5 Reasons Why Minoxidil is not Working in Men

Many people start on topical Minoxidil only to find out six months later that it doesn't work for them. So they are waking up at 2am searching on reddit how to regrow their hair and why they have not been successful despite dedicating six months and hundreds of dollars - yet they are afraid to tell their doctor it didn't work.  We take a deep dive into topical Minoxidil for the treatment of hair loss for men and how to improve the effectiveness of topical Minoxidil.

1. Minoxidil is a Pro-drug 

Minoxidil is a pro-drug and only becomes active once it comes into contact with an enzyme present in the hair follicle called Sulfotransferase. Numerous studies dating back to 1990 have demonstrated that approximately 50% of the population do not make enough of this enzyme to see appreciable improvements with Minoxidil. For this reason, many will stay on Minoxidil for months, only to find that it doesn't work for them.  

2. The Formulation

Preparation of Minoxidil requires solubility and stability. Traditional formulations of topical Minoxidil contain 30% to 75% alcohol. This can cause scalp dryness and irritation and hair to become brittle and break easily, making it difficult to regrow hair. 

Despite points one and two above, Olevit™ is scientifically formulated by Médicii Laboratories to allow Minoxidil to stay in solution and improves the absorption of Minoxidil without the addition of alcohol. You can find this exclusive formula in Minoxidil 5 Plus+

3. Concentration

Meta-analysis of several clinical studies show both males and females respond more favourably to 5% compared to 2% strength. Don't waste your time with the 2% topical strength.

4. Androgenic Alopecia is also due to a Hormone Imbalance 

Hair loss is accelerated by high levels of dihydrotestrone (DHT). Minoxidil does not have any effect on DHT levels.

The mechanism by which Minoxidil promotes hair growth is not fully understood. Minoxidil is a potassium channel opener and it is also a vasodilator (aka widens blood vessels). It is speculated that by widening blood vessels and opening potassium channels, it allows more oxygen, blood and nutrients to the follicle. This can also cause follicles in the telogen phase to shed and soon to be replaced by new, thicker hairs in a new anagen phase. 

5. Follicle Miniaturisation

High levels of DHT causes follicles to miniaturise with each new hair cycle. Minoxidil works by stimulating blood flow to the scalp area to stimulate thicker re-growth by providing sufficient blood flow and nutrients to the follicles. 

Studies have also shown micro-needling can improve hair thickness as well as hair count. When used in conjunction with Minoxidil, the results are superior compared to either therapy alone. 

 

How to Improve the Response Rate of Minoxidil

The response rate to Minoxidil can vary between individuals. Some may see cosmetic improvements within 2 months, some may take six months and for others, Minoxidil may not be the best option if your hair loss is primarily due to an increase in DHT levels.  Here are some ways to improve the response rate of Minoxidil for hair growth success:

    • Opt for a non-alcoholic formula and ingredients that work in synergy with Minoxidil which you can find in Minoxidil 5 Plus+.
    • Combine Minoxidil and micro-needling once a week. Ensure you are using medical grade needles that are approximately 1mm-2.25mm in length.
    • Combining Minoxidil and Finasteride, a potent prescription drug that inhibits 5 DHT. Topical Finasteride and Minoxidil solutions have shown be equally as effective as oral dosing with significantly less systemic adverse effects.

 

 

Author: Dan Atkinson  B Pharm

 

References: 

      1.  American Academy of Dermatology. “What is Male Pattern Hair Loss and can it be Treated?” News release Updated December 13, 2022. Last accessed June 5, 2023.
      2. Olsen, E et al. (2002). "A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men." Journal of the American Academy of Dermatology, 47(3), 377 385.
      3. Buhl, A et al (1990). "Minoxidil Sulfate is the Active Metabolite that Stimulates Hair Follicles." Journal of Investigative Dermatology.  1990 Nov;95(5):553-7.
      4. Gupta, A et al (2022).  "Minoxidil: A Comprehensive Review." Journal of Dermatological Treatments.   2022 Jun;33(4):1896-1906.
      5. Barbareschi, M (2018). "The Use of Minoxidil in Males and Females for Androgenic Alopecia, a Story of more than 30 years." Italian Journal of Dermatology and Venereology.2018 Feb;153(1):102-106.