in ideal conditions, you always have a head full of hair.
This entire hair cycle together takes months, when the hair grows, falls off and new hair replaces it. As mentioned above, minoxidil works by speeding the telogen phase of the weak hair follicles which makes hair fall out faster. This is why most people who start using minoxidil tend to notice hair fall within a few weeks of application and discontinue the use of minoxidil but rather than stopping the use of minoxidil, one must still continue to use it despite the hair shedding. This is because after speeding up the telogen phase of the hair, minoxidil also brings in new and thicker hair growth and increases the growth period of the hair strand.
The other thing is that just like medication for diabetes, cholesterol is to be consumed for a lifetime. In a similar way, minoxidil has been FDA-approved and is safe for long-time application. But again, many individuals abruptly stop using minoxidil after seeing hair regrowth, especially on the frontal hairline. Stopping minoxidil suddenly will cause hair strands and the cycle to back into a similar phase thus reversing the minoxidil effect. This will then allow DHT to take control of the hair follicles and shrink it again.
If you wish to stop using minoxidil, it has to be done gradually and not all at once. And in its place, use something else to help increase the blood flow. You can try using daily head massages or yoga with asanas that increase blood flow to the head and scalp. Alternatively, within a few months after the hair grows back, you can also switch to natural alternatives like redensyl, capixyl, and procapil to promote nutrient-rich blood flow to the hair follicles. For example, if you are someone who’s already using minoxidil and is now satisfied with the regrowth and wishes to stop, here’s what you can do. Since you apply 1mL minoxidil twice a day, what you could do is alternate with the serum which means instead of twice, you can apply minoxidil once a day and the second time of the application use an alternating serum. This is how you could slowly reduce the frequency of minoxidil to the point where you now use a serum instead of minoxidil for both times of the application.
Can Minoxidil Alone Regrow The Hairline?
The answer is a strong and big no. Because minoxidil alone cannot treat the underlying cause behind your hair fall. What truly helps is an overall and holistic treatment that fixes the internal cause behind hair fall. Sure minoxidil is FDA-approved to treat hair fall effectively in men and women but it is only 50% active by itself. To tackle hair loss holistically you need to do the following:
- Healthy Diet: One simple way to level up your hairline regrowth is by consuming a well-balanced and highly nutritious diet on a daily basis. Make sure to have one heavy meal a day that contains a majority of essential macro and micronutrients. The main ones include biotin, iron, zinc, folate, and all the vitamins necessary for hair. In case of deficiencies, be sure to take supplements along with a well-balanced diet.
- Treating The Root Cause Of Your Hair Loss: If you actually have hair loss at the hairline or balding, it would be best if you take a look at what’s causing it. Stress could be a major factor involved in hair thinning that affects hair density too. Other factors include lack of sleep, nutrient deficiencies, hormonal imbalance conditions like PCOS, Thyroid, and Diabetes; gut issues like chronic acidity, bloating, indigestion, constipation, and more.
- Be Consistent With A Treatment: Maintaining a healthy diet, exercising, and applying minoxidil just for a month won’t help. You have to be regular and consistently follow a strict and healthy lifestyle, if you wish to see the desired results and for minoxidil to effectively do its job.
Side Effects Of Using Minoxidil
One of the common side effects of minoxidil is experiencing itchiness, dry scalp, and sometimes rashes after minoxidil application. If you notice this sensitivity, immediately stop using minoxidil and speak to an expert doctor for advice. Uncommon side effects may or may not occur as well but these include, unexpected weight gain, swelling in the hands, shortness of breath, increased heart rate, chest pain, and light-headedness.
One must not be applying or consuming minoxidil if they are hypersensitive and can catch allergies easily, if they’re already taking prescribed medicines for blood pressure, if they’re taking vitamins, have a previous condition with the heart, kidney, liver, or any other scalp disease. And most importantly, if they are pregnant or breastfeeding. In all these cases, it’s best to avoid minoxidil and consult a doctor first before using minoxidil for regrowth.
Q1 - How Does Minoxidil Help Hair Regrowth?
Ans - Minoxidil works like a vasodilator. This means it increases the diameter of the blood vessel and pushes oxygen and nutrient-rich blood flow through the blood vessels that then reach the hair follicles. This helps to increase the diameter of hair follicles and promotes thicker and stronger regrowth than before.
Q2 - Is Minoxidil Effective For Hair Regrowth?
Ans - Minoxidil is an FDA-approved treatment for hair regrowth. This helps to reverse the shrinking effect of DHT and regrow thicker and stronger hair. However, minoxidil alone will not suffice, you have to maintain a healthy diet, exercise, and treat the internal root cause behind your hair fall.
Q3 - Does Minoxidil Work For Hair Regrowth?
Ans - This works by speeding up the telogen phase or hair shedding phase of the hair cycle and prolongs the next incoming phase which is anagen or the active hair follicle growing phase. One can also note that since minoxidil does not cross the blood-brain barrier (BBB).