Bryan: Minoxidil Finasteride difference question.

[CCS]

I remember looking at the studies you posted many times over the years, but want to make absolutely sure all the studies back this up before I put this in my signature:

Is it accurate to compare Minoxidil to Toppik and similar cosmetics? With continued use of minoxidil, your hairs grow bigger, giving a non-immediate cosmetic improvement to your hair. But minoxidil does not slow down the balding process like Propecia does. After 5 years on Propecia, the average hair counts go down, but not nearly as fast as the placebo group.

Do you have studies showing 2+ year results of minoxidil, showing that after it reaches a peak, people continue to lose hair as fast as the placebo group, and that when taken off minoxidil, then have a shed that puts them back to where the placebo group is?

Thanks. I remember seeing the studies, but I don't remember just how many years they were carried out for, and the exact shape of the graphs and how they were conducted.


If you think the studies are conclusive enough, and will post a few here, then I'd like to put in my signature:

"Minoxidil is like extra realistic, non-immediate Toppik. But Propecia slows the balding process."

 

[Bryan]

I remember looking at the studies you posted many times over the years, but want to make absolutely sure all the studies back this up before I put this in my signature:

I have to caution you here right away that there's a real dearth of long-term topical minoxidil studies. I know of only two or three.

Is it accurate to compare Minoxidil to Toppik and similar cosmetics? With continued use of minoxidil, your hairs grow bigger, giving a non-immediate cosmetic improvement to your hair. But minoxidil does not slow down the balding process like Propecia does. After 5 years on Propecia, the average hair counts go down, but not nearly as fast as the placebo group.

I kinda like that analogy with Toppik!

Do you have studies showing 2+ year results of minoxidil, showing that after it reaches a peak, people continue to lose hair as fast as the placebo group, and that when taken off minoxidil, then have a shed that puts them back to where the placebo group is?

The only ones I can think of which seem to show that effect are an early Elise Olsen topical minoxidil study which lasted for 5 years, and showed gradually declining haircounts (I should scan the simple graph she provides that shows that); and the 1999 Vera Price study which provided the following graphs which I've posted many many times over the years:

http://www.geocities.com/bryan50001/quitting-minoxidil.htm

Dr. Price herself was the one who suggested that in the people who used topical minoxidil, haircounts appeared to decline at about the same rate as the people who got the placebo; it was she who coined the term "offset of growth" which I find so useful.

Thanks. I remember seeing the studies, but I don't remember just how many years they were carried out for, and the exact shape of the graphs and how they were conducted.

If you think the studies are conclusive enough, and will post a few here, then I'd like to put in my signature:

"Minoxidil is like extra realistic, non-immediate Toppik. But Propecia slows the balding process."

I like that analogy with the Toppik, but you'll probably have to spend a lot of time explaining the ramifications to people!

 

[CCS]

Those graphs are jagged, and the 5% peaks at 12 weeks, whereas other studies show a peak at 1 year. That makes it hard to draw conclusions. The untreated group does not seem to fall off quite as fast as the propecia placebo group in Merk's study. The 2% group looks conclusive though. Maybe the 5% group just has more shed cycles, or less compliance.

My mentor would say, "If you don't understand your results, do NOT spend more time and money repeating the experiment; first analyze it more to find out why it was unexpected. Techniciand so experiments, and researchers analyze and plan them. Researchers are paid more than technicians because they save lab time."

My guess is the results are different because of the average amount of hair in the test area was different between the studies, and different between the placebo and treantment groups. Minoxidil will grow vellus hair anywhere, so you get a more dramatic percent change on a dead area. Propecia works best on long hairs. And I bet the Rogaine study was done on a different density area.

So I don't think we have enough study evidence to shoot down minoxidil. Only biochemical intuition can be used for that conclusion.

 

[Bryan]

Those graphs are jagged, and the 5% peaks at 12 weeks, whereas other studies show a peak at 1 year.

