Alopecia is the most common form of hair loss that affects men and women causing significant psychological distress and diminished quality of life. Among the various molecules that can be used, minoxidil plays a leading role. Minoxidil, a vasodilator drug known for its ability to slow or stop hair loss and promote hair regrowth. Introduced exclusively as an oral drug to treat hypertension, however, it has been found to have the important side effect (80% of cases) of increasing the growth or darkening of body hair.
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Concentrated topical formulation at 2 or 5%: reversible effects
This has led to the development of a topical formulation as a 2% concentrated solution for the treatment of female androgenetic alopecia or 5% for the treatment of male androgenetic alopecia. The measurable changes disappear within a few months of stopping treatment. The mechanism by which it promotes hair growth is not fully understood. In addition to dilating blood vessels, minoxidil (Kirkland minoxidil) increases potassium entry into cells, resulting in hyperpolarization of cell membranes. It is hypothesized that by widening blood vessels and opening potassium channels, it allows more oxygen, blood and nutrients to be delivered to the follicle. This can also cause the follicles to fall into the telogen phase, which are usually soon replaced by new thicker hairs in a new anagen phase. The increase in hair loss that can occur during the use of Minoxidil is due to the synchronization of the hair cycle that the treatment induces. It must be applied regularly, once or twice a day, to keep the hair acquired: the most common adverse reactions of the topical formulation are limited to irritating and allergic contact dermatitis on the scalp. There have been cases of allergic reactions to the non-active ingredient propylene glycol, which is found in some topical solutions especially if galenic.
Hypothesis of concentration up to 10%
Normally the concentrations of use vary from 2 to 5%, but some American studies hypothesize a concentration of up to 10%. A small study conducted in Dr. Marotta and Blakeney investigated the clinical efficacy and patient satisfaction of a topical formulation consisting of 10% minoxidil, 0.1% finasteride, 0.2% biotin and 0.05% hydroalcoholic caffeine citrate solution, in patients with alopecia male androgenetic. By applying 1ml to the entire frontal, parietal and occipital scalp, twice daily for 6 months, patients reported moderate, visually noticeable improvements as most patients had thicker and more voluminous hair, better scalp coverage and a better overall appearance of the hair. These results were consistent with the photographic assessment, which demonstrated an overall mean increase of +1.05 in patients’ hair density.
However, a recent article that appeared in March in the J Dermatolog treat compared the effects of a 10% solution versus 5% topical minoxidil in the treatment of alopecia. This study in 90 patients demonstrated that after 36 weeks of therapy the 5% concentration had a moderately greater effect than 10% and placebo in terms of reference change in mean total vertex and frontal hair counts, respectively. In particular, 10% minoxidil recorded more irritation side effects. Certainly new and more voluminous studies are needed to fully verify the effectiveness of this concentration. 05 in the hair density of patients.