Since I first wrote this submit a number of years in the past, there have been many new oral Minoxidil and hair progress associated research and updates. I checklist the most recent 2022 ones on high, with others from 2021 proven additional under.

Please seek the advice of your physician or dermatologist earlier than taking oral or sublingual Minoxidil.

Update: August 18, 2022 — The New York Times simply revealed an article on oral Minoxidil for hair loss. It describes the drug as an old medicine that grows new hair for pennies a day. It is turning into more and more widespread for off-label use in treating hair loss. Dr. Brett King makes an attention-grabbing level about their probably by no means being  costly medical trials for such a low-cost product.

Update: July 20, 2022 — A brand new research finds that critical opposed negative effects with low-dose oral Minoxidil for hair loss were due to compounding errors. After pharmacological lab evaluation of formulated capsules, it was discovered that each one the sufferers with critical negative effects have been receiving a lot greater doses than prescribed. This was because of compounding errors. While the prescribed dose of oral minoxidil ranged between 0.5 and 1 mg, these sufferers have been getting between 50 and 1000 mg per capsule. Please watch out when you ever go this route on your hair loss therapy.

Update: January 5, 2022 — Coming full circle in using low-dose oral Minoxidil (LDOM) within the therapy of alopecia.

Sublingual versus Oral Minoxidil

Oral Minoxidil Generic 5 mg.
Oral Minoxidil 5 mg.

The largest new replace was initiated yesterday by “Nik” on our Discord group. He talked about how sublingual Minoxidil (3 mg/day in a single go) was superior to oral Minoxidil in rising hair amongst his pals. Make certain to learn my previous submit on Minoxidil as a sublingual pill.

He then linked to this 2020 report on 64 patients the place the dose was solely 0.45 mg/day. The writer is Dr. Rodney Sinclair of Australia, who I cowl intimately on the backside of this submit. I posted about this on Twitter, and Dr. Corralo from Spain responded with an attention-grabbing remark.

Upon additional analysis, I additionally discovered this newer August 2021 report from Dr. Sinclair. It entails a Phase 1B medical trial, which could be very encouraging information. Detailed abstract from October 2021 can be read here. The curiosity in oral Minoxidil for hair progress has actually taken of through the previous few years. Online anecdotes point out superiority over topical Minoxidil, however I’m not but 100% sure.

“Almost 67% of patients who received the 4.05 mg dose experienced improvements in frontal and vertex hair density. In the 0.45 mg dose group, phototrichograms showed a mean increase in terminal hair count/cm2 of 4 for the frontal and 9 for the vertex scalp. Treatment with the 1.35 mg dose resulted in a mean increased terminal hair count/cm2 of 10 and 26. The 4.05 mg dose led to a mean increase terminal hair count/cm2 of 38 for the frontal and 88 for the vertex scalp.

According to Dr. Mirmirani’s succinct summary at the bottom of that page:

“The authors suggest that sublingual Minoxidil (SM) may have better bioavailability and fewer hemodynamic effects by avoiding first-pass liver metabolism. Will SM be a game changer? Although the data in this study are positive, it will take more to convince me that it is significantly better than oral Minoxidil (OM). Very few of my patients on low-dose OM for hair loss discontinue the medication due to side-effects. The other consideration is cost. OM it is an inexpensive, generic drug, that is covered by medical benefits.”

New Studies

Update: October 2021 — New research finds that low-dose oral minoxidil increases hair density and thickness.

Update: August 2021 — A review of low dose oral Minoxidil therapy for hair loss.

Update: February 2021 — Safety of low-dose oral minoxidil (LDOM) for hair loss in 1404 patients. Multicenter research. The most frequent opposed aspect impact was hypertrichosis.

Oral Minoxidil Hair Growth
Oral Minoxidil Hair Growth Before and After. Source: JAAD.

Since I first wrote this submit on oral Minoxidil a number of years in the past, plenty of main new developments have occurred.

An October 2020 research of low-dose 1.25 mg nightly treatment with oral Minoxidil (Loniten) for 3 months concluded favorable will increase in hair progress. More here. This is shocking, contemplating the low dose utilized relative to different research. The hair loss sufferers included men and women of varied ethnicities. Further therapy with 2.5 mg dosing was additionally analyzed.

In September 2020, a Thai research discovered good outcomes for males taking oral Minox 5mg daily. In July 2020, a review of 16 studies encompassing 622 sufferers concluded that oral Minoxidil is an efficient and well-tolerated hair loss therapy. However, extra statistical information continues to be wanted. Also see this June 2020 article that concludes low-dose 1.25 mg/day

In August 2019, Spanish researchers published positive findings on low-dose 5 mg per day oral Minoxidil. One of the outcomes from this research could be seen within the above earlier than and after hair progress photograph. It was despatched to me by Dr. Sergio Vañó.

Oral Minoxidil for Hair Loss

For a few years, I’ve heard that oral Minoxidil ends in much more hair progress in comparison with the topical model. This is true for each female and male sample hair loss (typically together with Spironolactone for ladies). However, I all the time assumed that the negative effects from the oral remedy could be a lot worse.

