Rogaine liquid or Rogaine Foam

[NS]

Which gives the better results? Rogaine Liquid or Rogaine Foam?

 

 

Thanks,

NS.

[Bill - Seemiller]

NS,

 

Both contain active ingredient minoxidil, but the delivery system is different.

 

In my opinion, the foam is superior simply because it doesn't contain propylene glycol found in the liquid which sometimes can irritate the scalp. In addition, I feel that in many cases, some of the liquid is lost as it drips down the front or back of your head where the foam appears to be cleaner and easier to apply without losing any.

 

This of course, is just my opinion.

 

Best wishes,

 

Bill

[JohnS]

Sorry to disagree but as per the clinical trials, minoxidil liquid is clearly superior to the foam. Anecdotal evidence supports this also. Too bad, the foam is so convenient!

[Dewayne]

The liquid usually ended up running down my neck, since my hair WAS so thin it couldn't stop it. I'm not sure, but the foam is a lot more convenient for sure. I remember one of the docs on the "live chat" one night a few months back said the foam was superior for other reasons.

[JohnS]

That seem to be a common misconception. Many doctors are really in the dark when it comes to the pharmacological aspects of hair growth. They assume that since Rogaine Foam is newer it is also better, not true in this case.

[Ceasar08]

John--

Can you post a link to the studies that show the liquid is better?

 

Thanks...

[Bleachcola12]

I am also interested in these studies as john stated... Where are you john?!!!

[JohnS]

This is the 5% Rogaine Foam study abstract submitted to the FDA for its approval.

 

A Multicenter, Randomized, Placebo-

Controlled Double-Blind Clinical Trial of a

Novel Formulation of 5% Topical Minoxidil

Foam vs. Placebo in the Treatment of

Androgenetic Alopecia in Men

 

Olsen, Elise;1 Funicella, Toni;2 Roberts, Janet;3 Kempers, Steven;4

Piacquadio, Dan;5 Wanser, Rita;6 Zhang, Paul;6 Kohut, Bruce;6

1. Duke University Medical Center, Durham, Northe

CArolina, USA; 2. DermResearch, Inc., Austin, TX, USA;

3. Northwest Cutaneous Research Specialists, Portland, OR,

USA; 4. Minnesota Clinical Study Center, Fridley, MN, USA;

5. Therapeutics, Inc., Lajolla, CA, USA; 6. McNeil Consumer

Healthcare, Morris Plains, NJ, USA

 

Although 5% topical minoxidil solution is safe and effective,

a vehicle that does not contain propylene glycol and is more

aesthetically pleasing to the consumer, would be a distinct

advantage to consumers for use in androgenetic alopecia

(AGA).

Objective: To assess the efficacy and safety of 5% topical

minoxidil when formulated in a new foam vehicle (TMF)

for men with AGA.

Method: Two-phase study:

"?? Sixteen week double-blind placebo-controlled phase

to evaluate the efficacy and safety of the 5% TMF.

This phase was conducted on 352 men ages 20-49 with

patterns IIIv, IV or V Hamilton Norwood with the primary

efficacy endpoints of change between Baseline and Week

16 target area hair counts (TAHC) and Week 16 subject

assessment of change in hair loss condition from Baseline.

 

"?? Open-label extension phase to collect 52 weeks of

safety data with 5% TMF. One hundred forty-three

subjects continued on this phase of the study. Safety

was monitored by taking intercurrent history, vital signs

and scalp irritation assessment by both investigator

and subject.

 

Results:

"?? Statistically significant increase at Week 16 compared to

Baseline in TAHC with the 5% TMF group (170.8 to 190.8

hairs) compared to placebo (168.9 to 174.4) (p<0.0001).

 

"?? Statistically significant subjective assessment of hair loss

condition (p<0.0001) on 5% TMF (70.6% noted increased

hair growth, including 47.8% moderate or marked hair

growth) compared to placebo (42.4% noted increased

hair growth, including 21.5% moderate or marked hair

growth).

 

 

"?? No significant safety concerns were raised and the 5%

TMF was well tolerated over a one year use period.

Conclusions: The 5% topical minoxidil product, formulated

without propylene glycol and in a foam vehicle, is a safe and

effective treatment for men with AGA.

 

Only 20 hairs grew in 16 weeks...

 

"Statistically significant increase at Week 16 compared to

Baseline in TAHC with the 5% TMF group (170.8 to 190.8

hairs) compared to placebo (168.9 to 174.4) (p<0.0001)"

 

 

Due to the fact that all the 5% minoxidil studies were evaluate beyond a 16 week trial, and it would be unfair to use them as comparison, I have submitted a sample 2-3% minoxidil liquid trial using the same 16 week time period...

