Prescription Strength Minoxidil
Custom-Blended 5% Minoxidil
Formulations:
Since 1979 Dr. Panagotacos has been prescribing prescription-strength
minoxidil formulations for himself and for selected patients.
Over the years he has developed a series of minoxidil formulations
containing additional medications designed to further enhance
the hair restoration effects of minoxidil. The additional medications
include retinoic acid, betametazone valerate, and 5 alpha reductase
inhibitors such as finasteride. The topical medications are custom
formulated for patients for personally seen and evaluated by Dr.
Panagotacos.
What it is | Benefits
| Risks | Variations |
Candidates |Treatment
What Minoxidil Is
Minoxidil (Rogaine): Minoxidil is the only medication approved
by the FDA to stimulate the regrowth of hair for those men and
women who have a hereditary tendency for pattern baldness or hair
loss. Minoxidil was first approved as a prescription medication
for treating high blood pressure conditions (and is sold as tablets
for that purpose under the Loniten brand name). Minoxidil is now
also sold as a scalp lotion under the brand name Rogaine. Rogaine
topical lotion is 2% and also 5% minoxidil in a solution of water,
alcohol, and propylene glycol.
What it Does: Minoxidil topical lotion only seems to
work on active hair follicles still capable of producing some
hair. For those with pattern hair loss, minoxidil seems to reduce
the rate of hair follicle miniaturization, and can reverse the
transformation of terminal follicles that produce full-size
hairs into vellus follicles that only grow "peach fuzz".
With minoxidil treatment, the miniature vellus follicles enlarge
back to their full size. The re-enlarged follicles begin to
grow wider and more pigmented hairs. Also, the enlarged follicles
seem to remain in the anagen, or growth stage for a longer period.
A longer growth period results in the production of longer hairs,
and a look of more hair.
Results Vary: For some people minoxidil seems to have
no effect at all. For others there is reduced rate of hair loss,
but no visible new hair growth. Some men and women experience
minimal new hair growth, but not enough to cover thin hair areas.
Those who have a moderate response to minoxidil treatment have
new hair growth partially covering their thin areas, but those
areas are still easily seen as being less dense than other area
without hair loss. The people who respond best to minioxidil
enjoy dense new hair growth, with areas that had previously
been thin now having hair density similar to areas that were
not affected by hair loss.
How it Works: When taken by mouth in tablet form, minoxidil
reduces blood pressure by relaxing and dilating blood vessels.
Scientists are not exactly sure how minoxidil helps to regrow
hair. Other vasodilator medications do not grow hair.
Side Effect: Hair growth was discovered as a side effect
of minoxidil treatment for high blood pressure. When minoxidil
is taken in high doses by mouth, it occasionally promotes hair
growth on various parts of the body, and not just the scalp.
In 1988, after years of additional studies to determine its
effectiveness as a topical lotion, minoxidil became the first
medication approved by the FDA for treating hair loss.
Now Available Without a Prescription: As a hair growth
treatment, minoxidil is applied as a lotion on the scalp two
times each day. This method of administering the drug causes
the hair-growing effect to be on the scalp only, and not on
other parts of the body. There is no effect on blood pressure
when applied as directed. In 1995 the US FDA declared that minoxidil
in a 2% topical lotion form no longer required a prescription
from a Medical Doctor for purchase in the US.
Benefits of Minoxidil
It Works: Clinical
studies were run during which some men and women with pattern
hair loss applied Rogaine topical lotion to their scalps, and
others with pattern hair loss applied the same mixture of water,
alcohol, and propylene glycol used in Rogaine lotion, but without
the minoxidil (a placebo). The men and women selected for the
study had thin hair or baldness on the top of their heads, where
minoxidil is most effective at promoting hair regrowth. The effectiveness
of the minoxidil treatment was compared to the placebo lotion.
The results of clinical studies involving thousands of men and
women have shown Rogaine topical lotion is able to cause statistically
significant increases in hair regrowth.
Get it Back: Minoxidil treatment for hair loss can
help people to stop hair loss and regrow their own hair. When
the treatment is effective, there is nothing to hide, or fall
off.
Safe: Minoxidil is safe. When used as directed in lotion
form applied to the scalp, only very small amounts of minoxidil
reach the blood. The risk of serious side effects is very small.
Gradual Change: Even when the response to minoxidil
is very good, the hair regrowth occurs over several months.
The new hair growth does not attract unwanted attention, and
no one has to know about it.
Transplants: Minoxidil can be used by hair transplant
patients. Many surgeons recommend using it within a few weeks
after surgery to promote the growth of the transplanted hair
follicles. Minoxidil may also help reduce the tendency for micro
grafts to temporarily enter the telogen, or rest phase, immediately
after being transplanted. Dr. Panagotacos likes
to have transplant patients use 5% Minoxidil for at least six
months after the surgical procedure.
