a problam with minoxidy

[PieceOfMeat]

I bought minoxidy today and i read on the directions that it's forbbiden to use it on a tan scalp. So the question is how should i use it in the summer?

[RCWest]

There's no problem using it on a tan scalp, just not a sunburned scalp.

[PieceOfMeat]

Thnx.

And by the way, why do you use the oral minoxidy?

[RCWest]

Thnx.

And by the way, why do you use the oral minoxidy?

 

I use oral minoxidil because it works way better than topical, plus it's a lot easier to take a pill than it is to apply it to your scalp twice a day.

[Magneto]

I use oral minoxidil because it works way better than topical, plus it's a lot easier to take a pill than it is to apply it to your scalp twice a day.

since when oral minoxidil should be used for hairloss ? i thought it shouldnt unless there are studies that allow it and i am not familiar about

[RCWest]

since when oral minoxidil should be used for hairloss ? i thought it shouldnt unless there are studies that allow it and i am not familiar about

 

Dr. Pathomvanich has prescribed oral minoxidil in his practice for hair loss for 20 years. Here is what he wrote in a different post.

 

 

 

Thanks for allowing me to share my experience for the use of Oral Minoxidil in the treatment of Androgenic Alopecia.

 

Minoxidil is a peripheral vasodilator used officially as an antihypertensive. It occurs as a white crystalline powder and is soluble in alcohol, propylene glycol and slightly soluble in water.

 

The chemical name is 2, 4, - pyrimidine-diamine, 6-(1- piperidinyl), 3-oxide with molecular wt. 209.25.

 

More than 90% of drug is absorbed from gastrointestinal tract, reaching the maximum plasma level within first hour and declining rapidly thereafter. The average half-life in humans is 4.2 hours. Approximately 90% is metabolized predominantly in Liver by conjugation with glucuronic acid, with some by conversion to more polar products. All metabolites are excreted in urine.

 

Minoxidil is a direct acting peripheral vasodilator capable of reducing both elevated systolic and diastolic blood pressure. It does not interfere with the vasomotor reflux and is therefore unlikely to produce orthostatic hypotension. The primary use is for the treatment of hypertension.

 

Dosage is usually 2.5 to 100 mg per day as a single dose for adults.

 

The side effect is salt and water retention, with swelling of hands and feet, face, lower legs; rapid weight gain can occur.

 

Cardiovascular effects including chest pain, hypotension, and fast and irregular heart beat are possible effects. Hypertrichiosis without virilism as elongation, thickening and increased pigmentation of fine body hair are seen in about 80% of users, developing within 3-6 weeks after starting the therapy. Hypertrichosis is usually first noticed on the temples, glabella, forehead or along the sideburns. Later it may extend to a back, arms, legs, and scalp. Upon discontinuation of minoxidil the growth of new hair is arrested, but 1- 6 months may be required to resume pretreatment appearance. No endocrine abnormalities have been found to explain to this abnormal hair growth.

 

Other effects like thrombocytopenia, nausea, vomiting are uncommon. Breast tenderness occurs in less than 1%. Allergic rashes, blurred vision; flushing of the skin; headache; decreased sexual desire or impotence; numbness or tingling in the hands, feet or face have all been reported.

 

Contraindication

Minoxidil should not be used in Pheochromocytoma or those who are sensitive to the components of the preparations. It may produce pericardial effusion and occasional tamponade. Angina pectoris may be exacerbated. Full details of the drug usage and side effects may be found in the PDR.

 

Minoxidil may pass from mother to the child through breast milk. Therefore, women who are pregnant and breast feeding should not use minoxidil.