 

Use of topical minoxidil in the treatment of male pattern baldness.

Savin RC.

 

This 12-month, double-blind, randomized study evaluated the safety and efficacy of topical minoxidil in the treatment of male pattern baldness. Three formulations were compared: 2% minoxidil solution, 3% minoxidil solution, and placebo. After 4 months all placebo patients crossed over to treatment with the 3% solution. Of the 96 patients randomized into the study, 79 were evaluable at month 12; 25 of these were in the 2% minoxidil group, 24 were in the 3% minoxidil group, and 29 were in the placebo-to-3% solution switchover group. At monthly intervals a hair count was obtained within a 1-inch diameter area on the scalp vertex. In addition, a gross visual estimate of the degree of new hair growth over the entire balding area was made independently by the investigator and the patient. At the end of 4 months there was significant regrowth of nonvellus (terminal and indeterminate) hairs in the patients using the 2% and 3% solutions (p = 0.0001). The mean nonvellus hair count at month 4 was 162.8 in the 2% minoxidil group, 155.4 in the 3% minoxidil group, and 107.1 in the placebo group. The mean increase in the 2% and 3% treatment groups was 58.2 and 48.8, respectively, whereas the mean increase in the placebo group was 4.0. Total hair counts at month 4 demonstrated significantly more growth of hair in the 2% minoxidil group than in the placebo group (p = 0.013), with no significant difference between the 3% minoxidil group and the other two treatment groups.(ABSTRACT TRUNCATED AT 250 WORDS)

 

Bottom line..... 2-3% minoxidil liquid grew 48.8 to 58.2 hairs as opposed to 5% minoxidil foam's 20 hairs, that amounts of 2.5-3.0 times as much hairs, clearly the superior of the two.

 

Please also note the in head to head trials, 5% minoxidil was clearly superior to 2-3% minxoidil at all data points.

[Ceasar08]

John---

Thanks... but this is super confusing. According to the foam study, there was a 40% placebo effect. That's pretty crazy.

Also, if the liquid is that much more effective, I can't believe we haven't heard this before. I switched over about a year and a half ago, thinking the foam was more effective. Now I'm quite upset that I switched...

I'd love to hear from others about this topic...especially doctors...

[Stimpson]

With all due respect, John, unless I am missing something (a possiblity), your data is not straight across comparable. The first study evaluates the foam. The second study evaluates the liquid at various strenghts.

 

The studies are not comparable AT LEAST because the first study (TMF) does NOT specify a 1 inch diameter area on the scalp for the TAHC, whereas the second study clearly does. If the TAHC areas were not directly comparable across studies, and it is unlikely that they would be, since the studies were NOT made for comparison with one another, than you CANNOT use the TAHC as a basis for comparison between the studies. That is undisputable fact.

 

Additonally, the first study indicates it was carried out on men of Norwood III, IIIv, or V. The second study is silent as to the subjects MPB patters.

 

What would be useful is a study evaluating the foam versus the liquid, carried out under EQUALLY CONTROLLED CIRCUMSTANCES (i.e. patients in similar control conditions, etc.).

 

Bottom line - Comparing two different studies with different control circumstances is a fruitless and meaningless endeavor.

 

Stimpy

[JohnS]

Originally posted by Ceasar08:

John---

Thanks... but this is super confusing. According to the foam study, there was a 40% placebo effect. That's pretty crazy.

 

 

That is easily explained. The foam acts as a thickening agent, this I am sure you noticed when using it. It simply makes your hair look thicker, quite in contrast to the liquid when makes it look worse, at least until it dries. But as you can see, the hair count increase averaged only 4 hairs in the specified area, definitely not enough to notice.

[Stimpson]

One additional thing that is getting lost in the shuffle here...

 

The foam and the liquid are merely CARRIERS.

 

The MINOXIDIL is the active ingrediant.

 

As long as both carriers are safe and effective (they are), the minoxodil is still just the minoxidil.

 

It is just a matter of preference. They are the same thing. Most agree the foam delivers better and irritates the scalp less.

 

Stimpy

[Ceasar08]

There's a doctor named Peter Proctor who is very well known for being extremely well versed on the subject of hair loss. He has long made the claim that the propylene glycol actually enhances growth quite a bit.

 

Again... I really would like to hear more on this topic. I'd like to know if I should switch back to the liquid.

[JohnS]

Originally posted by Stimpson:

With all due respect, John, unless I am missing something (a possiblity), your data is not straight across comparable. The first study evaluates the foam. The second study evaluates the liquid at various strenghts.

