Safety Long-Term Usage 5% Minoxidil

[Machiavelli]

First of all, my compliments for this website and usefull forum. I am glad with the knowledge I got form this forum and after about 1,5 years of only loosing the hairloss-battle, I feel that I am finally winning ground again by using 5% minoxidil. My crown area is finally looking much better, and my NW1-2 will definately not become a Norwood 2 -Vertex; something which I felt would happen soon if I wouldn't interfer.

However, like many users of hairloss products I feel that the biggest side-effect I am suffering from is FEAR of side effects. I tried finasteride for a bit but didn't feel to well on it and also suffered from objective side effects: acne outbreak.

Anyway, bottom line is: I love minoxidil for what it does to my hair (regrowth!) but fear possible damage I may do to my heart. I know that minoxidil is not advised for people suffering from a heart disease, but I am wondering if it is possible that minoxidil is the CAUSE of a heart disease? I tend to think that I feel something on my chest, but honestly cannot objectively determine whether it is real or not!

The following article is a bit scary:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1386573/

Finally, are there objective parameters I could check to see if minoxidil is effecting me such as morning rest rate (being an athlete I do know what my morning heart rate used to be) and blood pressure?

Any reassurence or information would be very welcome as I 1) love what minoxidil does to my hair but 2) do not want to do any damage to my body!

 

[Chris87]

you're right in that side effects from things like minoxidil tend to be in our heads..i havent been using minoxidil for very long (only a couple months). I remember the first time i ever applied it my heart rate shot way up for like 5 mins and I was sitting there thinking. OH f*** THIS MUST BE FROM THE minoxidil! turns out it was just anxiety from thinking about even having sides because it never happened again and i had used such a small amount of minoxidil the first time lol.

As far as long long term, Idont know..i havent seen anyone on here whos been on minoxidil for say, 10 years or something. That study you linked to is very old though...1988 so..about 22 years old.

 

[Bryan]

First of all, my compliments for this website and usefull forum. I am glad with the knowledge I got form this forum and after about 1,5 years of only loosing the hairloss-battle, I feel that I am finally winning ground again by using 5% minoxidil. My crown area is finally looking much better, and my NW1-2 will definately not become a Norwood 2 -Vertex; something which I felt would happen soon if I wouldn't interfer.

It's important for you to understand that topical minoxidil by itself will not interfere with the fundamental balding process! Your hair will inevitably get worse, even if it appears to get better for a period of time with minoxidil alone. You need to use other therapies in addition to minoxidil, if you want long-term success.

By the way, what country are you from?

 

[guybrush]

It's important for you to understand that topical minoxidil by itself will not interfere with the fundamental balding process! Your hair will inevitably get worse, even if it appears to get better for a period of time with minoxidil alone. You need to use other therapies in addition to minoxidil, if you want long-term success.

Bryan:

Where did you get that minoxidil does not interfere with the fundamental balding process? I've read you stating the same over and over again in this forum but still I haven't read an article pointing in such direction. If there is one, I'd really love to read it.

If I'm not wrong, I understand that what you believe is that minoxidil only increases the number of hairs in telogen phase, making them "more visible" and so improving appearance without preventing your hairs from thinning and falling out. But minoxidil seems to thicken up your hair too and make new terminal hairs pop up where there was nothing before. I also have two studies showing that minoxidil efficacy is maintained in the long term for as long as 5 years with just a slow decline in hair count.

I understand you might have read a lot more than me but from my point of view now I'm not sure what you say is totally right. Could you clear it up?

Thanks!

 

[Bryan]

Bryan:

Where did you get that minoxidil does not interfere with the fundamental balding process? I've read you stating the same over and over again in this forum but still I haven't read an article pointing in such direction. If there is one, I'd really love to read it.

That general idea comes from several long-term topical minoxidil studies in which measured hair counts and/or hair weights seemed to almost inevitably decline as time went by! They all show a beneficial increase in such counts over the short term, but almost always decline (I can think of only one rare exception), as more time goes by. A good example of such a study would be Vera Price's excellent 1999 study which compared 2% and 5% versions of topical minoxidil with placebo users. That was the study in which Dr. Price coined that term I've used so much about how all minoxidil does is provide an extra "offset of growth" to hair, as counts and weights continue to decline in the long-term.

I also have two studies showing that minoxidil efficacy is maintained in the long term for as long as 5 years with just a slow decline in hair count.

What are the two studies? If one of them is the Olsen et al study I'm thinking of, I'm already quite familiar with it. Like you said yourself, it _does_ show a steady decline in haircounts over the 5 years, which is what I've been saying.

