Is minoxidil Once a Day Enough for Results?

[tembo]

joseph,

Can you post exactly where you buy the Retin-A from and how you use it? Does usage vary if you use Rogaine foam? I use Rogaine solution at present, but plan on moving to foam soon.

Thanks a lot.

 

[Old Baldy]

I don't know Joe. Cousin's posted study seems to indicate once a day isn't as good as twice a day.

Thanks for posting that study Cousin. I read that study a while back but forgot about it. (IIRC, I think Bryan posted it.)

Thanks again!

 

[Strat54]

I couldn’t find any information regarding the once a day maintenance application on the Rogaine / Pfizer web pages.

The Rogaine Foam is so easy to apply and so cheap, that I don’t mind applying it twice a day for the rest of my life (or until something better comes alone).

 

[joseph49853]

I don't know Joe. Cousin's posted study seems to indicate once a day isn't as good as twice a day.

Thanks for posting that study Cousin. I read that study a while back but forgot about it. (IIRC, I think Bryan posted it.)

Thanks again!

That's a twenty-year old study using 2% and 3% concentrations. Only the 3% twice daily is going to be a slightly larger in concentration than 5% once-a-day. I don't even believe you can buy 3% minoxidil at the retail level any longer. So while those studies might have been relevant for women using 2%, I haven't seen a single study using 5% minoxidil that compares once vs. twice-a-day usage.

 

[SkylineGTR]

i think twice a day is just a rule of thumb to keep the concentration up on the actual scalp itself.

Sure it has a 22 hour half life but that is probably in your body total as opposed to in the skin on your scalp.

The spectral DNC site said 15 hours or something to that extent. I remeber reading it because before i started i wanted to know if it would be detrimental if i missed an application.

 

[AussieExperiment]

Retin A

Additionally that study did not mention RetinA. I am very spectacle as to whether RetinA adds any significant value. No one has been able to show any credible studies on the benefit of RetinA.

 

[joseph49853]

Re: Retin A

Additionally that study did not mention RetinA. I am very spectacle as to whether RetinA adds any significant value. No one has been able to show any credible studies on the benefit of RetinA.

Why would that study mention Retin-a? But actually, Tretinoin or Retin-a, along with Petrolatum and Corticosteroids, are mentioned as part of minoxidil's contraindications. All of these things are known to increase the absorption of minoxidil; although Vaseline only worked marginally well for me.

There's even a major clinical study performed by Upjohn comparing the effectiveness of Retin-a with 2% minoxidil. It found that tretinoin increased minoxidil's absorption by as much as almost three times.


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Influence of tretinoin on the percutaneous absorption of minoxidil from an aqueous topical solution.
Ferry JJ, Forbes KK, VanderLugt JT, Szpunar GJ.
Clinical Pharmacokinetics Unit, Upjohn Company, Kalamazoo, MI 49001.

Nineteen healthy male volunteers completed a three-way, randomized, crossover study to determine the effect of the synthetic retinoid, tretinoin, on percutaneous absorption of minoxidil. Subjects received, for 20 days, twice-daily administrations of 1 ml of an aqueous 2% topical minoxidil solution either alone, with once-daily applications of a 0.05% tretinoin cream, or with once-daily applications of a vehicle control cream. When minoxidil was coadministered with tretinoin cream, minoxidil absorption was increased nearly threefold, compared with a 1.3-fold increase in absorption observed with coadministration of vehicle control cream. Transepidermal water loss measurements, which are sensitive to changes in stratum corneum function, were also significantly increased with tretinoin. No treatment-related changes in stratum corneum thickness were observed on the basis of skin biopsy analysis. The findings indicate that percutaneous minoxidil absorption is enhanced by tretinoin as a result of increased stratum corneum permeability.

 

[Old Baldy]

Re: Retin A

Additionally that study did not mention RetinA. I am very spectacle as to whether RetinA adds any significant value. No one has been able to show any credible studies on the benefit of RetinA.

Here's another study showing the benefits of Retin-A:

Topical tretinoin for hair growth promotion.Bazzano GS, Terezakis N, Galen W.
Topical all-trans-retinoic acid (tretinoin) alone and in combination with 0.5% minoxidil has been tested for the promotion of hair growth in 56 subjects with androgenetic alopecia. After 1 year, the combination of topical tretinoin with 0.5% minoxidil resulted in terminal hair regrowth in 66% of the subjects studied. Tretinoin was shown to stimulate some hair regrowth in approximately 58% of the subjects studied. One female subject with pronounced alopecia for more than 20 years had regrowth of hair using only tretinoin for a period of 18 months. Tretinoin has been shown to promote and regulate cell proliferation and differentiation in the epithelium and may promote vascular proliferation. These factors are important for hair growth promotion. These preliminary results indicate that more work should be done on the role of retinoids in hair growth. The synergistic effect of retinoids in combination with a low concentration of minoxidil should also be further investigated.

