A few simples tests should be able to determine the cause if these are the symptoms you're experiencing. Currently, there are two medications, minoxidil Rogaine and finasteride Proscar, Propecia , that are used to treat male pattern baldness. They are both considered safe for use at your age. Minoxidil is a topical treatment that is applied directly to the scalp and works by promoting hair growth and thickness.
It needs to be used twice daily for at least three to six months before you'll notice anything. However, hair begins to shed less within a couple of months of treatment and by four to eight months, new hair growth should be apparent. This treatment seems to work best in certain circumstances: when hair loss has been present for less than five years, when the hair loss is mostly from the crown of the head and when the area that lost hair is less than 10 centimetres in diameter.
The main side effect of minoxidil is possible irritation to the scalp. If you have a history of heart disease, check with your doctor prior to starting this medication. You can buy it over the counter in lower concentration formulas, but a doctor can prescribe higher concentrations that may be more effective. Finasteride is a medication that was discovered while researching a treatment for enlarged prostate glands.
Laser Doppler velocimetry revealed that minoxidil may have vascular effects. Furthermore, a recent study by Yum et al demonstrated that topical minoxidil induced hypoxia-inducible factoralpha, which VEGF induction is dependent. Minoxidil also stimulated prostaglandin E 2 production by activating prostaglandin endoperoxide synthase-1 23 but inhibited prostacyclin production.
Moreover, it has been used as an off-label medication to treat several hair disorders such as alopecia areata AA , scarring alopecia, and hair shaft disorders as well as to improve body hair growth in other areas including the eyebrows and beard Table 1.
AGA is a non-scarring alopecia in which terminal hairs transform into miniaturized hairs. Typically in men, baldness occurs with frontal recession and vertex thinning, 26 while in women, hair loss is characterized by a decrease in hair density over the crown without frontal hairline involvement, also known as female pattern hair loss FPHL.
A meta-analysis showed that topical minoxidil at all concentrations provided superior results to those achieved in the placebo group. Regarding AGA, the study showed mean differences of 8. Numerous clinical trials were conducted with topical minoxidil at several concentrations in different preparations to test the efficacy of the formulation. Abbreviations: MS, minoxidil solution; MF, minoxidil foam. The higher occurrence of contact dermatitis with MS led to the development of PG-free foam formulations to treat hair loss.
Although there are limited data on teratogenicity, no serious adverse outcomes have been reported. As a safety measure, minoxidil should be avoided during pregnancy and lactation.
The treatment response to topical minoxidil in AGA patients can be predicted by measuring sulfotransferase activity in plucked hair follicles. This finding suggests that those who respond to minoxidil will not develop resistance to the existing dosage and, similarly, non-responsive patients will not turn into responders.
There has been an increase in the use of a novel formula, minoxidil sulfate-based solution MXS since it is an active metabolite of minoxidil. It has been proven that MXS has a higher efficacy than that of the conventional formula and might be an option for patients with low minoxidil sulfotransferase activity.
Side effects were tolerable irritation, erythema, and folliculitis. A combination of low-dose minoxidil 2. The mean severity score reduced to 2. Mild adverse effects including urticaria, postural hypotension, and facial hypertrichosis were reported. No significant change in blood pressure was observed in the study. AA is an autoimmune disease of the hair follicles with a clinical presentation ranges from patchy non-scarring alopecia to complete scalp alopecia totalis and body alopecia universalis hair loss.
Minoxidil is occasionally used off-label as monotherapy or in combination with other treatments. Minoxidil was initially tested in patients with AA, but there was a lack of satisfactory efficacy data. Hair growth was detected earlier and became denser at the treated site, but slight to no effects were observed in patients with extensive AA.
Only mild side effects of minoxidil were reported with no evidence of systemic effects. Histologic studies on the effect of minoxidil in AA demonstrated a decrease in perifollicular infiltration in respondents. Collectively, many studies have suggested that topical minoxidil offered some benefits to AA patients as it slightly increased hair growth without altering disease progression or inducing remission.
