minoxidil

Minoxidil Shampoo Pros and Cons

Minoxidil Shampoo

Minoxidil Shampoo - Good Idea or Not?

written by Matt Dominance

In this post you will find out:

  • What is M. Shampoo?
  • Effectiveness of Minoxidil-enriched Shampoos
  • Minoxidil Shampoo vs topical Minoxidil (Pros and Cons)
  • 3 Ways to boost Minoxidil effectiveness for non-responders
  • Conclusion

What is Minoxidil Shampoo?

It is a shampoo enriched with Minoxidil (usually 1% or 2%). Brands known for offering such shampoo are Foligain or less known – Bioken. 

 

Minoxidil Shampoo with 2% Minoxidil
Biotin Shampoo with Minoxidil
Biotin Shampoo with Minoxidil

Combining Shampoo with Minoxidil - Good Idea?

Minoxidil in a Shampoo

We know that shampoos with parabens and sulfates are bad for the overall health of our hair and skin.

We also know that DHT blocking shampoos containing useful Ketoconazole are scientifically proven to slow down hair loss and reduce/get rid of dandruff. 

But is Minoxidil really a must have ingredient in your shampoo?

Well, Minoxidil is known for prolonging the anagen (growing) phase of the hair follicles on the whole body not just on the scalp.

It can do so by opening potassium channels and also up-regulation of vascular endothelial growth factor (VEGF), which helps in maintaining dermal papilla vasculature and hair growth

How long should the Minoxidil Shampoo stay on the scalp?

In this study they also observed how soon Minoxidil 5% can stimulate cutaneous blood from in the scalp after one time application

minoxidil stimulates cutaneous blood flow in human balding scalps
Minoxidil 5% is able to stimulate cutaneous blood flow in the balding scalp within 15 min after application

We have to note, that only 0.25ml of 5% Minoxidil has been used in this study. 

Trying to achieve similar results with a Minoxidil Shampoo would require at least 1% Minoxidil concentration per each ml of the shampoo.

Furthermore, you would have to leave the shampoo on the scalp for up to 15 minutes.

How effective is the Minoxidil Shampoo 1%?

This study from 2015 investigated the therapeutic effect of Shampoo with Minoxidil 1% for 4 months.

It was a  double-blind placebo controlled trial with 60 subjects.

The treatment group used the Minoxidil Shampoo every other day for 4 months. The control group used a similar shampoo but with no Minoxidil in it.

Patients were also evaluated on a monthly basis.

Minoxidil Shampoo study

If we take a look at both parameters – vellus hair and terminal hair improvement, we can clearly see an increasing trend in the treatment group. In the placebo group on the other hand, it seems that the amount of vellus hair also improved in about 13% (21% in the treatment group). 

The amount of terminal hair increase however, seems to significantly improve between the treatment and placebo group.

The study unfortunately took only 4 months. Could we further assume increasing improvements in the terminal hair and vellus hair counts in the treatment group?

It seems that further studies are going to be necessary.

How does Minoxidil enriched Shampoo compare to Minoxidil 5% topical?

Before we try to compare the same active ingredient used in 2 different product variations, let’s take a look at what makes the active ingredient Minoxidil potent for hair loss:

  • Using Minoxidil with a proper application frequency
  • Allowing long enough absorption duration
  • Using Minoxidil in high enough concentration

The half-life of topical Minoxidil averages at 22 hours, which means that at least once a day application is required to maintain the ideal stimulatory benefits. That’s why it is recommended to use products with 5% Minoxidil at least once a day and sometimes even 2x a day.

Could you use MX Shampoo every day?

Although patients with very oily scalp and excessive sebum production could get away with shampooing their head every day, not everybody could do so without drying out the scalp and disrupting the ideal pH balance.

If we assume the usual shampooing frequency of 3-4x per week, and compare it to usual topical Minoxidil application of 1-2x every day, we get superior hair follicle stimulation by using Minoxidil with higher frequency than 3-4 times per week. 

How long will be the absorption with a Shampoo vs Topical solution containing Minoxidil?