Risks and Disadvantages of Minoxidil
Limited effectiveness:
Minoxidil treatment does not work on everybody with thinning hair
due to inherited pattern hair loss. It is less effective for hair
loss at the hairline than on the top of the head. It is less effective
on large bald spots than small ones. It is less effective on small
bald spots than on diffuse thin areas. It is less effective on
long-established baldness than recent hair loss.
Continuous use Required: Minoxidil treatment is not
a permanent cure. It must be applied twice-daily for as long
as the newly regrown hairs are desired to be retained. It requires
commitment. Those treating their hair loss with minoxidil have
to think about treating their hair loss every day.
Fear of stopping: Skipping a day or two occasionally
is not likely to cause any measurable difference in the effectiveness
of minoxidil treatment. However, after several months of discontinued
use, the regrown hairs are likely to be shed. Also, the hairs
that would have been shed if the minoxidil had not prevented
follicle miniaturization will also be lost as those follicles
begin to shrink. So both regrown hairs and hairs that would
have otherwise been lost if not for the minoxidil use may be
shed within just a few months after discontinuing use of minoxidil.
Delayed Results: Minoxidil takes time to produce results.
When 2% minoxidil lotion is used twice daily, it takes months
to produce only a gradual change in appearance. More months
are usually required before the maximum benefit can be realized.
Scalp Irritation: In clinical studies involving 6,000
men and women about 7% of those using Rogaine lotion experienced
some degree of scalp Itching, inflammation, dryness, or flaking.
Lotion on the Scalp: Although Rogaine topical lotion
is a colorless, odorless, and non-greasy liquid that dries quickly
and without any visible residue, some people simply do not like
putting lotions on their scalp.
Minoxidil Variations
Minoxidil With Betamethazone Valerate: Betamethazone
valerate is a cortisone medication that helps to prevent scalp
inflammation. In addition to reducing possible scalp irritation,
it may also enhance the hair restoration effect of minoxidil
in two ways: First, it helps block the metabolism of testosterone
in the cells of the hair follicle where the hormone signal to
"stop producing new hairs" takes place. Blocking this
signal may keep more hairs growing. Second, betamethazone valerate
helps to disperse the white blood cells that are called up to
push the hair shaft out of the hair follicle. This may keep
more hairs in place longer. Dr. Panagotacos has published this
information on his Website since 1993. A study done in 2001
demonstrated increased hair density in one year of use.
Minoxidil With Tretinoin (Retin-A): Tretinoin is a
prescription acne medication applied to the skin, and is also
famous for helping to reduce facial wrinkles. Minoxidil lotion
applied with low concentrations of tretinoin has been show to
promote greater hair growth, and possibly faster results, than
minoxidil used alone. Tretinoin may increase the absorption
of minoxidil through the skin, as well as having additional
hair growth promoting effects. In addition to the risks and
advantages of minoxidil use, tretinoin adds additional risk
of skin irritation and inflammation. These studies were done
in the early 1980's.
Minoxidil With finasteride: Finasteride is another
medication that demonstrates significant hair restoration effects.
Combining finasteride with minoxidil
can produce better hair restoration results than using either
medication alone.
Other Additives:
Other medications are progesterone derivatives, and spironolactone-like compounds.
Minoxidil Candidates
Try It: People
respond differently to minoxidil. For some people with pattern
hair loss it works very well, and for others there seem to be
no results at all. The only sure way to determine if minoxidil
will be effective is to try it twice-daily for at least 4 months.
For Best Results: Those likely to achieve the best
results are in the early stages of pattern hair loss. On average,
younger people get better results than older people. Those with
thinning or baldness on the top of their heads generally get
better results than those with hair loss at the hairline. People
with diffuse hair loss, especially women, tend to get better
results than those with clear bald spots. Those with smaller
bald spots usually show more regrowth than those with large
bald spots.
Minoxidil Treatment Described
Easy to Use: Rogaine
topical lotion is easy to use, and only takes a few minutes each
day for application. It is applied to a clean and dry scalp twice
each day using a dropper or sponge applicator.
In the Morning: The first application is usually done
in the morning, after shampooing and towel drying. The lotion
is applied directly to the scalp, and not to the hair.
Results: It takes about 4 months of twice-daily treatment
before initial results are noticeable, if at all. Initial results
can include less hair shedding and some new hair growth. The
newly regrown hairs may be finer and substantially less pigmented
than other full size hairs, however many of these hairs will
enlarge and darken as they grow out. The results may improve
over the next several months with continuous twice-daily use.
After about 12 months of minoxidil use, the maximum benefit
is usually achieved, and hair regrowth tends to stabilize.
What if I stop? If minoxidil treatment is discontinued
for several months, the regrown hairs will probably be shed,
and hair loss will resume.
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