“A daily minoxidil pill in concentrations ranging from 0.25 to 2 mg in women and 2.5 to 5 mg in men can be an effective therapy against androgenetic alopecia,” says Dr. Eduardo López Bran, head of the Dermatology Service at the Hospital Clínic Universitari San Carlos in Madrid
Oral minoxidil, a vital hair option
Minoxidil is a vasodilator, antihypertensive drug that is used to stimulate hair growth in people with moderate androgenetic alopecia. Minoxidil will not stop the progress of baldness, but it keeps the hair as long as the action of the treatment is not suspended.
“Oral minoxidil is also very useful in combination with other drugs and treatments both to stop the process of hair loss and to reverse this situation; in addition, it is optimal for improving the result of a hair transplant”, assures the trichology specialist.
The most common cause of hair loss on the scalp, where we have between 100,000 and 150,000 bulbs, is androgenetic alopecia or common baldness.
“It is caused by predisposition genetics or by the androgenic hormonal alteration, that is to say, the action of the male sex hormone (testosterone, androsterone and androstenedione)”, he emphasizes.
But these factors are not enough to cause marked hair loss. There are other triggers that can make the situation worse.
“Stress, anxiety, depression, endocrine, metabolic or digestive disturbances can trigger latent androgenic alopecia, also enhancing its development,” says Dr López Bran.
In women, the lack of control of the level of iron in their body also influences it.
“They have an excessive loss due to menstruation or a deficit due to inadequate intake of foods with iron; sometimes, due to a disorder in the synthesis. Adequate levels of iron help to keep the hair healthy and strong”, points out the dermatologist.
In any case, it is essential to establish an accurate diagnosis before prescribing minoxidil.
“Only after establishing the diagnosisif the patient suffers from common baldness (androgenetic alopecia), the most frequent type of hair loss in men and women, respectively, or if he presents any other type of hair loss (there are up to 150), he may be a candidate for the use of minoxidil orally”, emphasizes Dr. Eduardo López Bran.
Minoxidil, from the cardiovascular system to the hair
The drug minoxidil, an antihypertensive vasodilator agent, was used in the early 1980s to treat refractory hypertension (HT), with uncontrolled values above 140/90 mmHg.
They then discovered that the drug also facilitated the growth of hair in different areas of the body, in quantity and thickness (hypertrichosis).
At the end of the decade, clinical trials began in Spain, among trials worldwide, to check whether the topical minoxidil drug was effective and safe to treat androgenetic alopecia or common baldness.
“These tests, which I had the honor of coordinating in our country, confirmed that we were dealing with the first effective drug for the treatment of androgenetic alopecia,” remembers López Bran.
In those years it was determined that minoxidil formulated in a hydroalcoholic solution would be well accepted by patients, but the passage of time has proven otherwise.
Many patients reported that the application of minoxidil left their hair stiff and, contrary to what we had thought, we observed that patients were inclined to use a pill instead of a topical product, on the hair and the scalp”, he explains.
After the years, it has returned to the origin and offers to take doses of minoxidil orally. It is used in low concentrations, although in different proportions for men and women.
“One pill a day, preferably at night, in concentrations ranging from 0.25 to 2 mg in women and 2.5 to 5 mg in men, can be an effective therapeutic for your alopecia or hair loss.
It should be noted that oral minoxidil enjoys a higher patient sympathy than other drugs used for hair loss.
It can be prescribed if the patient has no history of changes in blood pressure, mainly low blood pressure or some other effect or cardiovascular disease or other systemic diseases. In each case, it will be necessary to assess the possibility of prescribing this type of drug.
In any situation, it will be observed if any side effects occur, such as a decrease in blood pressure, palpitations, etc.; in this case it would be necessary to adjust the dose and even suspend the treatment with minoxidil.
Your dermatologist will inform you of both the benefits you can get from minoxidil and its adverse effects, among which, in addition to those mentioned above, the growth and thickening of hair in other areas of the body other than the scalp should be emphasized.
These adverse effects are reversible by suspending the medication or reducing the dose once the case has been analyzed”.
Dr. Eduardo López Bran, head of the Dermatology Service at the Hospital Clínic Universitari San Carlos