The Avacor Hair Regrowth Blog
3Aug/111

Minoxidil Mini-Series: Part 5 – Benefits, Limitations, and Side Effects

This post will conclude the Avacor® Hair Regrowth Blog's five part “mini-series” on minoxidil, the first FDA-approved treatment for hair loss. Earlier episodes of the mini-series covered the early history of minoxidil, clinical trials showing its efficacy in treating androgenetic alopecia, and its approval by the FDA as a hair regrowth treatment. In this final segment we will highlight the benefits, limitations, and side effects associated with minoxidil.

Benefits of Minoxidil Treatment

Minoxidil products, such as Avacor Physicians Formulation® and Rogaine®, have helped thousands of men and women stop their hair loss and begin regrowing hair.

Several clinical trials have proven that minoxidil is able to prevent hair loss and regrow hair, with investigators observing hair growth in anywhere from 30-60% of patients (for details see our previous post on clinical trials). These studies also suggest that even if patients do not achieve noticeable hair regrowth with minoxidil treatment, they can at least stop losing hair and maintain their baseline hair count.

Minoxidil is the only hair regrowth medication that has been approved by the FDA for both men and women, unlike finasteride (Propecia®) which is only approved for use by men.

One of the other benefits of minoxidil is that it has not been associated with the sexual side effects experienced by some patients taking finasteride (Propecia®), such as decreased arousal and erectile dysfunction.1 For a description of the side effects that have been associated with minoxidil, keep reading for the section below on “Reported Side Effects of Minoxidil.”

Minoxidil’s Limitations

There is no magic cure for hair loss, so it is important to begin any hair regrowth regimen with accurate information and reasonable expectations. Minoxidil will not work for everyone; its effectiveness is limited to certain types of hair loss and the degree of hair regrowth experienced by each person will differ. In addition, minoxidil requires a consistent, diligent program of use to achieve maximum results.

Only Works for Certain Types of Hair Loss

The only types of hair loss for which minoxidil has been approved by the FDA are male and female androgenetic alopecia. Some studies have reported positive results for a small number of patients with alopecia areata, but the benefits have not been consistent enough to recommend widespread use of minoxidil for this condition.

Men: Minoxidil 5% topical solution, (such as Avacor Physicians Formulation® for Men) is only recommended for men with male pattern hair loss, and is not intended for treating frontal baldness or a receding hairline. Despite a conference presentation by the lead investigator of several early minoxidil trials suggesting that it is also effective in the frontal hairline area,2 the supporting data do not appear to have been published in any peer-reviewed journals or evaluated by the FDA. Patients using minoxidil should not expect to regrow hair in any areas other than the top of the scalp.

Women: Minoxidil 2% topical solution, (such as Avacor Physicians Formulation® for Women) is only recommended for women with female pattern hair loss (general thinning of hair on the top of the scalp). Minoxidil products are not indicated for hair loss that is sudden, patchy, or associated with stress or childbirth.

Minoxidil may not work for patients whose hair loss is too advanced. A general visual guide that shows the degrees of thinning hair for which minoxidil is most effective can be found on Avacor's product packaging.

Needs to be Used Consistently

In order to achieve the best possible results with minoxidil, it is essential to apply the topical solution regularly and consistently. The best way to do this is to commit to making it part of your daily routine, even if it's not your favorite part of the day. An analogy for this would be brushing your teeth: while no one particularly enjoys the act of brushing their teeth (at least that we are aware of), most people find the benefits are worth the little bit of time each day.

Like all good things, regrowing hair takes time. You may need to use minoxidil for at least 4 months before you see results, although you may begin to notice the effects as early as 2 months.

Continued use is necessary to prevent hair loss from progressing. One of the longest studies of minoxidil for male pattern hair loss (5 years) found that patients who continued to apply minoxidil twice per day were able to maintain nonvellus hair regrowth well beyond their baseline hair counts.3 Patients who stop using minoxidil will likely not maintain hair that has regrown during the course of treatment and will begin losing hair again.

Reported Side Effects of Minoxidil

More than 20 years after minoxidil was first approved for treating hair loss, the list of commonly reported side effects remains fairly limited. However, there are some rare side effects that should be watched for and taken very seriously.