 

The studies are not comparable AT LEAST because the first study (TMF) does NOT specify a 1 inch diameter area on the scalp for the TAHC, whereas the second study clearly does. If the TAHC areas were not directly comparable across studies, and it is unlikely that they would be, since the studies were NOT made for comparison with one another, than you CANNOT use the TAHC as a basis for comparison between the studies. That is undisputable fact.

 

Additonally, the first study indicates it was carried out on men of Norwood III, IIIv, or V. The second study is silent as to the subjects MPB patters.

 

What would be useful is a study evaluating the foam versus the liquid, carried out under EQUALLY CONTROLLED CIRCUMSTANCES (i.e. patients in similar control conditions, etc.).

 

Bottom line - Comparing two different studies with different control circumstances is a fruitless and meaningless endeavor.

 

Stimpy

 

 

As a matter of fact, the target area in both studies was exactly the same, one inch. You have to understand these are abstracts, not the full study, so they include only certain excerpts. My employer has a subcription to various online services so I was able to view these for further evaluation. You are free to do the same to satisfy your inquisitiveness.

 

As far as a study pitting Rogaine Foam to Rogaine Liquid, that would never happen, since it would be financial suicide to Johnson and Johnson if it appeared their new product was relatively ineffectual as compared to their older product. They had good reason to release this product, but that is a whole different thread.

[JohnS]

Originally posted by Stimpson:

One additional thing that is getting lost in the shuffle here...

 

The foam and the liquid are merely CARRIERS.

 

The MINOXIDIL is the active ingrediant.

 

As long as both carriers are safe and effective (they are), the minoxodil is still just the minoxidil.

 

It is just a matter of preference. They are the same thing. Most agree the foam delivers better and irritates the scalp less.

 

Stimpy

 

 

Well...yes and no. PPG is a very important carrier, but serves many other purposes also, something the glycerin, the carrier of choice in the foam, cannot approach.

 

One important note, many people may not realize it but PPG should be considered as an active ingredient, as is minoxidil, since it contributes to hair growth also.

[JohnS]

Originally posted by Ceasar08:

There's a doctor named Peter Proctor who is very well known for being extremely well versed on the subject of hair loss. He has long made the claim that the propylene glycol actually enhances growth quite a bit.

 

Again... I really would like to hear more on this topic. I'd like to know if I should switch back to the liquid.

 

 

Exactly! You hit the nail right on the head! Good!

[Stimpson]

-------------------------------------------

Originally posted by Ceasar08:

 

Thanks... but this is super confusing. According to the foam study, there was a 40% placebo effect. That's pretty crazy.

 

Reply by JohnS:

That is easily explained. The foam acts as a thickening agent, this I am sure you noticed when using it. It simply makes your hair look thicker, quite in contrast to the liquid when makes it look worse, at least until it dries. But as you can see, the hair count increase averaged only 4 hairs in the specified area, definitely not enough to notice.

 

end quote

 

-------------------------------------------

Again, how do you know that the study evaluated the hair AFTER the foam was applied, as opposed to after, say, a shower? That would NOT be scientifically sound to put the foam in ones hair and say "hey, it's thicker". Why are we to assume they did this?

 

As for the hair increasing by only 4 in the specified area, you DO NOT KNOW WHAT THE SPECIFIED AREA IS!! That is perhaps the biggest problem with comparing these studies, although there are too many others.

 

I'll say it again. Different control circumstances = not comparable.

 

As for proplyene glycol increasing hair growth, that's new to me. I guess we can all save many on minox and just start smearing our heads with anti-freeze. It's what, like $15 a gallon? We'll save a lot of money.

 

Stimpy

[Stimpson]

Okay John, do you have evidence supporting your claim the prolyene glycol increases growth?

 

All it ever did was make my scalp irritated to the point it peeled.

 

Regards - Stimpy

[JohnS]

Anti Freeze sounds novel, I don't believe it's been tried, maybe it does work! Hopefully someone can run a trial on this also.

[JohnS]

Originally posted by Stimpson:

Okay John, do you have evidence supporting your claim the prolyene glycol increases growth?

 

All it ever did was make my scalp irritated to the point it peeled.

 

Regards - Stimpy

 

You just said the magic word, "irritated". PPG is a known irritant, something that everyone who has used it finds out at one point or another. Skin irritants can cause hair growth. This has been proven time and time again in trials with Alopecia Areata. In fact dinitrochlorobenzene, one the most potent skin irritants, is used to treat it. Another skin irritant, retinoic acid, aka Retin-A, works in a similar manner.