PMID: 3771854 [PubMed - indexed for MEDLINE]

 

[Old Baldy]

I don't know Joe. Cousin's posted study seems to indicate once a day isn't as good as twice a day.

Thanks for posting that study Cousin. I read that study a while back but forgot about it. (IIRC, I think Bryan posted it.)

Thanks again!

That's a twenty-year old study using 2% and 3% concentrations. Only the 3% twice daily is going to be a slightly larger in concentration than 5% once-a-day. I don't even believe you can buy 3% minoxidil at the retail level any longer. So while those studies might have been relevant for women using 2%, I haven't seen a single study using 5% minoxidil that compares once vs. twice-a-day usage.

I'm a little old and slow now Joe. I don't understand what you are saying. Cousin's study showed twice a day application is better than once. Why should I be concerned about percentage amounts of minoxidil.?

Why wouldn't it follow that twice a day of 5 percent minoxidil. be better than once a day, (i.e., just like it was for 2 or 3 percent)? (Now I'm not talking about doubling the dose with the once a day application, or anything like that.)

Dr. Lee suggests guys use a morning application of minoxidil. even if they are using 15 percent minoxidil. at night.

 

[joseph49853]

I'm a little old and slow now Joe. I don't understand what you are saying. Cousin's study showed twice a day application is better than once. Why should I be concerned about percentage amounts of minoxidil.?

I don't know how to make myself any clearer. But if you were to dilute your 5% minoxidil in half, and then apply this 2.5% twice-a-day instead of a 5% once-a-day, I doubt it would make it any more effective. We just don't have any studies to verify 5% once vs. twice daily application, only a rule of thumb.

Why wouldn't it follow that twice a day of 5 percent minoxidil. be better than once a day, (i.e., just like it was for 2 or 3 percent)?.

Because there aren't any studies showing the relationship to be that linear. Although, in my own personal experience, I can tell you that I saw a miniscule difference between 5% twice daily and once daily... this was over quite a good deal of time. And yet, I did find using Retin-a along with 5% minoxidil to be far more effective than 5% minoxidil by itself. Meaning: I was able to get away with less minoxidil, and avoid unnecessary applications. To be honest, I dislike having that crap in my hair during the day, it looks stupid.

Dr. Lee suggests guys use a morning application of minoxidil. even if they are using 15 percent minoxidil. at night.

The more minoxidil you use, the more cash Dr. Lee makes. And God bless him. But I haven't even seen any studies showing enough returns to make even a 15% twice daily minoxidil dosage worthwhile.

 

[Old Baldy]

I see what you're saying now Joe.

I don't have an answer to the "linear" point you made. Just don't know.

I haven't read much about minoxidil. I know that sounds crazy but I just accepted much of what Upjohn said when I started using it a couple of years ago.

Plus, IIRC, some members have said putting 2.5 percent on your head twice a day might be better than 5 percent once a day because the medication is just plain on your scalp longer. I don't really know either way but "on your scalp longer" does make some sense to me.

 

[Bryan]

Using 5% minoxidil twice a day is definitely well within the area of "diminishing returns" for topical minoxidil. Here, take another look at Vera Price's graphs from her study comparing 2% and 5% versions of Rogaine:

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

As you can plainly see by comparing the final results (both haircounts and hairweights) after 96 weeks of use, not by any stretch of the imagination did the 5% solution grow 2 1/2 times as much hair as the 2% solution, compared to placebo! :wink: So the response definitely isn't "linear" at that dosage level, in the accepted sense of that word. You're well-past the area of linearity, even with ordinary Rogaine.

Bryan

 

[LookingGood!]

Looking at that graPH clearly tells me that after 96 weeks it doesnt matter if you are using 2 or 5% minoxidil. Well I would like to see more studies b/c I am losing the Faith!

 

[SkylineGTR]

lol that graph also shows at 108 weeks all their hair fell out lol. Dang dont quit minoxidil ever haha

 

[Old Baldy]

You're right Bryan. I forgot about that graph. In fact, I remember commenting to you when you posted it before that 2 percent gave about 78 percent of the results of 5 percent minoxidil. (Come on Old Baldy - Duh! )

Thanks for reposting the info.!

So do you think twice a day application of 2 percent minoxidil. would be more beneficial than once a day of the 5 percent minoxidil.?

 

[CousinIt]

Personally I believe the Price study underestimates the magnitude of difference between 5% and 2%. In my own experience, having employed both concentrations, I have found 5% to be significantly better then 2%. This particular study more accurately reflects my personal experience.

************************************************************

J Am Acad Dermatol. 2002 Sep;47(3):377-85. Related Articles, Links


A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men.