 

[guybrush]

Did not haircount "inevitably decline" in Propecia trials after 12 months?

These are the studies I mentioned, the second one from Olsen as you said:

- http://www.hairlosstalk.com/hair-loss-pdf/rogaine-4year-study.pdf
- http://www.hairlosssucks.com/download/minox5yrresults.pdf

And here's the paper from Vera Price:
- http://viewer.zoho.com/docs/vdxddw

I'll read it up later and see if it helps me to clarify the issue.

Thanks Bryan

 

[Bryan]

Did not haircount "inevitably decline" in Propecia trials after 12 months?

Not as consistently as it did in topical minoxidil studies, I believe. In fact, one finasteride study by Vera Price found that counts pretty much held steady or even increased very slightly during the 96 weeks of the study, if I recall correctly.

These are the studies I mentioned, the second one from Olsen as you said:

- http://www.hairlosstalk.com/hair-loss-pdf/rogaine-4year-study.pdf
- http://www.hairlosssucks.com/download/minox5yrresults.pdf

The first one, the Rietschel report, is the "rare exception" which I mentioned earlier in this thread; he found an actual increase in haircounts over an extended period of time. Balancing that one unusual study would be the one from Olsen above; another one from Koperski (it's mentioned by Rietschel above); the minoxidil study by Price; and yet another study (I don't remember the authors) which compared 2% and 5% minoxidil. Those last two found VERY significant reductions in haircounts after the first year, if I recall correctly.

Aside from that odd Rietschel report, it's very very common to find reductions in haircounts in minoxidil studies after the first year or so. I think the reason for that is obvious and inescapable: minoxidil doesn't really interfere with the fundamental balding process!

 

[Machiavelli]

@Bryan: I am from the Netherlands, why?

Are there relevant studies available that asses the long-term safety of minoxidil, respecially regarding the health of one's heart.

In addition, I am aware that minoxidil does not stop the underlying cause of MBP. Therefore I will be adding ASC-J9 to my regime soon (finasteride was not a succes for me).

 

[Bryan]

@Bryan: I am from the Netherlands, why?

Just curious. It was obvious that you were from somewhere in Europe!

Are there relevant studies available that asses the long-term safety of minoxidil, respecially regarding the health of one's heart.

Not that I know of. By the way, I posted years ago on alt.baldspot about that same study you mentioned in your first post in this thread! It _is_ a rather troubling study. I asked Dr. Proctor if he knew of any evidence on whether or not the increase in LV mass that you get with topical minoxidil continues to increase for as long as you use it, and all he said was something like "I hope that doesn't happen."

 

[Machiavelli]

@Bryan: Hmmm, it is indeed troublesome! All other studies I could find mention that Minoxidil has no systematic side effects, but I tend to believe this was one of the few studies that did in-depth research regarding minoxidil's effect on one's heart. Right now I am seriously considering to drop minoxidil, it's not worth to risk my heart's health for my hair; how much I'd like to keep my hairs though...

I am just curious, how can a product that has such significicant REPORTED side effects be approved by the FDA? In addition, why do we find so many (sometimes unrealistically dramatic) stories about fina's side effects but zero to none stories about minoxidil?

 

[Machiavelli]

As far as I understand this article about ORAL minoxidil, minoxidil does not seem to effect LV mass in this 6 month study:

http://www.ncbi.nlm.nih.gov/pubmed/2959236

 

[Bryan]

@Bryan: Hmmm, it is indeed troublesome! All other studies I could find mention that Minoxidil has no systematic side effects, but I tend to believe this was one of the few studies that did in-depth research regarding minoxidil's effect on one's heart. Right now I am seriously considering to drop minoxidil, it's not worth to risk my heart's health for my hair; how much I'd like to keep my hairs though...

I am just curious, how can a product that has such significicant REPORTED side effects be approved by the FDA?

What if the proper and correct response to all those points is that no, the use of topical minoxidil does NOT cause a steady and continuous increase in those heart changes for as long as you use it, even after years and years of use? I can see why the FDA would approve it, if it caused no more than the slight changes reported in that one study.

 

[Machiavelli]

Still, it troubles me that I cannot find any research follow up on the recommendation of the study I cited (that further research is needed regarding long-term safety). To me it just seems as an assumption that LV will not increase after 1 year usage.... and LV mass is_kind_of a critical factor in one's life. Are there really no other studies around about this subject?

