In Today’s article, we will discuss on the best combination treatments for hair loss in both men and women. We will also list out the 5 best topical minoxidil formulations with no side effects. We will also discuss on how to use and which formulation to use depending on your stage of baldness and also briefly discuss on how these medications work to promote hair growth.
Topical Minoxidil solution is the only non-prescription, over-the-counter hair loss treatment, clinically proven and FDA approved medication for female and male pattern hair loss.
Minoxidil belongs to a class of medications known as VASODILATORS, that means those medications dilate the blood vessels.
Minoxidil was actually discovered in the clinical trials for high blood pressure treatment. During the trials, oral use of minoxidil showed unexpected increase in scalp and body hair. These incidental findings led to the development of topical minoxidil for the treatment of androgenetic alopecia.
Now lets quickly discuss on the Mechanism of action by which minoxidil works:
Minoxidil is a potassium channel opener which dilates the blood vessels of the skin around the hair follicles and this allows more entry of oxygen, blood, and nutrients to the hair follicles. This increases follicular size and hair shaft diameter and prolongs hair growth and keeps hair in anagen phase for a longer time. This brings back miniaturized hair follicles back to normal. Miniaturized follicles are those that are weakened by the action of DHT – dihydroxytestosterone.
Minoxidil may cause follicles in the telogen phase to shed – that is why you experience hair loss for intial few days after minoxidil application! These hair are then replaced by thicker hair in a new anagen phase. You can check out a detailed animated explanation on hair growth cycle to understand the how hair grows from HERE.
For what Type and Stage of Baldness is minoxidil effective?
Minoxidil is more effective in younger people who have experienced hair loss for less than 5 years. Minoxidil is less effective when the area of hair loss is large.
Minoxidil use is more effective for central or vertex hair loss and may not be effective to treat receding hairline.
You can start minoxidil from early stages of baldness like Stage 1 and 2 to prevent progression of baldness. You can watch a detailed video on the stage-wise treatment of male and female pattern baldness from links at the end screen of this video.
It is proven that about 40% of men experience hair regrowth after 3–6 months of minoxidil treatment. Minoxidil must be used indefinitely for continued support of existing hair follicles and the maintenance of any experienced hair regrowth.
Before we move on to the Different formulations and combinations of Minoxidil, we will quickly list out some rare side effects of minoxidil.
Burning sensation or redness at the application site may occur. If these persist or worsen, contact your doctor or try a different formulation like minoxidil foam.
Rarely, this medication can be absorbed through the skin and cause systemic side effects including: unwanted facial/body hair, dizziness, fast/irregular heartbeat, fainting, chest pain, swelling of hands/feet, unusual weight gain, tiredness, difficulty breathing especially when lying down.
A very serious allergic reaction to this drug is very rare.
And lastly, Alcohol and propylene glycol present in some topical preparations may dry the scalp, resulting in dandruff and contact dermatitis.
Now let’s discuss on the different Formulations and Combinations of Minoxidil for Hair loss Treatment:
- Minoxidil 2%, 5% and 10% solution or foam. 2% is recommended twice daily for stage 1 and 2, 5% for stage 2 onwards twice daily and 10% stage 3 onwards once daily. Minoxidil foam is recommended for those who have scalp irritation on using regular minoxidil solution.
- Minoxidil 5 and 10% + Finasteride 0.1% – This is really effective hair loss treatment for stage 3, 4 and 5 and can revert your stage to previous level within 6 months to 1 year. 5% solution should be used twice daily and 10% once daily one or two hours before bed and hair can be washed with a mild shampoo the next day morning. This is also recommended for those who cannot tolerate oral finasteride of 1 mg daily and report adverse effects like erectile dysfunction and loss of libido.
- Minoxidil + Diaminopyridine – This is another effective combination. Here Diaminopyridine prolongs life cycle of a follicle by stimulating the anagen phase.
- Minoxidil + Aminexil – Here aminexil increases the circulation of blood to hair follicles which triggers an increase in hair growth and also prevents the hardening of hair shaft and the build-up of collagen around it. It can be used by both men and women dealing with hereditary hair loss or androgenic alopecia. Aminexil has no reported side effects.
- 5% minoxidil and 0.01% tretinoin is another proven topical combination where tretinoin increases the percutaneous absorption of minoxidil and hence the efficacy and safety of combined 5% minoxidil and 0.01% tretinoin once-daily therapy appear to be equivalent to those of conventional 5% minoxidil twice-daily therapy for the treatment of Andro-genetic Alopecia.
Minoxidil + Tretonoin: https://www.ncbi.nlm.nih.gov/pubmed/17902730
Minoxidil + Finasteride: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314881/