Will minoxidil have effect without Propecia?

[jero]

hey

I am planning on using minoxidil for the first time and I wondered if it will be effective if I'm not using Propecia? I just want to maintain my current hair and I'm not really looking for regrowth, but I don't want to mess with my hormones so I don't want to use Propecia.

 

[amsch]

Yes it will, but without propecia it will not last long.

 

[CCS]

Yes it will, but without propecia it will not last long.

correct. You will get regrowth if you are an above average responder. But you will see it go away permenantly eventually if you are not on propecia.

At least get on nizoral. It will slow stuff down a bit, but not stop it like propecia. Minoxidil does not slow it down at all.

 

[AssignmentZero]

If you're looking to maintain then doing it backwards is better. Start with finasteride and then add minoxidil if finasteride doesn't work...but since you don't want to start on finasteride then the others are correct. You'll probably get regrowth but not lasting.

 

[casperz]

About 10 years ago I tried minoxidil alone for about six months to a year and saw no
regrowth at all and I was still losing so I stopped. When I started finasteride/minoxidil/retinA
it only took 90 days and I had significant regrowth.

 

[CCS]

If you're looking to maintain then doing it backwards is better. Start with finasteride and then add minoxidil if finasteride doesn't work...but since you don't want to start on finasteride then the others are correct. You'll probably get regrowth but not lasting.

The only place I need to regrow is between my grafts where it is smooth bald. Unless minoxidil can regrow significant hair there, I think hair transplant is my best bet. But if I have to keep it soaked in minoxidil all the time to get those results, what is the point?

 

[Nevis]

Yes it will, but without propecia it will not last long.

I see this idea a lot. And I understand the underlying "growth offset" logic, that your follicles are still "dying" (shrinking) w/o some sort of anti-androgen. So yes, when people come on the board and ask is minoxidil enough, people give the answer "no" and advise them to get on something else to slow the "attack"-process down: whither the enemy.

But do we have time frames or any personal experience on what "long" is?

I watched some friends go from hardly noticeable thinning and receding hairlines to NW5-7 in times ranging from 3-5 years with no treatment. But that's just me, and i'm spitballing here to get the convo rolling. So, let's say that, once started, the balding process will clean you out to a subjective level of "bald" in some time span like that without any treatment.

How long would 2x/day minoxidil alone add to your time before you viewed yourself as subjectively bald? 1 year relative to untreated? 2? 5?

Long story short, what is the rate at which minoxidil slows down the progression?
-Nevis

PS. I realize that there are complications to the analysis I'm asking for here. We can perhaps assume for simplicity but not accuracy that all your hair follicles respond the same to minoxidil. So that the application is indeed doing the same thing to all of them, and not, without anti-androgen treatment, letting some minoxidil-non-responding follicles shrink and die while others stay full for a longer time before following the same route. And would your progression be in the same "pattern" as it would be left untreated, or have a tendency to move to more diffuse stages rather than receding/thinning in spots leaving thick areas...anyway, I'd still like to hear thoughts and, above all, evidence. I want to be clear though that I'm not criticizing the advice, just want to clarify the adjectives used in the advice.

 

[Nevis]

Sorry for the long post, but it's a new pet-question I have not seen answered in my many years lurking.

Given that in many countries, you can get minoxidil over-the-counter or through online outlets cheaply and easily, I wonder how many people out there get a little worried about thinning/balding, start on minoxidil from their local supplier, and never check in here. But nevertheless have satisfactory results for a solid amount of time, therefore lending a selection bias to the opinions and information regarding minoxidil-only regimes here. I could, however, be inventing a demographic that doesn't exist too! Thanks for indulging me here guys...

 

[Nevis]

Nobody wants to take a stab at that question? Was it really so stupid?

 

[Nuli]

If you want to stay away from propecia I would use spironolactone or better yet, proxiphen. I think spironolactone/minoxidil/nizoral is a usable regimen.

 

[Nevis]

True, but that's the typical big stuff---anti-androgens + growth stimulants.

I'm more interested here in the length of time that minoxidil alone would be expected to help your subjective judgement of baldness. I feel that these forums have a major selection bias toward the people who are concerned enough about their hairloss to come, read, and throw lots of things at the problem; kitchen sink to just the big 3, and modifications on those patterns. (Since no one seems to have an answer and the thread didn't spark any interest, I'll take that as anecdotal evidence of just such a bias.)

But I still wonder how many people are out there just using minoxidil and feel "fine" about their hairloss, the way lots of people here (myself included) use the big 3 and have 5, 10, 15+ years relative success---at least in halting the progression, stabalizing, and going on with life. Are there minoxidil-only guys with similar success, albeit likely shorter, who just go into the drug store or online and get the stuff OTC, use it, and continue on with life? Thus, my question: How much shorter is their success?

Just a Gedankenexperiment here, but no less relevant than a lot of other speculative threads...

 

[Bryan]

I'm more interested here in the length of time that minoxidil alone would be expected to help your subjective judgement of baldness.

