What is the REAL purpose of Minoxidil?

[Guest]

Right now I'm on Propecia and by most accounts am either a Norwood 1 or Norwood 1.5. I am 22 years old. You can look at my regimen for the full list of what I am on which is not much: 1.25 mg finasteride per day, 1% Nizoral every 3 days, and a daily multivitamin.

I would be happy if I just maintained my hair and regrew nothing. Does minoxidil serve any purpose for me? Some people keep telling me that propecia+minoxidil is better than just propecia alone, but I thought that minoxidil regrows hair and propecia simply maintains it, so people who just want to maintain do not need minoxidil.

Does this mean if I some day develop aggressive hairloss that I will need minoxidil to counteract the effects of my genetics overpowering the propecia? What does aggressive hairloss mean anyway? Does it mean when someone starts losing hair early in life or does it mean a lot of shedding? etc. I know I'm n ot much of a newbie on here anymore but I just keep hearing conflicting accounts of these medications and hairloss from people. Thanks.

 

[CCS]

Early balding is a sign of agressive balding, but does not mean you have it. Agressive balding is when a high number of follicles are quickly become sensitive to even low DHT levels or other balding causes we don't yet know about. That means that even reducing DHT levels to 25% their normal level might not be good enough for such people because maybe now or in a few years their follicles will only be able to tolerate 15%.

If you have aggressive balding, minoxidil will give you more hair soon, but it will not stop you from loosing hair at the same rate as before once you get you immediate increase. And if you are loosing hair fast enough, the gain from minoxidil can be hidden in the loss.

If your hairloss becomes aggressive, you need to get on Avodart or topical anti-androgen or SODs. These can maintain hairs. Minoxidil just gives you a quick fix that can be maintained by hormonal drugs but does not maintain hair in its own mechanism.

If propecia is maintaining your hair, and you are happy with your current levels, then you should not bother with minoxidil, unless you've been taking it this whole time and some of the hair you have is from the minoxidil. If you stop, you will find out what hair is from minoxidil in 2 weeks, or rather maybe 45 days if you had a lot. After that, you can regrow it all back in 2 months to a year if you decide you want to.

If you use SODs, anti-androgens, and 5ar blockers, and regrow hair and then switch to propecia later, you can accomplish the effect of having started the propecia years earlier. Your hair counts will drop, but only to the level you would have been on had you been on propecia years earlier when you naturally had that much hair. Minoxidil is different because when the extra hair falls out (and does so much sooner) you fall to where you would have been without the minoxidil; you don't get the effect of starting propecia sooner.

Because minoxidil regrows twice as much hair as propecia, and grows a lot even with 2%, I feel it is worth using, unless the rest of my regimen gives me dramatic results.

Minoxidil regrows more hair mass than propecia, but can't maintain it without propecia. I don't know which concentration is used here.
http://www.hairlosstalk.com/newsletter/ ... le&sid=290

 

[Guest]

Thanks

So you are saying that I should switch to Avodart at the first sign I see that Propecia is not maintaining my hair, then I should be able to continue to maintain indefinitely with Avodart?

And you're also saying that Minoxidl isn't one fifth of the drug that Propecia is when it comes to stopping hair loss and maintaining hair?

How much better is Avodart than Propecia, truly? How important is decreasing the type 1 reductase to maintaining hair levels? Or is it the additional decrease in type 2 reductase that really makes Avodart better than Proepcia?

Finally, does it stand to reason that if Avodart is more effective because of the additional type 2 reduction, that most people will not lose any more hair once on Avodart?

Thanks/.

 

[CCS]

Avodart should stop hair loss in a larger percentage of men than propecia does. But becuase no long term studies were done, we will never know. We just know that in 26 weeks it regrew about 40% more hair than proscar, I think. With aggressive hair loss, even avodart may not be enough. Read Aplunk1's story. The poor guy is considering hair transplant now.

Serum DHT does contribute to hair loss, but not very much. And there is a lot produced by 5ar1 right next to the follicle, which gives local high levels of scalp serum DHT. This DHT has little effect on how soon a balding man will bald. It has a small effect (maybe 10 or 15%) on how fast a guy on propecia will bald, or how much hair he will keep. When 98% of 5ar2 is stopped, the remaining DHT from 5ar1 has a much larger effect, as is seen from 2.5mg/day dustasteride regrowing 20% or so more hair hair than 0.5mg/day even though both inhibit 99.5% and 98+% of 5ar2 respectively.

