II. Indications
-
Androgenetic Alopecia
- Most effective for vertex balding (than in frontal area), and effects are delayed 6-12 months
- Consider in combination with oral Finasteride for greater efficacy
III. Medications
- Regular Strength 2% solution
- Similar efficacy to 5% solution in Androgenetic Alopecia
- Extra Strength 5% solution or foam
- Indicated as adjunct in Alopecia Areata
- Higher Incidence of facial Hypertrichosis
- Consider 5% foam when solution causes excessive greasy feeling to hair
IV. Mechanism
-
Minoxidil is originally an Antihypertensive agent when used systemically
- Found to promote Hair Growth as an adverse effect
- Increases Hair Shaft epithelial cell growth
- Potentiated by Retin A
- Direct effect on Hair Follicle
- Activates Hair Follicles in Catagen
- Extends Anagen duration
- Expands Hair Follicles
- Decreases hair shedding
V. Dosing
- Expect initial hair shedding on starting (may take 6 months of consistent use to see results)
- Apply twice daily to dry scalp
- Spray 6 times (1 ml) or
- Dropper bottle
- Wipe away excess runoff
- Prevents systemic absorption from thin skinned regions of the face/neck
- Wash hands carefully after applying
- Reduces risk of spread to face and Hypertrichosis
VI. Advantages
- Appropriate for both men and women
- Modestly effective
- Most effective for vertex baldness
- Vertex baldness under 5 years
- Hair Loss under 10 cm (4 inch) diameter
VII. Disadvantages
- Less effective for frontal Hair Loss
- New hair lost when treatment discontinued
VIII. Adverse effects
-
Hypertrichosis (excessive facial hair)
- Resolves by one year even if Minoxidil continued
- Bleach more evident darker hairs
- Pruritus of scalp
- Allergic or Irritant Contact Dermatitis (usually to propylene glycol)
- Compounding pharmacist can use alternative base