The well being associated side effects embrace blood stress fluctuations, coronary heart price adjustments, and potential water retention. However, I used to be most involved in regards to the aspect impact of extra physique hair progress from Minoxidil drugs turning me right into a werewolf. Note: Make certain to learn my submit on topical Minoxidil and beard progress.

Introduction

I’ve mentioned Minoxidil (model title Rogaine) many instances on this weblog previously. It is considered one of solely two medicine formally authorized by the US FDA to deal with male sample hair loss. The different being Finasteride, which targets dihydrotestosterone (DHT) discount.

Most males use 5% topical Minoxidil foam and apply it to their scalps twice per day. For those that get opposed reactions, dosage is typically decreased to as soon as per day. Women have a tendency to make use of the two% topical formulation to regrow thinning hair. Very few folks use oral Minoxidil to deal with male androgenetic alopecia or feminine sample hair loss.

Unbeknownst to many, Minoxidil was initially authorized in 1979 as an oral remedy (model title “Loniten”) to treat hypertension (hypertension). It was solely authorized for treating hair loss in males in 1988 as a topical remedy.

A girls’s model was authorized in 1991. To today, it’s not completely clear as to how Minoxidil works in selling hair progress, with plenty of theories on the market, implying the probably involvement of a number of mechanisms. These embrace agonistic impacts on adenosine-triphosphate (ATP)-sensitive potassium channels; prostaglandin stimulation within the dermal papillae; and anti-androgenic properties.

Low-Dose Oral Minoxidil for Hair Loss

Several years in the past, I learn a really prolonged and considerate remark by Thai hair transplant surgeon Dr. Damkerng Pathomvanich. He outlined why he prescribes oral Minoxidil to a choose few of his sufferers   Low-dose oral Minoxidil (LDOM) for hair loss in choose sufferers could be very efficient. Update: In October 2020, Dr. Ratchathorn Panchaprateep from Thailand additionally released positive findings in relation to this drug.

According to Dr. Path (in addition to per different physicians that had given him suggestions), 5 mg per day was a great dosage that didn’t change affected person blood stress readings considerably. Some physicians even advocate attempting 2.5 mg per day. In truth doses as little as 0.25 mg to 1.25 mg per day have ends in hair progress in some sufferers.

However, some western publications and web sites advocate a decrease dosage (see hyperlinks in among the feedback to this submit). Image under exhibits generic 5 mg Minoxidil tablets from Thailand. Please don’t attempt to purchase this on-line as it may be harmful.

Side results are nonetheless attainable at low doses. Dr. Pathomvanich doesn’t prescribe oral Minoxidil to sufferers who’ve blood stress, coronary heart, liver or kidney issues.

Note that in accordance with the official brochure for Loniten, most beneficial dosage is listed as excessive as 100 mg per day, which appears loopy. Most sufferers taking the drug for hypertension don’t cross 40 mg per day.

Side Effects

Another main current information story concerning oral Minoxidil additionally comes from Spain in August 2019. Apparently, 17 toddler kids have been mistakenly given oral Minoxidil as an alternative of heartburn remedy.

Update: December 2020 — Over a yr after the medical error, households of some kids are complaining that the body hair keeps growing. Also from Spain, a September 2020 research on low-dose oral Minoxidil and hypertrichosis.

Oral Minoxidil Hypertrichosis Body Hair Side Effect.
Oral Minoxidil Excessive Body Hair Increase Side Effect.

The kids subsequently developed a condition called “werewolf syndrome” during which giant elements of their our bodies turn into lined in hair. This situation can be known as hypertrichosis.

Luckily, the physique hair will disappear a number of months after the kids cease taking oral Minoxidil. Above photograph is from the video of this shocking news story.

Dr. Sinclair Recommends Oral Minoxidil

I had forgotten in regards to the above until right now, when commentator “Billa” posted an attention-grabbing hyperlink to a new audio interview with Australian Dr. Rodney Sinclair. I’ve lined this well-known hair skilled plenty of instances on this weblog previously.

In this newest interview, one of many issues that Dr. Sinclair states is that oral Minoxidil is way more efficient than topical Minoxidil in the case of hair progress. He reaches this conclusion primarily based on some medical trials that his clinic is presently enterprise. Make certain to additionally take a look at my submit on Dr. Sinclair’s Hairy Pill.

While the article describing the above interview states that negative effects from oral Rogaine weren’t vital, I didn’t hear that within the audio interview. I’m guessing that this have to be true or else they might cease conducting the trials.

Dr. Sinclair has additionally efficiently examined oral Minoxidil and Spironolactone mixture therapy in female pattern hair loss patients.

Note that oral Minoxidil isn’t presently FDA authorized for treating hair loss. I don’t intend to take the drug, largely as a result of I don’t wish to danger getting any extra physique hair.

Another physician from Australia recommends oral Minoxidil for hair loss:



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