Pharm

Topical Minoxidil

search

Topical Minoxidil, Rogaine

  • See Also
  1. Minoxidil
  2. Androgenetic Alopecia
  • Indications
  1. Androgenetic Alopecia
    1. Most effective for vertex balding (than in frontal area), and effects are delayed 6-12 months
    2. Consider in combination with oral Finasteride for greater efficacy
  • Medications
  1. Regular Strength 2% solution
    1. Similar efficacy to 5% solution in Androgenetic Alopecia
  2. Extra Strength 5% solution or foam
    1. Indicated as adjunct in Alopecia Areata
    2. Higher Incidence of facial Hypertrichosis
    3. Consider 5% foam when solution causes excessive greasy feeling to hair
  • Mechanism
  1. Minoxidil is originally an Antihypertensive agent when used systemically
    1. Found to promote Hair Growth as an adverse effect
  2. Increases Hair Shaft epithelial cell growth
  3. Potentiated by Retin A
  4. Direct effect on Hair Follicle
    1. Activates Hair Follicles in Catagen
    2. Extends Anagen duration
    3. Expands Hair Follicles
  5. Decreases hair shedding
  • Dosing
  1. Expect initial hair shedding on starting (may take 6 months of consistent use to see results)
  2. Apply twice daily to dry scalp
    1. Spray 6 times (1 ml) or
    2. Dropper bottle
  3. Wipe away excess runoff
    1. Prevents systemic absorption from thin skinned regions of the face/neck
  4. Wash hands carefully after applying
    1. Reduces risk of spread to face and Hypertrichosis
  • Advantages
  1. Appropriate for both men and women
  2. Modestly effective
  3. Most effective for vertex baldness
    1. Vertex baldness under 5 years
    2. Hair Loss under 10 cm (4 inch) diameter
  • Disadvantages
  1. Less effective for frontal Hair Loss
  2. New hair lost when treatment discontinued
  • Adverse effects
  1. Hypertrichosis (excessive facial hair)
    1. Resolves by one year even if Minoxidil continued
    2. Bleach more evident darker hairs
  2. Pruritus of scalp
  3. Allergic or Irritant Contact Dermatitis (usually to propylene glycol)
    1. Compounding pharmacist can use alternative base
  • Resources
  1. Minoxidil Topical Solution for Men (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=81489e33-92be-45a5-9fa1-b352b640340b
  2. Minoxidil Topical Solution for Women (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4d72e033-8ae1-4bb0-b629-f29bd9b03017
  • References
  1. Price (1999) N Engl J Med 341:964-73 [PubMed]