In order for Minoxidil to work – namely prolong the anagen and delay the telogen phase of your hair follicle.
Your scalp has to “produce” enough sulfotransferase.(1)
Sulfotransferase is an enzyme which exists in the outer root sheath of your hair follicles.
This enzyme converts the topically applied Minoxidil into its metabolite – Minoxidil Sulfate.
Minoxidil Sulfate is the active form of Minoxidil.
Insufficient sulfotransferase activity in the hair follicle can restrict the efficacy of Minoxidil.
Oral Minoxidil has been shown efficacious by non-respondents to the topical Minoxidil 5% (more about that in another post though).
Topical Minoxidil Sulfate has 40% higher mollecular weight than Minoxidil. Obviously it will restrict the proper transcutaneous absorption of Minoxidil Sulfate.
Minoxidil Sulfate has been shown less stable than Minoxidil and thus it should be kept in small bottles.
It should be preferably produced in relatively small batches.
The good news….
One study on 44 subjects (non-respondents to 5% Minoxidil) showed effectiveness of Minoxidil Sulfate 10% upgrading onto Minoxidil 10%.(1)
Minoxidil Sulfate clearly needs more scientific evidence which would confirm its efficacy on non-respondents to Minoxidil 5%. Minoxidil Sulfate, however, may not really help respondents to Minoxidil 5% who start noticing decrease effectiveness of 5% Minoxidil solution.
Taking advantage of the Minoxidil dose-response seems logical. Will higher Minoxidil concentration yield better results and thicker hair regorwth though?
Doses-response of Minoxidil has been confirmed in this study(5) comparing Minoxidil 2% and 5%.
Dose-response of Minoxidil 10% and 5% hasn´t been observed unfortunately(2).
Dose-response of Minoxidil 15% and 5% showed different efficacy in this study(3)
Although Minoxidil 7%, 10%,12% or 15% concentrations are not FDA approved for treating hair loss.
Some studies already suggest that upgrading 5% Minoxidil after seeing lesser and lesser efficacy can be experimented with. Prescription is not necessary though.
If you want to experiment with higher concentrations of Minoxidil, feel free to do so. Please make sure you get your Minoxidil from a trusted supplier though and use it only for research purposes.
In case you have already used Minoxidil 5% and the effectiveness started fade, upgrading onto 10% or even 15% may help you.
In case you haven´t responded to Minoxidil 5% at all – even after 1 year of use, I´d recommend switching to Minoxidil Sulfate or oral minoxidil (more about these alternatives in another post).
Azelaic acid is a naturally occuring acid which has been already used for treating alopecia. Nobody really understands though, how it contributes to healthy hair growth and improvements in terminal hair regrowth.
20% Azelaic acid has been shown somewhat efficacious in treatment of alopecia areata(6)
This study assessed terminal hair regrowth score of alopecia areata patients and observed improvements.
This study(7) compared 5% Minoxidil to another 5% Minoxidil enriched in 1.5% azelaic acid. The additional azelaic acid concentration hasn´t proven any extra benefits.
Although 1.5% concentration of Azelaic acid didn´t show any additional benefits, higher concentrations of 5%-20% may add more potency to a topical Minoxidil solution. Further research is needed.
Azelaic acid in nature
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