Instead of taking 2.5mg/day, your best bet is to use topical anti-androgens, since when most DHT is gone, even the testostosterone and other weak androgens can hurt the hair in their large concentrations. They don't do much, but for very sensitive follicles, their effects are non-zero. Best of all, testosterone does not stand a chance against spironolactone. spironolactone just does not fight DHT too well, since DHT is 30 times as strong as testosterone.

Stopping

 

[Guest]

This DHT has little effect on how soon a balding man will bald. It has a small effect (maybe 10 or 15%) on how fast a guy on propecia will bald, or how much hair he will keep. When 98% of 5ar2 is stopped,

I thought the main cause of hair loss was DHT though, convincing the body that the hairs do not belong in the follicles and continuously rejecting them?

So if DHT has a small effect on how fast i will bald on propecia, then what has the biggest effect?

Thanks.

 

[CCS]

Rogaine does not maintain hair. It just gives you more while you are using it. You start to get it in 2 months, maybe, and you get all you will get in 1 year. After that, your maintainance depends solely on the finasteride or dutasteride.

Rogaine might give a little protection to blood vessles, which might extend your hairs life by a little, but not much. If you were going bald in 5 years, you might last 6. There may be a few exceptions to that, but we won't know since we don't know where they would have been without the rogaine. But if someone lost a lot, and then got on Rogaine for 20 years, and regrow and kept a lot, then they will be saying the rogaine does keep hair. But from the graphs I've seen, this is not the case for most people.

 

[Guest]

Ccs I was just referring to the propecia exclusively actually, forgetting the minoxidil.

Now, when you said that DHT has a very small effect on the balding process of men on finasteride, what did you mean? What else could be causing the hair loss in these people?

My only goal is maintenance. My hair is curly enough that I can just grow it out long(which im currently doing) to hide the scalp that can be seen right now. I am wondering though what to do if my genetics start to overpower the propecia. Just switch to avodart? By then Hair multiplication should be out and nd then I won't have to worry about any of this right?

The reason you brought up the serum I assume is because finasteride inhibits much more serum dht than scalp dht right? I read that propecia reduces scalp dht by 38%? Is this enough to halt the balding process in most men? If my numbers are wrong please correct me.

I think that this topic will be of interest to a lot of people who are in the same situation that i am in - norwood 1's and 1.5's etc who don't have need for your regimen yet. So it's good that we are discsussing it.

 

[CCS]

I never said DHT has little effect on hair loss in men taking propecia. You need to quote the whole sentence. I said SERUM DHT has little effect on hair loss. Many cells in the body produce DHT, which leaks into the blood after it is used and is metabolized by the liver. The DHT produced inside the follicle is the primary cultprit in hair loss. DHT in the blood has little effect.

Merk made a drug that inhibits just 5ar1, and it did nothing for hair loss. That shows that most of the DHT attacking follicles does not come from the nearby sebatious glands. Even when 70-80% of DHT from 5ar2 is gone, the DHT from sebacious glands still is a farely small contributer. But when 98+% of 5ar2 is inhibited, the DHT from the glands starts to become the main factor, which is why 2.5mg/day dutasteride, which inhibits 855 of 5ar1 is stronger than 0.5mg/day, which inhibits only 50% of 5ar1.

Scalp DHT is what you measure if you take blood from the scalp. It is a mixture of DHT from 5ar1 and 5ar2 and has little impact on hair loss. The reason it is not lowered as much as serum DHT (blood from an arm vein) is because the DHT from 5ar1 has not yet been diluted to the rest of the body. You should not take those 65% and 38% numbers seriously. Proscar inhibits about 80% of the DHT that matters in the follicle.

 

[Guest]

Now I understand, thanks for clearing that up. Now if your 80% number is correct then that if people's hair can withstand around 20% of original DHT levels then they will be able to maintain their hair count with 1 mg finasteride?

 

[CCS]

yes.

and 5mg reduces 5ar2 activity more than 1mg, but not by much. i don't have any graphs with 1mg.

But....
Not all your hairs are equally sensitive. There is a distribution, and maybe a bell curve. Some follicles, if they are still alive in your NW0 area, are probably very sensitive now, because of genetics and time, and there is a continuous spectrum. You have to decide how hard you are going to fight for the most sensitive hairs. And you have to guess at which areas have dead follicles and which areas are just sleeping. At least you can positively monitor the hairs you can see.

Fibrosis does not set in right away. Even smooth bald scalp will often grow hairs again in immune deficient mice, which proves those follicles were not killed yet. Given time, they probably are. But the presence of shiny sebum does not tell you this since many guys with hair on their head have shiny sebum. The sebum gland and the follicle are two different structures.