You have to keep in mind that there's a VERY significant difference between Vera Price's excellent 1999 study and other topical minoxidil studies: Dr. Price conducted haircount and hairweight measurements every six weeks for the duration of the study, whereas other studies did their measurements generally at only six months and/or yearly. Therefore, you can't really just assume that those other studies showed a peak at 1 year. They may have had peaks at 12 weeks, too, just like Price's study, but you couldn't see it because they didn't actually MEASURE the hair at 12 weeks like Price did.

That makes it hard to draw conclusions. The untreated group does not seem to fall off quite as fast as the propecia placebo group in Merk's study.

One problem with making a direct comparison between the two is the strange INCREASE in haircounts for the placebo/no-treatment group in Price's study. She acknowledges that problem, but has no explanation for it. However, the hairWEIGHT measurements went pretty much according to expectation, which is one reason why Price considers hairweights to be a more accurate measure of progress than those pesky haircounts.

Interestingly, Dr. Price's subsequent study with finasteride in 2002 (which was performed with a very similar protocol as the 1999 topical minoxidil study) showed the same damned thing: a mysterious increase in hairCOUNTS in the placebo group, at least for the first year or so. The hairWEIGHT measurements again went according to expectations.

The 2% group looks conclusive though. Maybe the 5% group just has more shed cycles, or less compliance.

Perhaps.

"Techniciand so experiments, and researchers analyze and plan them."

What?

So I don't think we have enough study evidence to shoot down minoxidil.

Oh, I think what Dr. Price says makes a lot of sense. It just has that "ring of truth", in my opinion. Here's what she says in the Discussion section in the 1999 topical minoxidil study:

"Mean percentage changes in interval weights from baseline are shown in Fig 1. The placebo and untreated groups appear to behave similarly, showing a steady decrease in hair weight from baseline over the 120 weeks. This decrease can be taken as the 'normal' hair loss for this group of subjects with androgenetic alopecia and amounts to about a 6% decrease in weight per year. The 2% and 5% minoxidil groups appear to decrease with nearly the same average downward slope, once the peak rate of growth has been passed. The treatments appear to induce a consistent increased growth offset (above placebo or untreated groups) of roughly 25% for the 2% minoxidil treatments and 35% for the 5% minoxidil treatment, an average of about 30%, maintained during the 96 weeks of treatment. These growth offsets represent a long-term retardation of the hair loss process by both 5% and 2% topical minoxidil treatments."

 

[SoThatsLife]

Have any one of you seen any studies about 15% minoxidil?

I remember talking to Mr. Barry about minoxidil, and after what I remember when the positive result of 5% wears of and hair starts to miniaturize rapidly, the only chance to save the hair is to jump on a stronger minoxidil mix. How would this be for minoxidil 15%, will one get the partly long lasting effect one could get if one starts with 2% and then steps up to 5% and then so on, or is it just the instant effect of 15% like many people describes, and then it wear of like regular 2% and 5%?

 

[Bryan]

I remember talking to Mr. Barry about minoxidil, and after what I remember when the positive result of 5% wears of and hair starts to miniaturize rapidly, the only chance to save the hair is to jump on a stronger minoxidil mix. How would this be for minoxidil 15%, will one get the partly long lasting effect one could get if one starts with 2% and then steps up to 5% and then so on, or is it just the instant effect of 15% like many people describes, and then it wear of like regular 2% and 5%?

Have you read the first four posts in this thread?

 

[SoThatsLife]

Sorry, should have read that there is only a few minoxidil studies. But do you have an opinion about the effect and timeline with 15% minoxidil?

Dr. Lee is probably a bright man, at least business wise. But it seem like he only sells a "short dream" with his Xandrox 15%.

 

[Bryan]

Sorry, should have read that there is only a few minoxidil studies.

That's not really what I was referring to. I was talking about the general "offset of growth" effect of topical minoxidil, which implies a lot about some of those things you said.

But do you have an opinion about the effect and timeline with 15% minoxidil?

To the very best of my knowledge, there have never been any published studies of topical minoxidil in any vehicles allowing for more than just a standard 5% solution. To what extent those high-potency solutions work (if any) hasn't been explored in the published medical literature. All we have are user anecdotes, and claims from the doctors who make and sell those alternate products.