[Stimpson]

Personally, I have not seen nor heard of any of this. We have ALL heard crazy claims about magical hair growth solutions. With all due respect, this sounds like just one more crazy claim. Personally, I am not going to intentionally irritate my scalp. That's silly. But to each their own. Have fun. I think anti-freeze is on sale at Wal-mart for $9.99.

 

btw - propylene glycol is an ingrediant in many types of anti-freeze. That's why I mention anti-freeze.

 

Stimpy

[Ceasar08]

Stimpy--

I don't know where I come down on this one. Not sure if John is right or wrong. I will tell you that there are reputable people who do believe that Propelyne Glycol is the ideal delivery system and may actually grow some hair by itself. It's not just John's opinion.

[Stimpson]

Okay Ceaser. Do what you want. It's nothing to me. Just beware. There are people out there who think that MANY things grow hair (see the epic argument about the laser comb). I am not making accusations here, btw. I am just saying that this particular field is full of quackery. Beware. And again, as to the cited studies, without the same control environments, they are a waste of time. Even if the TAHC area *is* the same in both cases, it still doesn't work. Without the same controls, you are NOT comparing apples to apples. It is simply NOT scientifically sound to make comparisons across different control sets. No credible scientist would even make the attempt. To be valid, the comparison must be apples to apples.

 

The argument has left the realm of minoxidil, which is delivered in either the liquid or the foam, and shifted to whether of not propylene glycol is a hair growth stimulant. I don't know if it is or not. My guess is that it is not. Too many things have been touted as magical baldness solutions before, and I am naturally skeptical.

 

btw - my understanding was that Rogaine in *either* form is not horribly effective at growing *new* hair, but rather it strengthens *existing* hair.

 

I have no horse in this race. Best of luck at whatever you choose. For me personally, I can't even use the liquid. The foam is okay.

 

Regards - Stimpy

[Bill - Seemiller]

This thread is rich with good information, controversial as it may be.

 

I too would like to see some clinical evidence that propylene glycol itself is a hair growth agent. This is news to me.

 

I suppose to come up with an accurate conclusion, we'd have to read and evaluate both clinical studies in detail rather than the abstracts.

 

However, I'm not so sure we are comparing apples to apples. These two studies were not designed to compare the foam to the liquid. Therefore, I tend to agree with Stimpson that comparing two individual studies with different controls isn't the best form of assessment.

 

In my opinion, the foam and liquid method of minoxidil delivery are comparable in effect assuming the percentage of minoxidil is the same.

 

Best wishes,

 

Bill

[JohnS]

Originally posted by Bill - Associate Publisher:

 

I too would like to see some clinical evidence that propylene glycol itself is a hair growth agent. This is news to me.

 

 

Bill

 

I am rather surprised that you would not be aware of this, but I am more than happy to provide you with several references.

 

I hope this information can enable members to make a more informed decision in their determination of the appropriate treatments. One should research hair loss protocols with the same fervor as one does hair transplant surgeons. Those that do reap the benefits, those that don't accept the dissapointment.

 

 

 

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Lassus A, Kianto U, Johansson E, Juvakoski T. PUVA treatment for alopecia areata. Dermatologica. 1980;161(5):298-304.

 

Li LF, Fiedler VC, Kumar R.The potential role of skin protein kinase C isoforms alpha and delta in mouse hair growth induced by contact dermatitis. J Dermatol. 1999 Feb;26(2):98-105.

 

van der Steen PH, Boezeman JB, Happle R. Topical immunotherapy for alopecia areata: re-evaluation of 139 cases after an additional follow-up period of 19 months. Dermatology. 1992;184(3):198-201.

 

Rokhsar CK, Shupack JL, Vafai JJ, Washenik K. Efficacy of topical sensitizers in the treatment of alopecia areata. J Am Acad Dermatol. 1998 Nov;39(5 Pt 1):751-61.

 

Shapiro J. Topical immunotherapy in the treatment of chronic severe alopecia areata. Dermatol Clin. 1993 Jul;11(3):611-7.

 

Rauch H. The effects of topical applications of chemical agents on hair development. Physiol Zool. 1952; 25: 268-272.

 

Chase HB, Montagna W. Relation of hair proliferation to damage induced in the mouse skin. Proc Soc Exptl Biol Med 1951; 76: 35-37.

 

LI L.-F.; FIEDLER V. C. ; KUMAR R.; Department of Dermatology, University of Illinois; Induction of hair growth by skin irritants and its relation to skin protein kinase C isoforms; British Society for Investigative Dermatology Annual Meeting, Cardiff , ROYAUME-UNI (07/04/1999)

1999, pp. 783-810 (26 ref.)