Shampoo absorption will normally last no longer than 5 minutes while a topical solution can be left on the scalp for many hours.

minoxidil absorption chart

Minoxidil absorption over time has been researched in this study which discovered a more rapid absorption rate of 50% within the first hour of application followed by a less rapid absorption rate (another 25%) between 1 – 4 hours. 

We can assume a 100% (close to 100%) absorption within 8 hours. 

Minoxidil application intervals in this study were every 12 hours.

This makes it impossible for the MX shampoo to beat topical MX 5% in terms of absorption duration.

In order for this to be a fair battle, we need to get a shampoo standardized with 5% Minoxidil in each 1ml of shampoo. Why is it important? 

Significance of 5% concentration over 2%

Long term effectiveness of 5% Minoxidil has outperformed the 2% Minoxidil.

By comparing the effectiveness of the Minoxidil Shampoo 1% (as it was described in the previous study) to 5% topical solution (FDA approved MX solution for androgenetic alopecia), the latter one will likely win the battle! 

Minoxidil Shampoo for non-responders to the traditional Minoxidil 5% solution

It has been shown, that patients with a very low activity of sulfotransferase enzyme on the scalp are less likely to have a less favorable clinical response to Minoxidil. That’s the reason why only every other person can actually regrow hair after using Minoxidil 5%.

Sulfotransferase enzyme is responsible for converting the inactive ingredient Minoxidil to Minoxidil Sulfate (MXS). By applying Minoxidil on the scalp, this conversion happens topically. 

This study on individuals with low/no sulfotransferase activity on the scalp has shown that applying Minoxidil Sulfate directly helped improve their clinical response. The concentration of MXS solution was 10%..

The problem with MXS though, is its instability. Therefore it should be supplied in a small package.

Individuals with little to no clinical response to traditional 5% topical Minoxidil in the past who are considering Minoxidil shampoo, should rather do the following:

 

3 Ways to boost Minoxidil effectiveness for non-responders

1. Minoxidil Solution enriched with Tretinoin

Topical tretinoin application influences the expression of follicular sulfotransferase. It has been shown in this cohort study. Another study compared Minoxidil 5% vs Minoxidil 5% + 0.01% Tretinoin and also confirmed potential benefits of including tretinoin in the topical Minoxidil formulations. 

Among very few available Minoxidil solutions with Tretinoin I’d suggest this one with 0.025% Tretinoin called Dualgen – 5R (Minoxidil 5%, Tretinoin 0.025%, Azelaic Acid 5%, Adenosine, Biotin and Caffeine).

Although topical application of Biotin hasn’t shown any significant stimulatory benefits on hair growth, Adenosine and Caffeine have been shown to positively affect the anagen (growing) phase of the hair follicle.

2. Minoxidil Solution enriched with Diclofenac sodium 0.5% and Tea Tree Oil 5%

In this study, they created a special micro-emulsion with Minoxidil 5%. Micro-emulsions are mixtures of liquid, oil and surfactant. 

Minoxidil study

Topical Diclofenac 3% is often times used as a treatment for Actinic Keratosis. This skin condition develops over time due to sun overexposure. This study accidentally included males with Actinic Keratosis who were also suffered from androgenetic alopecia. 

As a side effects of this treatment improvements in terminal hair growth was observed.

Unfortunately, I haven’t been able to find any topical micro-emulsion with Minoxidil incl Diclofenac sodium which is commercially available. 

The good new is, that Diclofenac sodium has been shown to be pretty stable. In this study they found out that a suspension with Diclofenac sodium stored in 60ml bottles for 93 days still retained 99.5% of its original concentration. 

3. Derma rolling or Micro-needling

Using derma roller regularly in conjunction with Minoxidil therapy helps open the pores in the skin and results in better transcutaneous absorption.

In the Derma Roller (DR) and Minoxidil (MX) study on 99 patients (50 in the DR+MX group and 44 in the MX only group), they observed:

8.5% increase in the mean hair count after 12 weeks in the MX only group

40% increase in the mean hair count after 12 weeks in the MX+DR group

In this article you can read more about how to use a derma roller, best derma roller frequency, and how to clean it after every use.