Some of the most common side effects are:
• Localized scalp reactions or skin irritation (i.e., dryness, itching, redness and mild burning)
• GI discomforts (e.g., mild heartburn, nausea, constipation and diarrhea)
• Hair growth in other body areas (i.e., face, arms, back)

If you experience any of the following rare side effects, you should discontinue use immediately and consult your physician:
• Dizziness, light headedness, faintness, headaches
• Sudden unexplained weight gain, water retention
• Rapid heart beat or chest tightness/discomfort
• Swelling of the mouth, face, lips, or tongue

In addition to these side effects, some people have experienced changes in hair color and/or texture.

If you have heart disease you should talk to your doctor before using minoxidil. Minoxidil may be harmful if used when pregnant or breast-feeding, should not be used by children under the age of 18, and should be kept out of reach of children at all times.

Conclusion

Thanks again for checking out the “Minoxidil Mini-Series” here on the Avacor Hair Regrowth Blog. We hope the information we have collected here has given you a better understanding of the history, benefits, and limitations of minoxidil and that it will help you choose the best course of action for regrowing your hair.

If you have any questions or would like to see more information on a particular topic, please leave a comment below. We'd love to hear from you!

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1. Irwig MS, Kolukula S. Persistent sexual side effects of finasteride for male pattern hair loss. J Sex Med. 2011 Jun;8(6):1747-53. Link to Pubmed

2. Olsen EA, Whiting DA, Miller JJ. Increased Frontal Scalp Coverage and Frontal Hair Regrowth with 5% and 2% Minoxidil Solution. Presented at the American Academy of Dermatology 61st Annual Meeting, March 2003.

3. Olsen EA, Weiner MS, Amara IA, DeLong ER. Five-year follow-up of men with androgenetic alopecia treated with topical minoxidil. J Am Acad Dermatol. 1990 Apr;22(4):643-6. Link to Pubmed

22Jul/110

Minoxidil Mini-Series: Part 4 – FDA Approval and Transition to OTC

So far in the Avacor® Hair Regrowth Blog’s “Minoxidil Mini-Series,” we have documented the initial use of minoxidil as a blood pressure medication, the surprising discovery that it regrew hair in patients with androgenetic alopecia, and the clinical trials that eventually proved minoxidil’s effectiveness for treating hair loss.

Today the story continues with the Food and Drug Administration’s initial approval of 2% minoxidil for male pattern baldness in 1988, supplemental approvals allowing use by women and availability over-the-counter, and finally the approval of 5% minoxidil (extra-strength) for men in 1997.

FDA Approves Minoxidil for Male and Female Pattern Hair Loss

After the efficacy of minoxidil for treating hair loss was demonstrated in clinical trials (see our last post for a summary), Pharmacia & Upjohn submitted a New Drug Application (NDA) to the FDA seeking approval to market a 2% topical minoxidil solution for male pattern hair loss.

NDA 19-501 for “Rogaine® Topical Solution” presented data on the safety and efficacy of the formulation, pharmacokinetic studies of drug absorption, a statistical review of the clinical results, and proposed package labeling for the product. With its approval on August 17, 1988, minoxidil became the first-ever FDA-approved treatment for hair regrowth.

Soon after, a supplemental application was made for the use of 2% minoxidil by women suffering from female androgenetic alopecia. Supported by several clinical trials that showed the effectiveness of minoxidil for treating hair loss in women (also summarized in our last post), the application was approved in 1991 and Rogaine® became available to women on a prescription basis.

The product was a huge success, reaching sales of $100 million per year by 1995.1 On February 9, 1996, just two days before Pharmacia & Upjohn's patent on minoxidil expired, the FDA approved a supplement to NDA 19-501 allowing over-the-counter distribution of 2% minoxidil for men (in a blue package) and women (pink package).

FDA Approval of “Extra-Strength” Minoxidil (5%) for Men

Since earlier studies had shown a dose-dependent increase in the effectiveness of minoxidil for hair regeneration in men,2 it was only a matter of time before studies began to test whether doses higher than 2% minoxidil could be more effective in regrowing hair.