 

When I started my private practice 20 years ago, I have seen a large number of patients who were taking oral minoxidil other than minoxidil lotion from other physicians and some patients even took on their own. I was entirely against taking oral minoxidil since it is not approved by the FDA and encouraged those patients to change to minoxidil lotion only, in fear of the side effects from oral minoxidil. After many years of practice, I have realized the remarkable effect on hair growth from oral minoxidil compared with the lotion. In many patients the result has changed from minimal hair over the scalp i.e. miniaturized hair to the cosmetic fullness of hair i.e. more terminal hair growth over both the front and the crown areas. Some have responded only at the crown but not at the front; also, there were patients who did not respond other than hypertrichosis. I have a few patients, whom I turned them down for hair transplantation surgery since they were poor candidates’ i.e. poor donor and severe degree of hair loss. One of them took oral minoxidil on his own and I was amazed when he returned to see me in four months, his temples hair was full with moderate hair growth at the crown but not at the front and made him a candidate for hair transplantation. Please see the attached photograph below. I did two sessions of hair transplant surgery on him and he was happy with the final results.

 

I prescribed oral minoxidil for hair loss treatment in less than 1% of patients in my practice over past 20 years. These are those hopeless patients who have the hair loss problem with no response from finasteride, dutasteride and minoxidil lotion but the patient wants to have some treatment option to treat the hair loss. I use it with caution, since there is no study regarding the dosage and safety in treating androgenic alopecia.

I do not prescribe this medicine to patients who are known to have cardiovascular disease, history of deranged blood pressure, liver and kidney dysfunction.

 

What is the optimal dose of oral minoxidil for the hair growth with minimal side effects?

 

I have learned from other physicians, who have prescribed minoxidil extensively to treat androgenic alopecia and was informed that 5 mg daily was enough to stimulate the hair growth without any effect on blood pressure and heart rate. One of my patients, who took oral minoxidil tablet and lives close by the clinic, came to the clinic twice a day for blood pressure monitoring for one month and all the reading were within the normal limits of his baseline; therefore, I am no longer monitoring the blood pressure as often as I did in the past. I have been using 5 mg daily for years and in some patient taken a low dose such as 2.5 mg tab per day or 5mg every other day still reported significant hair growth and stopped the hair loss to his satisfaction.

 

The most common side effect in my practice was puffy eyelids, leg swelling. Similar to any other forms of hair growth product, the gain hair will shed in 3-4 months on stopping the pill. This oral form should not be used in women due to hypertrichosis, it may persist in cases even on discontinuing the drug.

 

All of my patients were informed that the US FDA did not approve the use of oral minoxidil for hair growth and they have to take at their own risk, after understanding the risk and complications of the drug. I believe all the drug have side effects whether they are finasteride, dutasteride, spironolactone or dianee (for female hair loss). The long term treatment with oral minoxidil has more benefit than the chances of over said side effects at the low dose 2.5 - 5 mg once daily needs to be further studied. I advise the patient once the hair loss has stopped and experienced hair gained to stop oral minoxidil and switch back to minoxidil lotion for the long term maintenance usage. However, most of the patients did not want to switch to minoxidil lotion since there was no side effect noted. In some patient who switched to minoxidil lotion reported progressive hair loss.

 

I did not prescribe the diuretic as a routine since most of patients who experience water retention, refused to continue with this drug. Publications from Upjohn explicitly stated that a diuretic "must be" taken in conjunction with Loniten in most cases. The rationale is that while Loniten lowers blood pressure, your body's defense mechanism will automatically return your blood pressure to the original elevated level. Your body accomplishes that by retaining water and salt so that there will be more fluid to pump throughout the body. So in order for Loniten to be safe to consume, it is necessary to use a diuretic medication to remove excess water and salt from your body. Spironolactone is a natural choice for most hair loss sufferers since not only is Spironolactone a diuretic, it is also a potent anti-androgen.

 

In conclusion, only few percentage of the bald population in the world approaches the hair restoration clinics for the solution for hair loss. Of these there are many people who have marked social and emotional impact of hair loss in their lives thus, affecting their psychology. Most of these patients are very well benefited by the treatments like topical minoxidil, oral finasteride and the currently available artistic hair transplant surgeries offered by the clinics.

