Professor Sinclair Hair Loss Q&A Megathread - May 2022

[RStGeorge]

[See post on Reddit sub] for background of Professor Sinclair and his offer to
run a Q&A on this sub-reddit.

**Professor Sinclair has kindly volunteered to answer Hair Loss related treatment questions on this sub-reddit as the resident-Expert. This is his first Q&A Megathread.**

Prof Sinclair is Professor of Dermatology at the University of Melbourne and Director of Epworth Dermatology, past-president of the Australasian Society for Dermatology Research, and has over 400 research publications to his name.

Prof Sinclair convened the World Congress of Hair Research in Cairns in 2010 and has pioneered the use of oral minoxidil to treat hair loss, and holds worldwide patents on the use of oral minoxidil for the treatment of hair loss.

**Please feel free to post treatment-related questions (for Hair Loss) to Professor Sinclair in this thread and the Professor will do his best to provide answers based on his extensive experience.**

 

[RStGeorge]

Preliminary Answers Provided by Professor Sinclair to some of the posted questions

**Question 1:** Does hypertrichosis as a result of Minoxidil treatment indicate anything regarding scalp hair efficacy?

**Prof Sinclair:** "Hypertrichosis is not a prerequisite for scalp hair growth, but when it does occur, it indicates hair will also be growing on the scalp."

**Question 2.** Minoxidil and facial skin ageing. Is there a connection?

**Prof Sinclair:** "I have never been convinced that the suggested association is real. I have certainly never seen it in my clinic."

**Question 3.** Minoxidil treatment efficacy and SULT1A1 enzyme. In your opinion does it increase efficacy, and if so, how can an average person get a hold of the enzyme?

**Prof Sinclair:** "There is no commercially available treatment to modify SULT1AI, although there is a suggestion the micro needling can induce it."

**Question 4.** Minoxidil and shedding. Does it indicate a better eventual treatment response?

**Prof Sinclair:** "The increased hair shedding seen 4-6 weeks after initiating minoxidil treatment is paradoxically a good sign as it indicated induction of anagen growth in resting telogen hair follicles. In other words dormant follicles are re-activated and the new emerging hair pushes out the incumbent resting hair."

**Question 5.** Minoxidil. Oral or topical, and optimal doses in each case

**Prof Sinclair:** "Varies from person to person. Topical minoxidil is unstable in concentrations greater than 5% and so the shelf life of higher concentration formulations will be limited ( 1- 2 months maximum) The recommended dose is 1 ml once or twice a day. Application more frequently that twice daily confers no additional benefit. Regarding oral minoxidil it is prudent to start with low doses and gradually increase the dose once it is established you can tolerate the dose. I generally stat patients off on 025 mg or 0.5 mg twice daily."

**Question 6.** Supplements to correct serum deficiencies in D3, zinc and Ferratin. Any studies that indicate that supplementation reduces hair loss in Androgenetic Alopecia, or if such correction has zero impact on Androgenetic Alopecia progression?

**Prof Sinclair:** "The key nutrient is Cysteine. Based on animal studies, cysteine incorporation into the hair follicle is the rate limiting step for hair growth. The relative importance of other nutrients has not been quantified."