The results of a 48-week, double-blind, placebo-controlled, randomized, multicenter trial in 393 balding men showed that “5% topical minoxidil was clearly superior to 2% topical minoxidil,” producing an earlier response to treatment and resulting in 45% more hair regrowth without evidence of systemic effects from the increased concentration.2 In light of the clear benefits of 5% minoxidil, NDA 20-834 for “Rogaine® Extra Strength For Men (5% Topical Minoxidil Solution),” was approved by the FDA on November 14, 1997.

While the benefits for men were clear, a subsequent trial comparing 5% minoxidil to 2% minoxidil or placebo in female patients did not support its use by women.3 Although the 5% minoxidil solution proved superior to placebo (and resulted in favorable impressions from patients), it did not provide a statistically significant benefit over 2% minoxidil for any of the objective measures of hair regrowth.

Avacor Products’ ANDA for Minoxidil

When Pharmacia & Upjohn’s patents covering topical minoxidil for hair regrowth expired, other companies received FDA approval through the Abbreviated New Drug Application (ANDA) process to manufacture and sell minoxidil for hair regrowth. Avacor Products LLC currently holds such approval in the form of ANDA #075619 and provides topical minoxidil solutions (Avacor Physicians Formulation®) for both men and women.

Make sure to tune in next week when we wrap up the story with the final episode of the Avacor Hair Regrowth Blog’s “Minoxidil Mini-Series.” Our goal with this blog is to provide you with the information you need so that you can make an informed decision about your approach to hair regrowth; part of this process is making sure you have a clear understanding of what you can and cannot expect from using minoxidil.

In the last installment we will give a summary of the benefits that minoxidil can provide, but also explain the limitations and potential side effects you might experience. In the end we hope that having all this information in one place will make it easier for you to navigate the world of hair regrowth treatments and find the right solution for you.

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1. Gellene, Denise. “TV Ads for Rogaine to Sprout.” Los Angeles Times. April 19, 1996. (Accessed July 22, 2011)
http://articles.latimes.com/1996-04-19/business/fi-60266_1_rogaine-sales

2. Shupack JL, Kassimir JJ, Thirumoorthy T, Reed ML, Jondreau L. Dose-response study of topical minoxidil in male pattern alopecia. J Am Acad Dermatol. 1987 Mar;16(3 Pt 2):673-6. Link to PubMed

3. Olsen EA, Dunlap FE, Funicella T, Koperski JA, Swinehart JM, Tschen EH, Trancik RJ. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol. 2002 Sep;47(3):377-85. Link to PubMed

4. Lucky AW, Piacquadio DJ, Ditre CM, Dunlap F, Kantor I, Pandya AG, Savin RC, Tharp MD. A randomized, placebo-controlled trial of 5% and 2% topical minoxidil solutions in the treatment of female pattern hair loss. J Am Acad Dermatol. 2004 Apr;50(4):541-53. Link to PubMed

20Jul/112

Minoxidil Mini-Series: Part 3 – Efficacy in Clinical Trials

In the last episode of the “Minoxidil Mini-Series,” we followed minoxidil from its inception in the laboratory through the world of cardiovascular medicine, ending with the exciting discovery that minoxidil was actually reversing male pattern baldness in some patients. This week on the Avacor® Hair Regrowth Blog the story continues with a summary of the clinical trials that proved minoxidil's effectiveness as a hair regrowth treatment.

Minoxidil’s success in clinical trials led to the first FDA approval for a hair loss drug, initially requiring a doctor’s prescription but available now as a popular over-the-counter product. This review is focused primarily on the findings of efficacy of minoxidil for hair regrowth; a summary of the side effects reported in the various trials will appear later in the Mini-Series.

After the initial reports of hair growth induced by minoxidil, several clinical groups began studying the safety and efficacy of minoxidil as a topical treatment for hair loss in both men and women.

Since there have been many studies on the efficacy of minoxidil for treating androgenetic alopecia, it would be impractical to go into great detail on each one here. If you would like to know more about the results of any of the studies listed in this post, please leave a comment about your particular area of interest and we will answer your question as quickly as possible.

Clinical Trials of Minoxidil for Male Pattern Hair Loss

A series of pivotal trials were conducted by Elise Olsen, M.D. and colleagues at the Duke University Medical Center, including one of the first major placebo-controlled, double-blind studies of minoxidil for male pattern baldness.