 

 

Conclusion

Although adding extra Minoxidil into your Shampoo could be superior compared to not including it there at all based on this randomized placebo-controlled trial, the additional benefits of such a shampoo should be still taken with a grain of salt before further research will be conducted.

There is also no reason to use such shampoo if one is already a user of topical Minoxidil 5%.

Short shampooing times compared with relatively long Minoxidil absorption time is really unfavorable for the efficacy of all Minoxidil-containing shampoos. 

For a more effective hair loss prevention regimen it would be much more advisable to use the standardized 5% Minoxidil solution topically together with the Ketoconazole Shampoo to maximize the results instead. This is the Shampoo I use myself and recommend.

Also you can read more about why Ketoconazole Shampoo is good for hair loss prevention here.

Individuals who were previously non-responders to conventional MX 5% are likely to get no additional benefits from using Minoxidil-enriched shampoos. In such case, additional use of tretinoin, diclofenac sodium or MXS can be considered for better clinical response to Minoxidil.

the big 3 of hair loss

The Big 3 of Hair Loss Prevention

The Big 3 of Hair Loss Prevention

written by Matt Dominance

If you are new to my website, make sure you read Medical Disclaimer before you continue reading this article.

3 Simple Steps to Prevent Early Balding

In this short post you will find out what are the 3 best anti hair loss treatments you can start using once you notice the first signs of male pattern baldness!

These treatments have been selected based on:

  • Their proven effectiveness in multiple clinical studies 
  • Friendly cost of a monthly supply 
  • Treatments are easy to stick to

1. Ketoconazole Shampoo

Ketoconazole shampoo is known for providing extra protection against dandruff, which could be responsible for scalp inflammation and additional hair loss. Ketoconazole could benefit not only to kill dandruff but potentially block DHT topically and thus slow down the hair miniaturization. 

The shampoo with Ketoconazole I use is the Revita Shampoo with 1% Ketoconazole in it. I’ve been using it successfully for more than 2 years by now. 

I have been noticing reduced hair loss several days after shampooing. My daily shedding tends to increase a little, if I don´t apply Ketoconazole shampoo for more than 5 days.

Ketoconazole seems to improve the proportion of anagen hair folliclesfights seborrheic dermatitis and promotes hair thickening.

2. Minoxidil 5% and Derma Roller

Minoxidil is a hair stimulant which supposedly works by opening potassium channels via topical application on the scalp. This treatment is FDA approved and for it to be successful, patients have to apply it consistently at least once a day on a dry scalp. 

This medication also prolongs the anagen (growing) phase of the hair follicle and delays the hair shedding. It also comes with initial shedding stage (first 1-3 month of using Minoxidil).

Minoxidil – induced shedding is completely normal and it is a sign that this medication is working.

In case you want to try another hair stimulant which comes without the initial hair shedding, you can check out my article about Stemoxydine and how it compares to Minoxidil.

Derma-rolling is another great tool to have in your hair loss prevention toolkit. Regular use of the derma roller or derma pen has been shown to boost the absorption of Minoxidil 5% and thus increase the hair regrowth potential of Minoxidil treatment.

If you decide to combine these two together, make sure you don’t apply Minoxidil product on the scalp earlier than 24 hours after your derma rolling session.

In this article I explain how I practice derma rolling as well as its additional benefits compared to using Minoxidil alone.

3. Finasteride

Please consult your doctor before taking Finasteride/Propecia as it requires prescription!

Finasteride is the 2nd FDA approved medication next to Minoxidil with only one difference – it requires a prescription from a doctor (dermatologist, or a hair transplant doctor). Side effects from Finasteride incl. decreased libido, erectile dysfunction or depression are linked to inhibition of 5 – alpha – reductase.

Inhibition of 5AR enzyme is the main mechanism of action by Finasteride. It’s the reason why this drug can successfully prevent hair loss. 5 AR converts Testosterone into more potent Dihydrotestosterone DHT and thus acts as a precursor of male pattern hair loss by genetically predisposed individuals.

This drug has to be taken orally once per day. Usually 1mg is the standardized dose prescribed by doctors. 

