Minoxidil is mainly indicated in young patients with hair thinning in progress, without excluding the use by patients of older ages. Treatment with minoxidil is considered a very important part of the pre-operative and post-operative transplant protocol of patients with hair loss, and in patients undergoing hair transplantation. Minoxidil is widely used on a worldwide scale and is generally well tolerated.
Minoxidil can be used without problem in conjunction with either vitamin supplements or neutral pH shampoos for sensitive hair. There are also specialty shampoos against hair loss which can be combined with the use of minoxidil without any side effects.
Minoxidil is used in the form of a lotion or foam at concentrations of 2% and 5% which is applied locally to the scalp. The 2% solution is commonly used by women or in cases where local irritation of the scalp appears after use of the more concentrated solution of 5%. Usually 3-4 sprays twice a day are recommended on the dry area of the scalp that presents hair loss. The application of the lotion or foam should be accompanied by mild skin massage for better absorption.
Minoxidil foam with a 5% concentration is currently used widely, because it is easier to use and causes much less irritation than the minoxidil solution. If used daily, it will take 2-3 months for the first results to become visible. Minoxidil can be safely used on a long term basis.
The most common side effect of minoxidil is local irritation of the scalp, which may be accompanied by itching, redness, heat sensation and local dry skin. Also, hypertrichosis can be observed in unwanted areas such as the face, ears, etc., especially in women. In chronic use, there a small likelihood of increase of the level of liver enzymes (transaminases), due to the hepatic metabolism of minoxidil. However, in any case, topical use of minoxidil is safe and even if adverse effects occur, dose reduction or discontinuation of the therapy suffices to make these disappear.
Hair loss treatment with minoxidil should be lasting, in fact, as long as the problem of hair loss persists, which in the case of androgenetic alopecia is practically a lifetime Discontinuation of the treatment with minoxidil will lead to reversal of the results in a few months’ time. Contrary to earlier beliefs, it is now considered that stopping the use of minoxidil for a continuous period exceeding 15 days will cause the hairs that have benefited to pass into the telogen phase, resulting in intense hair loss 2-3 months after discontinuation of the drug.
At Advanced Hair Clinics, the hair loss treatment with minoxidil 5% starts 7-10 days after the hair transplant session as an integral part of our post-operative protocol, in order to safeguard the existing hair and achieve faster growth of the transplanted hair. It should be noted that, according to scientific studies, the use of minoxidil after hair transplantation with FUE does not affect the final result of the transplantation, i.e. the number of hairs that will eventually develop.
However, it does appear to significantly reduce shock loss of new hairs during the first two to six weeks after the operation, as minoxidil prolongs the anagen phase of the hair cycle, thereby speeding up the results of hair transplantation.