 

[Bryan]

Doesn't it seem that as long as Rogaine and other topical minoxidil products have been used around the world (years and years and years), we would all have heard about it by now, if LV mass continued to get larger and larger? :dunno:

 

[Michael84]

Can Minoxidil cause additional hairloss? Is it temporary or not? Should a person continue taking it if hair loss increased?

 

[WarLord]

Did not haircount "inevitably decline" in Propecia trials after 12 months?

Not as consistently as it did in topical minoxidil studies, I believe. In fact, one finasteride study by Vera Price found that counts pretty much held steady or even increased very slightly during the 96 weeks of the study, if I recall correctly.

These are the studies I mentioned, the second one from Olsen as you said:

- http://www.hairlosstalk.com/hair-loss-pdf/rogaine-4year-study.pdf
- http://www.hairlosssucks.com/download/minox5yrresults.pdf

The first one, the Rietschel report, is the "rare exception" which I mentioned earlier in this thread; he found an actual increase in haircounts over an extended period of time. Balancing that one unusual study would be the one from Olsen above; another one from Koperski (it's mentioned by Rietschel above); the minoxidil study by Price; and yet another study (I don't remember the authors) which compared 2% and 5% minoxidil. Those last two found VERY significant reductions in haircounts after the first year, if I recall correctly.

Aside from that odd Rietschel report, it's very very common to find reductions in haircounts in minoxidil studies after the first year or so. I think the reason for that is obvious and inescapable: minoxidil doesn't really interfere with the fundamental balding process!

lol Have you read it at all? The first study says that 80% assessable patients maintained their regrown hair after 5 years.

The second study says that 14 patients taking 3% minoxidil twice daily continued to have a slight increase in hair counts between 1-3 years. 17 patients taking 3% minoxidil once daily experienced a slight decline. After they switched back to twice daily use, their hair loss stabilized. In summary, 9 out of 31 patients regrew hair between 1-5 years. Four users were below baseline after 5 years. These are the individuals, who were primarily responsible for the decline of the average curve. In other words, it works as I expected.

So much to the mythology that "minoxidil does not address the underlying cause of male pattern baldness". Don't waste space on this board with your "theories". You are a nut, who didn't use minoxidil on his own and can't interpret a written text.

 

[Bryan]

lol Have you read it at all? The first study says that 80% assessable patients maintained their regrown hair after 5 years.

The second study says that 14 patients taking 3% minoxidil twice daily continued to have a slight increase in hair counts between 1-3 years. 17 patients taking 3% minoxidil once daily experienced a slight decline. After they switched back to twice daily use, their hair loss stabilized. In summary, 9 out of 31 patients regrew hair between 1-5 years. Four users were below baseline after 5 years. These are the individuals, who were primarily responsible for the decline of the average curve. In other words, it works as I expected.

So much to the mythology that "minoxidil does not address the underlying cause of male pattern baldness". Don't waste space on this board with your "theories". You are a nut, who didn't use minoxidil on his own and can't interpret a written text.

You appear not to have read (or at least, haven't UNDERSTOOD) any of these studies. Go back, and re-read ALL of them. I stand by what I said in my old post above: of the five mentioned studies, Rietschel was the only one that had steady increases in haircounts; the other four had decreases. An average one-out-of-five rating isn't anything to brag about.

What may have confused you in most of the above studies is that some of them still had increases above baseline, at the time two or three or four years later, when haircounts were being measured; but the thing you need to understand is that HAIRCOUNTS WERE SLOWLY DROPPING, AT THAT POINT. You have to be smart enough to understand that ALL topical minoxidil haircounts increase at the very beginning, before they slowly and inevitably start dropping again. Why? Because minoxidil causes an "offset of growth", which can take a period of time (a few years, in some cases) to be depleted. After that time, hair is sloooowy dropping in both count and weight, once again. Why? Because minoxidil does nothing to interfere with the fundamental cause of balding. Sooner or later, hair is going to go bye-bye, even though minoxidil may slow it down just a bit, thanks to that "offset of growth".

 

[azuri]

Are you referring to the use of minoxidil alone?

What if you also take finasteride alongside minoxidil?

 

[temp28]

so basically bryan, if i understood your point, when somebody uses minoxidil it will set off more growth but after, let's say 10 years, we're down to baseline again.

that means one could drop minoxidil after a few years because it lost it's effectiveness? is this right?

 

[Bryan]

Are you referring to the use of minoxidil alone?

What if you also take finasteride alongside minoxidil?

Yes, I was referring to the use of minoxidil alone. Yes, I'd ALWAYS want to use finasteride (or an antiandrogen) alongside minoxidil. I don't think it's a good idea to use topical minoxidil alone.