Is oral minoxidil really superior to topical? Reference study linked

[A Fue Good Men]

I hear oral minox is prescribed frequently nowadays. Usual doses range between 1.25-5mg per day.

There are users on Reddit and other platforms showing good results. However, based on the study linked, I don’t see why or how. The findings state:

 

”systemic doses in the range of 2.4 to 5.4 mg/day can be anticipated if application is made to entire scalp.”

 

And this is with a 1% or 5% solution assumingly applied once per day.

 

From a dosing perspective, if we experience the same systemic absorption with topical minoxidil, why is oral superior?

 

im guessing it has to do with how the liver may help break down minoxidil into the actives required to increase hair growth?

 

thoughts?

 

link: https://jamanetwork.com/journals/jamadermatology/article-abstract/545803

[Melvin- Admin]

This study is 12 male participants. Hardly enough to draw any conclusion with that sample size. I can say for certain that oral minoxidil has been far superior for me than the topical version.

[Curious]

Is oral minox helping to keep what you have or growing new follicles?

[GoliGoliGoli]

On 9/26/2022 at 7:33 PM, 5BetaReductase said:

I hear oral minox is prescribed frequently nowadays. Usual doses range between 1.25-5mg per day.

There are users on Reddit and other platforms showing good results. However, based on the study linked, I don’t see why or how. The findings state:

 

”systemic doses in the range of 2.4 to 5.4 mg/day can be anticipated if application is made to entire scalp.”

 

And this is with a 1% or 5% solution assumingly applied once per day.

 

From a dosing perspective, if we experience the same systemic absorption with topical minoxidil, why is oral superior?

 

im guessing it has to do with how the liver may help break down minoxidil into the actives required to increase hair growth?

 

thoughts?

 

link: https://jamanetwork.com/journals/jamadermatology/article-abstract/545803

Ya quite interesting, although I would imagine they're applying twice per day since that's what the typical instructions list. 

It's hard for me to believe that oral is vastly superior to topical without seeing a real side-by-side comparison that proves such. But ya if their is some benefit to the oral it must be in how it's broken down. 

[Curious25]

On 9/27/2022 at 5:07 AM, Melvin- Moderator said:

This study is 12 male participants. Hardly enough to draw any conclusion with that sample size. I can say for certain that oral minoxidil has been far superior for me than the topical version.

Pretty bold statement after 4 weeks 😂

[Curious25]

I think oral is largely likely to be superior due to patient adherence, and the consistent dosing quantity.  

Then, after that, bypassing the enzyme issues. 
 

I’ve been on 5mg daily for 8 months now, and it’s been great. Never used topical though so I’m unable to compare. 

 

[GoliGoliGoli]

14 minutes ago, Curious25 said:

I think oral is largely likely to be superior due to patient adherence, and the consistent dosing quantity.  

Then, after that, bypassing the enzyme issues. 
 

I’ve been on 5mg daily for 8 months now, and it’s been great. Never used topical though so I’m unable to compare. 

 

Ya the adherence is likely a big factor. I work from home so adherence hasn't been an issue for me with topical. If I ever have to go back into an office I would probably just apply it once I get home  from work and then wash it out before bed. I only apply it once a day already. 

Have you experienced noticeable regrowth on the oral? 

[Curious25]

11 minutes ago, GoliGoliGoli said:

Have you experienced noticeable regrowth on the oral? 

Yes. 

[Melvin- Admin]

30 minutes ago, Curious25 said:

Pretty bold statement after 4 weeks 😂

I’ve been on topical for 8 years, while one month isn’t long, certainly long enough to notice a positive difference. You don’t have to wait a year to see benefits of medication. 

[Curious25]

15 minutes ago, Melvin- Moderator said:

I’ve been on topical for 8 years, while one month isn’t long, certainly long enough to notice a positive difference. You don’t have to wait a year to see benefits of medication. 

What’s happened in 4 weeks ? 

[LookMaxx]

Superior in what respect? 