A dose escalation study by this group found that 1% was the minimum concentration of minoxidil that was effective at increasing total target area hair counts, but that 2% minoxidil produced superior results in the investigator’s assessment of cosmetic response.1

The same group conducted a double-blind, placebo-controlled crossover trial involving 126 men with early male pattern baldness (median age of ~36 years old) that compared topical minoxidil to a placebo control.2 After the first four months, patients receiving placebo were switched to a 3% minoxidil solution. The results showed that, during the first four months, patients using 3% minoxidil achieved significantly more hair growth than patients using placebo. When the placebo patients were switched over to 3% minoxidil, they experienced a “marked increase in terminal hair count,” achieving a greater than three-fold increase in average terminal hair count over the next eight months, from 59 (+/- 98) to 219 (+/- 168). The authors also note that none of the patients experienced a net hair loss in the target area during the study, suggesting that patients who do not achieve noticeable hair regrowth can at least maintain their baseline hair count with minoxidil treatment.

At the end of this trial, 41 of the patients enrolled in a long-term maintenance study in which they continued using minoxidil for another 90 weeks. At the end of the trial they were assessed for nonvellus hair counts (vellus hairs - fine, “peach fuzz” type hairs - were not evaluated).3 While some patients who continued applying 3% minoxidil solution twice a day lost a portion of the initial gains made during the first part of the trial, the average nonvellus hair count increased slightly from 323 (range of 15 to 589 hairs) to 335 (range of 13 to 808 hairs) during the maintenance study.

The Olsen group then extended this trial even further, following 31 patients who went on to complete 4.5 to 5 years of therapy.4 They ultimately concluded that “hair regrowth with topical minoxidil tends to plateau at about 12 months of treatment” and that “continued use of topical minoxidil is associated with a slow decline in the 12-month hair counts but continued maintenance of nonvellus hair regrowth well beyond that at baseline.”

Several other studies have been conducted, some of which are briefly summarized here:

Savin RC. J Am Acad Dermatol. 1987 Mar;16(3 Pt 2):696-704. PubMed
- Double-blind, randomized 12 month study
- 79 patients
Total hair counts showed significant increases at 12 months (p < 0.001) with a mean increase of 144.2 hairs in the 3% minoxidil group. The investigators' visual assessment showed moderate to dense regrowth in 64% of these patients. The author suggests that the increases in nonvellus hair count observed during the study support the conclusion that “minoxidil stops the progression of male pattern baldness.”

Civatte J, et al. Dermatologica. 1987;175 Suppl 2:42-9. PubMed
- Double-blind, randomized 48 week study
- 225 patients
Minoxidil (2%) showed superiority to placebo with respect to non-vellus hair counts (p = 0.0084), changes in non-vellus hair counts compared with baseline values (p = 0.0227), and investigators' evaluations of hair growth (p = 0.019). Moderate or dense hair growth was reported in 32.7% of the patients by investigator evaluation.

Rietschel RL, Duncan SH. J Am Acad Dermatol. 1987 Mar;16(3 Pt 2):677-85. PubMed
- Double-blind, randomized 12 month study
- 102 patients (up to 7 may have been female)
Hair counts at 12 months increased from 63.5 to 180.6 (2% minoxidil), 61.0 to 179.9 (3% minoxidil), and 65.0 to 191.1 (placebo crossover to 3%). Investigator evaluations showed visible hair growth in 89 patients (~87%) and dense hair growth (enough to cut or comb) in 33 patients (~32%), with patients reporting even more favorable results. The authors suggest that patients who considered themselves nonresponders in fact experienced prevention of hair loss, and suggest an “ultimate success rate for hair growth of about one third of the patients.”

Koperski JA, et al. Arch Dermatol. 1987 Nov;123(11):1483-7. PubMed
- Double-blind, randomized 30 month study
- 59 patients at 12 months, 33 patients at 30 months
Hair regrowth appeared to peak at 12 months. Of the patients who used minoxidil for the full 30 months, 70% finished the trial with “at least 50% more hairs than when they originally started the drug therapy” and a subset of patients “appeared to sustain a continued increase in hair counts.” The authors suggest that patients who are “excellent responders” in the first 12 months may be more likely to have a continued hair growth response.