 

[Bryan]

I would be happy if I just maintained my hair and regrew nothing. Does minoxidil serve any purpose for me?

What minoxidil does is give you an extra offset of hair.

Also, Avodart gave 22% better haircount improvements than Proscar in Glaxo's testing (when compared to placebo, which is the proper way to do it).

Bryan

 

[CCS]

Since 22% is smaller than 50%, I take it the placebo group lost a lot of hair in 6 months.

 

[Bryan]

I used to have a link to a site that had all the raw data from the Glaxo trial of dutasteride and finasteride, but I lost it when I had a computer crash about a year ago. Does anybody else have that same link I'm talking about? In any event, here's the pertinent data from that trial:

Haircount change from baseline using a 0.79 square-inch target area, after 24 weeks.

placebo: -29.6

finasteride (5 mg/day): +73.2

dutasteride (0.05 mg/day): +24.8
dutasteride (0.1 mg/day): +72.3
dutasteride (0.5 mg/day): +95.5
dutasteride (2.5 mg/day): +109.8

As you can see, the 0.5 mg/day dutasteride dose grew 95.5 + 29.6 = 125.1 more hairs than placebo, and the finasteride grew 73.2 + 29.6 = 102.8 more hairs than placebo. So Avodart was 125.1 / 102.8 = 21.69% more effective than Proscar in that test.

Bryan

 

[Guest]

I would be happy if I just maintained my hair and regrew nothing. Does minoxidil serve any purpose for me?

What minoxidil does is give you an extra offset of hair.

Also, Avodart gave 22% better haircount improvements than Proscar in Glaxo's testing (when compared to placebo, which is the proper way to do it).

Bryan

how long will that extra offset last? So the haircount is increased with 22% on avg with avodart, okay. Does this translate to better maintenance compared to propecia or is it just the increase in haircount means your total haircount decreases more slowly?

cause im primarily concerned with maintaining the hair i have and im wondering how the increased haircount correlates with better maintenance?

thanks

 

[Bryan]

how long will that extra offset last?

The offset from minoxidil? Until I see evidence to the contrary, I'm going to assume that it lasts as long as you continue to use the minoxidil. Now having said that, I _hope_ you understand what I mean!

So the haircount is increased with 22% on avg with avodart, okay. Does this translate to better maintenance compared to propecia or is it just the increase in haircount means your total haircount decreases more slowly?

Nobody knows, since there are no long-term trials with dutasteride like there are with Propecia.

Bryan

 

[Guest]

Thanks

And that sucks because there probably never will be, right? The reasons are as others have alluded to, that the generics are ripping off the patents overseas and they don't think it would profitable.

I'm sorry but I still don't understand how the minoxidil induced hair regrowth can stay on the head but the other hair can't.

 

[Bryan]

And that sucks because there probably never will be, right?

I think it's very very very unlikely that there will ever be a 5-year study of dutasteride for hairloss. There may not even be any more short ones, like just 1 year or so.

I'm sorry but I still don't understand how the minoxidil induced hair regrowth can stay on the head but the other hair can't.

Did you read this other post of mine? It explains in a nutshell what I mean by that minoxidil-induced "offset of growth":

http://www.hairlosstalk.com/discussions ... c&start=20

It's the fourth post from the top on that page.

Bryan

 

[Guest]

i gotcha. so you're saying the guy balds a little slower than his brother because the minoxidil adds 100 hairs to his scalp.

andbasically theres no reason for someone in the early stages of hair loss to do minoxidil now, since they can always do it later?

thanks.

 

[htownballa]

i gotcha. so you're saying the guy balds a little slower than his brother because the minoxidil adds 100 hairs to his scalp.

andbasically theres no reason for someone in the early stages of hair loss to do minoxidil now, since they can always do it later?

thanks.

No balding rate is the same, but you bald at the same rate with MORE hairs...only propecia/possibly CPs slow the actual rate because they work against DHT, the fundamental cause of male pattern baldness

 

[Guest]

i gotcha. so you're saying the guy balds a little slower than his brother because the minoxidil adds 100 hairs to his scalp.

andbasically theres no reason for someone in the early stages of hair loss to do minoxidil now, since they can always do it later?

thanks.

No balding rate is the same, but you bald at the same rate with MORE hairs...only propecia/possibly CPs slow the actual rate because they work against DHT, the fundamental cause of male pattern baldness

I thought copper peptides regrow hair just like rogaine. i didnt think they inhibited DHT. Topical antiandrogens like spironolactone can inhibit DHT.