That depends on your own individual rate of balding, and your own individual response to minoxidil (I'm assuming here that the "offset of growth" theory about topical minxodil is correct).

Let me give you some simple numbers, just as an illustration of what I'm talking about: let's say that you are balding at the rate of 5% a year, meaning that you lose 5% of your haircount every year. Let's also say that minoxidl works in you by providing an extra 10% offset of growth. Using those numbers, you would get a spurt of growth of 10% from the minoxidil at the very beginning, but it would be gone (back to the original starting baseline) after 2 years. If your normal balding rate is only 2% per year, you'd be back to the original starting baseline in 5 years. See what I'm saying?

 

[Nevis]

Yep, thanks Bryan that's what I was getting at. I'm assuming then though that both the personal balding rate and the response rate to minoxidil are highly variable and individual specific? Or do we have some averages and ranges to work with?

 

[Bryan]

Yep, thanks Bryan that's what I was getting at. I'm assuming then though that both the personal balding rate and the response rate to minoxidil are highly variable and individual specific?

You bet!

Or do we have some averages and ranges to work with?

Well, this would be a good time to re-post these graphs from Vera Price's excellent 1999 topical minoxidil study:

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

As you can see, not only do they show the results of individual test-subjects who used 2% and 5% topical minoxidil, they also show the results of subjects who used just a placebo solution, and even subjects who got no treatment at all. Looking at all four groups, you can get a reasonable idea of the gradual decline in hairweights (I suggest using the hairWEIGHTS rather than the hairCOUNTS, since the weights seem to be more consistent and dependable) in untreated people, compared to the gradual decline in people who use topical minoxidil. That'll give you some idea of what you're asking about.

 

[Nevis]

As always Bryan, thank you. Very interesting. That's quite a result there---can't imagine how it felt being in the 5% group after the 96wk mark. You catch right up to where you would have been without treatment don't you! Certainly shows a remarkable minoxidil dependence?

On the other hand, I was surprised at the rather slow progression in all groups. Just personally surprised...i had no scientific preconceptions. The growth offset is more significant than I supposed. Even the 2% group (a level of minoxidil usage that is almost never discussed here) would get approximately 3.5-4yrs of above-baseline hair weight counts (the growth-offset effect). That's far better than the impression I got from casually reading the posts here as to the effectiveness of minoxidil...and thus the reason I asked my question in the first place.

Thanks for answering!

 

[Nevis]

on a side note, now that I'm looking at more of the studies and less of the opinion here, it really drives home that an ounce of prevention is worth it's weight in platinum. I wish the tone or the environment around hairloss wasn't so much around cures and regrowth (including advertisements for minoxidil and Propecia).

Of course i'd love a cure and tons of regrowth, but I know in the last 10 years I often felt like I was losing the battles, but in reality, I was on the cutting edge of what we could achieve...slowing down the progression to a tiiiinny fraction of what it otherwise would have been; really winning the war. Sure, I didn't fill in that thin spot that played with my confidence, but man it didn't go anywhere either.

I would have save a lot of time and energy if I had just "set it and forget it" as Ron Popeil says...

Thanks again

 

[Bryan]

As always Bryan, thank you. Very interesting. That's quite a result there---can't imagine how it felt being in the 5% group after the 96wk mark. You catch right up to where you would have been without treatment don't you! Certainly shows a remarkable minoxidil dependence?

Yes. Things start to go downhill in a hurry when you discontinue topical minoxidil, even falling below baseline for a period of time. But things seem to rebound after that, and you apparently get back to where you WOULD have been, had you never used it at all.

On the other hand, I was surprised at the rather slow progression in all groups. Just personally surprised...i had no scientific preconceptions. The growth offset is more significant than I supposed. Even the 2% group (a level of minoxidil usage that is almost never discussed here) would get approximately 3.5-4yrs of above-baseline hair weight counts (the growth-offset effect). That's far better than the impression I got from casually reading the posts here as to the effectiveness of minoxidil...and thus the reason I asked my question in the first place.

In the early days of my posting on hairloss sites, I spent a lot of time arguing with other guys who were absolutely CONVINCED that 2% topical minoxidil was completely useless, and there was nothing I could say that would convince them otherwise. I vaguely recall one of them telling me at the time that using 2% Rogaine was no better than putting water on top of your head. It's too bad I didn't have access at that time to the studies that I have now!

 

[Nevis]

Indeed....but it's the unfortunate truth that people will turn opinion into truth in the absence of good evidence. Glad there are good---albeit small---studies like this one.

The consistency in the 2% group relative to the 5% group is striking as well. Especially considering how much chatter here is devoted to sheds and increased incidence of hair-in-the-hand or -drain.
For maintenance where constancy over long term is the proper target given the state-of-the-art, 2% deserves a good look! (to the extent that the variance in hairweights stays as consistent as we scale up from 9 patients per group to many.)

keep fighting the good fight bryan!