Thus, it has been recommended as an adjuvant therapy for AA. The use of oral minoxidil 5 mg twice daily in 65 recalcitrant AA patients was studied. The medication was relatively tolerable with 2 g of strict sodium intake.
Systemic symptoms of sodium and water retention developed in patients who did not adhere to the sodium restriction protocol. Other side effects included headache, palpitation, and facial hypertrichosis. Telogen effluvium is a common non-scarring alopecia characterized by excessive telogen hair shedding triggered by stressful events such as pregnancy, a major illness, and surgery. Chronic telogen effluvium CTE is defined as hair loss persisting over 6 months.
There have been limited clinical trials on topical minoxidil use to treat telogen effluvium. However, oral minoxidil may be a promising treatment option. Recently, a retrospective review was conducted among 36 female patients with CTE treated daily with oral minoxidil at doses ranging from 0.
Marked reduction in hair shedding was observed at 6 and 12 months. Some patients demonstrated mild facial hypertrichosis, dizziness, and altered blood pressure as adverse events.
In scarring alopecia, medical treatment should be initiated as early as possible. The aim of the treatment is to preserve the remaining hair follicles and halt disease progression. It usually presents with hair loss on the vertex and spreads toward the periphery. However, a decrease in disease severity score in some patients might suggest that the medication can slow the course of the condition. Topical minoxidil has been used to treat frontal fibrosing alopecia FFA , a scaring alopecia condition affecting the frontal and temporal hairlines.
The characteristic feature of being non-scarring and reversible in the initial stages of the condition may benefit from minoxidil use. Hair loss is one of the common side effects of chemotherapy. The medication was used throughout and for up to 4 months after chemotherapy treatment. Low-dose oral minoxidil 1 mg once daily might be a potential treatment for permanent chemotherapy-induced alopecia PCIA.
A patient diagnosed with acute myeloid leukemia who had PCIA for 16 months showed an increase in hair growth at 6 weeks. Significant hair regrowth with re-emerged anagen follicles and decreased miniaturization was demonstrated histologically following 2 years of treatment.
Minoxidil has been used to treat monilethrix, a rare autosomal dominant hair disorder manifested as fragile hair shafts with a regular beaded appearance. The effect seen might be due to anagen phase prolongation. No adverse effects were noted. Oral minoxidil had been used in many cases of hair shaft disorders as topical minoxidil application may worsen hair shaft brittleness.
Promising results were seen in one case with reduced hair shedding, lengthened hair, and initial significant improvement in hair density in the 3rd and 6th month.
Improvement in the hair condition was maintained with the same dosage after 18 to 24 months. No adverse event was observed. She received oral minoxidil 0. Topical minoxidil has been employed to stimulate hair growth on eyebrows and beard growth Table 4. Eyebrows serve an important role as periocular landmarks on the face.
Eyebrow hypotrichosis is a condition comprising a reduction in eyebrow density and a lack of growth. Eyebrow density and diameter also increased significantly. Statistical differences in both subjective and objective assessment were noticed from week 8 to Beard hair is a collection of hair on the chin that frames the facial appearance and symbolizes masculinity.
Compared to placebo, minoxidil was superior in enhancing beard growth, with only mild adverse effects. Topical minoxidil has been considered safe; however, some patients experienced side effects after application. The most common side effect of MS is irritant contact dermatitis with the typical symptoms of itching and scaling. Allergic contact dermatitis can also occur because of PG or minoxidil itself. A patch test should be performed to determine the causative agents.
Although an allergic reaction to minoxidil could occur, it is infrequent. Minoxidil is the only drug which is FDA-approved to treat female pattern baldness. It works by prolonging the growth phase of the hair follicles, Yang says. In most women, minoxidil slows down or stops hair loss. And in up to a quarter of the women who take it, minoxidil can actually encourage new hair to grow. Try the Hair Loss Prevention Diet.
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