Olsen EA, Dunlap FE, Funicella T, Koperski JA, Swinehart JM, Tschen EH, Trancik RJ.

Duke Dermatopharmacology Study Center, Durham, North Carolina, USA.

BACKGROUND: Topical minoxidil solution 2% stimulates new hair growth and helps stop the loss of hair in individuals with androgenetic alopecia (Androgenetic Alopecia). Results can be variable, and historical experience suggests that higher concentrations of topical minoxidil may enhance efficacy. OBJECTIVE: The purpose of this 48-week, double-blind, placebo-controlled, randomized, multicenter trial was to compare 5% topical minoxidil with 2% topical minoxidil and placebo in the treatment of men with Androgenetic Alopecia. METHODS: A total of 393 men (18-49 years old) with Androgenetic Alopecia applied 5% topical minoxidil solution (n = 157, 2% topical minoxidil solution (n = 158), or placebo (vehicle for 5% solution; n = 78 twice daily. Efficacy was evaluated by scalp target area hair counts and patient and investigator assessments of change in scalp coverage and benefit of treatment. RESULTS: After 48 weeks of therapy, 5% topical minoxidil was significantly superior to 2% topical minoxidil and placebo in terms of change from baseline in nonvellus hair count, patient rating of scalp coverage and treatment benefit, and investigator rating of scalp coverage. Hair count data indicate that response to treatment occurred earlier with 5% compared with 2% topical minoxidil. Additionally, data from a patient questionnaire on quality of life, global benefit, hair growth, and hair styling demonstrated that 5% topical minoxidil helped improve patients' psychosocial perceptions of hair loss. An increased occurrence of pruritus and local irritation was observed with 5% topical minoxidil compared with 2% topical minoxidil. CONCLUSION: In men with Androgenetic Alopecia, 5% topical minoxidil was clearly superior to 2% topical minoxidil and placebo in increasing hair regrowth, and the magnitude of its effect was marked (45% more hair regrowth than 2% topical minoxidil at week 48. Men who used 5% topical minoxidil also had an earlier response to treatment than those who used 2% topical minoxidil. Psychosocial perceptions of hair loss in men with Androgenetic Alopecia were also improved. Topical minoxidil (5% and 2%) was well tolerated by the men in this trial without evidence of systemic effects.

 

[docj077]

Someone please feel free to correct me if i'm wrong, but i was under the impression that Minoxodil has a 22 hour half life when applied to skin.

Just because a drug has a half-life of 22 hours, that doesn't mean that the drug is completely eliminated in 22 hours. It really all depends upon whether or not minoxidil is eliminated in a zero order or first order kinetics fashion.

 

[mbehr22]

Using 5% minoxidil twice a day is definitely well within the area of "diminishing returns" for topical minoxidil. Here, take another look at Vera Price's graphs from her study comparing 2% and 5% versions of Rogaine:

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

As you can plainly see by comparing the final results (both haircounts and hairweights) after 96 weeks of use, not by any stretch of the imagination did the 5% solution grow 2 1/2 times as much hair as the 2% solution, compared to placebo! :wink: So the response definitely isn't "linear" at that dosage level, in the accepted sense of that word. You're well-past the area of linearity, even with ordinary Rogaine.

Bryan

Bryan,

Thanks for the info - now plz allow me to aska stupid question ... is 30% increase in growth per sq cm that much of an increase? Are you saying the graph (on the R) is a good thing or bad?

Talk to me like Im 5 ... LOL

Im going to add minoxidil - my front hairline is losing ground and im tired of waiting on the Propecia to work on the front/temples ...

my biggest concern now is once or twice a day

 

[Bryan]

Looking at that graPH clearly tells me that after 96 weeks it doesnt matter if you are using 2 or 5% minoxidil.

Well, to be precise, it doesn't make a WHOLE LOT of difference. Furthermore, those comparisons are made at the same dose of 1 mL, twice a day. There's nothing to stop you from simply using MORE of the 2% solution, to make up the difference.

I find it amusing that back in the glory days of alt.baldspot, guys were constantly posting things about how you should ONLY use the new 5% Rogaine (which had just become available around that time, I believe), because the old 2% version was "pure garbage", "completely ineffective", totally useless", etc. etc. And I tried to tell those clowns that that didn't make any sense, that there shouldn't be THAT much difference between 2% and 5% Rogaine. And they couldn't believe that I was even serious about it! They said to me, "Come on Bryan, you don't REALLY believe that 2% is nearly as effective as 5%, do you??"

Well I would like to see more studies b/c I am losing the Faith!

Losing faith in what?

Bryan

 

[Bryan]

lol that graph also shows at 108 weeks all their hair fell out lol. Dang dont quit minoxidil ever haha

Yes, but it came roaring back after another 12 weeks or so! :wink:

Bryan