However you can also take anywhere from 0.25mg to 1mg to successfully block the DHT on the scalp.

Taking 1mg is recommended to achieve a faster Finasteride accumulation in the scalp tissue and thus faster hair loss prevention.

Here you can check out my experience with Finasteride and results after 1 year of use!

Are you interested in a hair transplant but don´t know where to start?

Minoxidil vs Stemoxydine for hair growth

Minoxidil and Stemoxydine for Hair Growth

Minoxidil and Stemoxydine for Hair Growth

Minoxidil vs Stemoxydine for hair growth

written by Matt Dominance

If you are new to my website, make sure you read Medical Disclaimer before you continue reading this article.

Commonalities of Stemoxydine 5% and Minoxidil 5%

  • Availability over-the-counter in most countries
  • Hair growth stimulants 
  • Don´t affect hormones e.g DHT, Testosterone or enzymes (5-alpha reductase)
  • Affect hair follicle growth cycle 
  • Only effective as long as you use them continuously 
  • Mechanism of hair growth stimulation is likely to be more complex and hasn´t been fully established yet
Minoxidil vs Stemoxydine for hair growth

How Stemoxydine is different from Minoxidil?

stemoxydine
  • Doesn´t come in a foam version (liquid only)
  • Available as Serioxyl (Loreal) or Cerafill
  • Comes in a 90ml bottle
  • 3-month supply is slightly more expensive than 3-month supply of Minoxidil
  • Shortens the Kenogen phase (phase of inactivity between the old Telogen and new Anagen hair follicle phase)
  • Doesn´t affect the Anagen phase at all
  • Not FDA approved for treating androgenetic alopecia
  • Patented and developed by Loreal
  • Most of the clinical data on Stemoxydine comes from Loreal (company bias)
  • Dries quicker than liquid Minoxidil
  • Grows less hair than Minoxidil (less effective)
  • Side effect profile is milder compared to Minoxidil

How Minoxidil is different from Stemoxydine?

Minoxidil 5% from Kirkland
  • Comes in liquid and foam version
  • Available by dozens of brands (due to expired patent)
  • Comes in a 60ml bottle
  • 3-month supply is cheaper than 3-month supply of Stemoxydine 
  • Prolongs the Anagen phase and shortens Telogen phase
  • Causes premature shock loss (during the first months of use)
  • Clinical data on Minoxidil comes from various sources (low company bias)
  • FDA approved for treating androgenetic alopecia
  • The liquid version takes longer to dry compared to Stemoxydine
  • Grows more hair than Stemoxydine (more effective)
  • Side effect profile of Minoxidil can be higher as it is known for being an anti-hypertensive vasodilator (in its oral form e.g Loniten)
  • Minoxidil tends to irritate the scalp more compared to Stemoxydine, because of Propylene Glycol 

Hair Follicle Growth Phase

Below you can see the different mechanisms of actions between Minoxidil and Stemoxydine.

Minoxidil vs Stemoxydine Hair Growth Cycle

Minoxidil helps the hair follicle to stay in the Anagen (growing) phase while Stemoxydine helps it to return back to the Anagen phase after Telogen phase has been completed.

Telogen phase can never be avoided and belongs to a natural regeneration process of the hair follicle.

Patients with androgenetic alopecia may have suboptimal hair follicle growth cycle.

It means that hair follicles may not always pass to the Anagen phase right after the Telogen phase has been completed.

As a result of that, the hair follicle can get stuck in the Kenogen phase and its return to the Anagen phase may be delayed.

Kenogen phase can be further divided into Exogen, when the hair falls out, and Neogen, when the new hair and follicle are developing.

Conclusion

Minoxidil and Stemoxydine are both topical stimulants for more hair growth.

Their efficacy will depend on the stage and severity of patient´s hair loss.

They should be seen as complements. By using both patients can achieve synergistic effects.

Minoxidil is superior to Stemoxydine in terms of efficacy and scientific evidence.

Stemoxydine and Minoxidil can be purchased as over-the-counter medications and cost about the same. 

Minoxidil is FDA approved for treating hair loss while Stemoxydine is not.