Ease of use and compliance - sure

Side effect profile? No, oral is absolutely worse than topical in this regard. 

Efficacy - Depends on individual case. Some people don’t have the enzyme in sufficient quantity on their scalp to convert to active minoxidil but even those people benefit from increased topical dosage up to 10-15% in some studies. 

As with most drugs, topical delivery form delivers max amount of drug safely compared to oral version. Topical minoxidil can deliver more dose to problem areas compared to oral especially if not diffuse thinner. 

Neither is superior to another and depends on individual needs. This is same as asking if topical finasteride is superior to oral, there’s no superiority of one delivery method to another, there are pro and cons to each that every individual might benefit from.

[GoliGoliGoli]

8 minutes ago, LookMaxx said:

 

Efficacy - Depends on individual case. Some people don’t have the enzyme in sufficient quantity on their scalp to convert to active minoxidil but even those people benefit from increased topical dosage up to 10-15% in some studies. 

 

What are you referring to being 10-15%? Are you talking about topical formulations with 10-15% Minoxidil concentration? 

[Melvin- Admin]

42 minutes ago, Curious25 said:

What’s happened in 4 weeks ? 

My hair has gotten thicker and my hair is shedding a lot less.

 

[GoliGoliGoli]

8 minutes ago, Melvin- Moderator said:

My hair has gotten thicker and my hair is shedding a lot less.

 

Did you stop using topical completely when you switched to oral or ween yourself off? I would be worried about losing gains from topical if I switched cold turkey to oral

[Melvin- Admin]

1 hour ago, GoliGoliGoli said:

Did you stop using topical completely when you switched to oral or ween yourself off? I would be worried about losing gains from topical if I switched cold turkey to oral

I still use 0.5 ml of 15% minoxidil at night 

[LookMaxx]

2 hours ago, GoliGoliGoli said:

What are you referring to being 10-15%? Are you talking about topical formulations with 10-15% Minoxidil concentration? 

https://pubmed.ncbi.nlm.nih.gov/28078868/
 

56 minutes ago, Melvin- Moderator said:

I still use 0.5 ml of 15% minoxidil at night 

Wow. But your HT is successful, you’re on topical dutasteride, 15% topical with oral minoxidil seems excessive. 

Can’t have too much hair 😄

[GoliGoliGoli]

9 minutes ago, LookMaxx said:

https://pubmed.ncbi.nlm.nih.gov/28078868/
 

Wow. But your HT is successful, you’re on topical dutasteride, 15% topical with oral minoxidil seems excessive. 

Can’t have too much hair 😄

I still don't know to what you're referring by 10-15%. 

Also when did Melvin hop on topical Dut? 

[LookMaxx]

23 minutes ago, GoliGoliGoli said:

I still don't know to what you're referring by 10-15%. 

Also when did Melvin hop on topical Dut? 

The usual formulation contains Minoxidil 50 mg/ml (5%w/v)

So 10-15% means more minoxidil mg in the same amount of water/solvents as normal formulation. I hate chemistry but this is pretty basic math here

 

I thought Melvin used xyonhealth which was topical dut but now I see it’s topical fin. 

[GoliGoliGoli]

1 hour ago, LookMaxx said:

The usual formulation contains Minoxidil 50 mg/ml (5%w/v)

So 10-15% means more minoxidil mg in the same amount of water/solvents as normal formulation. I hate chemistry but this is pretty basic math here

 

I thought Melvin used xyonhealth which was topical dut but now I see it’s topical fin. 

Lol, yea my question wasn't on your math it was on what the hell you were referring to

I believe Melvin is planning to start on Xyon I don't think he has already

[Mike10]

It is. Just as oral Fin is more effective than topical Fin.

Before getting overly enthousiastic, think of this. You must first be a responder. Minox only works for 2 out of 3 persons whcih is not a great ratio. And Minox oral only has not been proven to work long term at this point. I guess the jury is still out there for the latter but I do not see how this should be different than for the Minox topical whcih effect typcially wanes off after a few years. 

My experience with PRP has been way more positive than with Minox.