 

However there are number of patients, who are poor candidates for the hair transplant as they have poor donor area i.e. small donor area, thinning over donor area or have poor quality (more miniaturization at donor site) with large area of baldness NW-Class VII and searching for any possible hope that might improve their hair loss. These patients need to be emphasize regarding the side effects of oral minoxidil and with no FDA approval for hair loss indication. If patient consent's for this treatment, we propose to these terminal hair loss but high hoping patient that they might get benefit from opting to the oral minoxidil as the last sort of therapy till further new drug is available.

 

Best regards,

D. Pathomvanich MD FACS

[Sigildark]

Isn't taking oral minoxidil how they actually realized that it assisted with hair growth thereby spawning the topical solution? Downside must be a higher risk of sides as it is systemic and not local. Upside, higher effectiveness? any idea by how much?

 

RCWest, would love to see pictures of the impact that your regimen has on you. Really stacking all the odds in your favor in respect to proven methodologies. Guess you would have done that already if you were so inclined 8)

Edited May 17, 2011 by Sigildark

[rws]

I'm raving about oral minoxidil at the moment as I've had such noticeable results in just three months - it's not only given the hair at my crown a real boost, but the hairs in the frontal region are now fuller and thicker, giving a much thicker cosmetic appearance overall - and fine hairs that looked to be on the way out are now beginning to thicken up and sprout out.

 

I had a 1500 FUE session in February, and I think the oral minoxidil has also helped stimulate growth of the grafts post-shedding.

 

Of course it needs to be used with extreme caution, as all drugs do - but I'm only on a small dose (2.5mg twice a day) and I've noticed no side-effects at all, apart from increased hair growth in the beard, around the eyebrows and on the body (although this isn't unacceptably excessive by any measure).

[wb280]

rws, RC west, i am abt to embark on the oral minox journey and i really need u guys to shed more light on it. No side effects at all? I can live with more hair on the body, beard whatever, hell more hair at the groin suits me fine too all pun intended haha!

 

What worries me is the blood pressure. Do u guys have that checked religiously? If i am to consume, i will defn go to my GP fortnightly for a BP check!

 

Also, is the growth u experienced significant or just some mental satisfaction? Have u any documented pictures, like at a couple mths interval? That would really help out a lot! thanks!

[rws]

wb280, I'm lucky as my Mum is a nurse, and regularly checks my BP when I go back for visits weekly. I've told her I'm on minoxidil, so she's agreed to monitor my BP in this way, and so far it's just a little lower than it was before (which was a little high, so it's actually been good for me in this way!). It's still completely within normal limits, no problems at all. I'd agree that it's a good idea to be monitored regularly, so you're doing the right thing by involving your GP.

 

Pics might be a bit misleading with me, as I've just had a HT in February this year, which obscures the results! Will try and post some of my crown soon, which is thickening nicely with Loniten - although sadly I have no before shots of that.

[wb280]

rws! thanks for the prompt response! My doc is really hoping i can start the medication as he is of the idea that it works v well for my category of patients. mid 30s and experiencing aggressive loss, and the whole head is starting to thin out, he said that if it works, not only can i save my current hair, but all the terminal hairs will become normal again. He asked me to try out for 4mths first.

 

Whats your opinion?

[rws]

Well I'm no doctor, but I can just give my own experience in this - I think 4 months should be long enough to see whether it works for you or not. Like I say, I'm at about 3 months since starting Loniten, and already I am very happy with the results so far. Like your doctor hopes, I've found that terminal hairs have thickened back up and look very healthy again, and the appearance of bulk / density is much improved at the front and the crown. This is with 2.5mg taken twice a day - a very small dose compared to the amount sometimes prescribed for high blood pressure.

 

I can understand your anxiety about it as I wrestled with the idea of taking a 'serious' drug for hair loss before taking the plunge... But I'm glad I gave it a go, as it's been the most effective oral remedy yet for me.

 

Good luck with it - I hope you have great results and look forward to hearing about your progress on here!

[RCWest]

The only side effect to speak of is I have to tweeze my eyebrows every now and then. I get a few long ones I have to pluck and there are some fine hairs around my eyebrows and on my forehead that darkened. No problems taking it healthwise. Like I've mentioned before, 5 mg. is an extremely low dose. Hypertension patients can take between 40-100 mg. a day.