>
> I want to know youir opinion on this. I am not on Propecia yet and am
> thinking on it. I am not sure if saving hair is worth taking chances with
> that medication. Hence I wanna try spironolactone 5% instead of Xandrox. What do you
> suggest ? I want to get on these ASAP.
I have suggested that you only try spironolactone if you want to enhance your
results after 6 or so months of treatment. Xandrox can often be as effective as
a combination of minoxidil and spironolactone. The main problem with too many
topicals is the hassle involved. You may become discouraged and rather than the
2 applications per day that I am recommending, you may revert to no applications
per day. However, if you want to use spironolactone in lieu of azelaic acid, it
is important to understand that you should also use minoxidil with your
treatment. Drugs such as Azelaic acid, spironolactone and finasteride (Propecia)
protect the follicles from DHT in the scalp but protecting from DHT in the scalp
isn't the whole solution. Even men who have been castrated for treatment of
prostate cancer and have no source of DHT will stop the balding process, but
they do not grow back significant amounts of hair (unless they also use
minoxidil as a hair growth stimulant). That's why a combination of minoxidil and
an anti-androgen is important for growth outside the vertex/crown area.
The efficaciousness of topical spironolactone in decreasing the amount and
action of DHT on the hair follicle is dependent on how much is absorbed into the
scalp and over how long a period of time.
The 2% spironolactone alcohol solution allows for faster and more efficient
absorption. Consequently, the scalp may be rinsed off an hour after
application. The 5% lotion, which allows for slower but more prolonged
absorption, should be left on the scalp after it is applied.
As with any topical medication in lotion form, only those molecules of the
medication adjacent to the skin are absorbed. So, it's a waste of medication to
apply more than a thin film to the scalp. The most convenient method of
application of the 5% lotion would be to apply a small amount to the affected
areas with your fingertips.
If you do not find the lotion cosmetically unacceptable by leaving it on the
scalp over night or for several hours during the day, then an application of 5%
lotion can be more effective than an application of 2% spironolactone solution.
Apply 2% spironolactone 10 minutes before applying minoxidil or Xandrox to keep
minoxidil off the surface of the roll-on dabber. The chemical reaction of
minoxidil with the spironolactone can form an offensive odor on the dabber after
a few hours.
Alternatively, apply 5% spironolactone in the morning or in the evening at bed
time, several minutes after applying minoxidil or Xandrox. The spironolactone
lotion will act as an occlusive cover for minoxidil or Xandrox and consequently
improves the absorption of minoxidil.
If you are allergic to propylene glycol, then you should not use 2%
spironolactone. It has propylene glycol in its liquid base. The 5% lotion is
propylene glycol free.
For the time being use a topical spironolactone concomitant with 5% minoxidil as
instructed above. When the 12.5% minoxidil solution is available, use it in
place of 5% minoxidil.
Regardless of the concentration of minoxidil, it is important to be aware of the
possible side effects:
Side Effects: Patients with any history of heart disease should not use
Xandrox15. Also patients who have a known adverse reaction to minoxidil should
avoid using Xandrox15. Although rare, patients who are sensitive to minoxidil
can experience a rapid heart rate, a drop in blood pressure and water
retention. As a result, they may experience headaches, dizziness, chest pain
and/or edema of the ankles. If that happens, the patients should discontinue any
formulas containing minoxidil. In our experience, these side effects have
occurred in less than 0.1% of patients.
Grow well,
Dr. Thomas A. Bowen