Shupack JL, et al. J Am Acad Dermatol. 1987 Mar;16(3 Pt 2):673-6. PubMed
- Double-blind, randomized 6 month study
- 58 patients
The investigators identified a “clear dose-response correlation for the increase of nonvellus hairs” with escalating doses of minoxidil. Mean nonvellus hair counts increased by 25.9 with 0.1% minoxidil, 36.8 with 1% minoxidil, and 54.1 with 2% minoxidil, however “clinically perceptible hair growth” occurred only in patients treated with 1% or 2% minoxidil solution.

Clinical Trials of Minoxidil for Female Pattern Hair Loss

One of the first studies published on the effectiveness of minoxidil for female androgenetic alopecia was conducted at the University of Minnesota School of Medicine. In this trial, 25 patients were treated for 48 weeks with a 3% topical minoxidil solution.5 Each patient's degree of hair loss was assessed at study entry and classified as either 25-50% hair loss (13/25), 50-75% hair loss (10/25), or 75-99% hair loss (2/25). The study reported significant improvement (P = 0.0083) at 48 weeks, with five of the 25 patients moving to a lower category, and patient self-assessments were positive with 17 patients reporting hair regrowth. While these results were promising, the lack of a placebo control group necessitated further trials with a placebo control group.

Two multicenter, double-blind, placebo-controlled 32 week trials were then conducted in Europe (10 sites, 294 patients)6 and the U.S. (11 sites, 256 patients)7 to compare 2% topical minoxidil solution with placebo.

The trial in Europe revealed that women using 2% minoxidil achieved a significantly greater increase in nonvellus hair count than women in the placebo group (P = 0.0001), with an increase of 33 hairs compared to 19 hairs, respectively. The U.S. study found that average nonvellus hair counts in a 1 cm2 target area increased by approximately twice as much in the 2% minoxidil group (23 hairs) as the placebo group (11 hairs).

These trials were notable for the relatively high percentage of patients in the placebo group who were reported to experience hair growth, both by investigator assessment (~30-40%) and patient self-reporting (~40%).

The results of two smaller studies are summarized here:

Olsen EA. Cutis. 1991 Sep;48(3):243-8. Pubmed
- Randomized, placebo-controlled 32 week study
- 28 patients
The study reported statistically significant increases in both nonvellus target area hair counts (p = 0.006) and investigator's assessment of hair regrowth (p = 0.007), although the study participants were unable to discern a difference between treatment groups.

Whiting DA, Jacobson C. Int J Dermatol. 1992 Nov;31(11):800-4. Pubmed
- Double-blind, randomized 32 week study
- 28 patients
Nonvellus hair counts for patients in the minoxidil group increased from a baseline mean of 169 hairs to a final count of 195 hairs (~15.4% increase) at study completion, compared to an increase from 161 hairs to 177 (~9.9%) in the placebo group. Assessment of hair growth showed 60% of women using minoxidil experienced minimal to moderate hair growth compared to 46% of placebo patients.

Conclusions

Together these trials provided significant evidence of the effectiveness of minoxidil for stopping hair loss and regrowing hair in both male and female patients suffering from androgenetic alopecia. While not all study participants experienced significant hair regrowth, many male patients grew hair that in some cases persisted for up to 4-5 years of minoxidil use. The results of the women's trials were not as simple to interpret as those for men. Many women in the placebo groups appeared to regrow hair during the course of the trials, but in most cases the increased hair growth achieved with minoxidil was statistically significant compared to the placebo group.

Next time on the Avacor Hair Regrowth Blog's “Minoxidil Mini-Series,” we will document minoxidil's approval by the FDA for treating hair loss and its eventual approval as an over-the-counter medication.

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1. Olsen EA, DeLong ER, Weiner MS. Dose-response study of topical minoxidil in male pattern baldness. J Am Acad Dermatol. 1986 Jul;15(1):30-7. Link to Pubmed

2. Olsen EA, Weiner MS, Delong ER, Pinnell SR. Topical minoxidil in early male pattern baldness. J Am Acad Dermatol. 1985 Aug;13(2 Pt 1):185-92. Link to Pubmed

3. Olsen EA, DeLong ER, Weiner MS. Long-term follow-up of men with male pattern baldness treated with topical minoxidil. J Am Acad Dermatol. 1987 Mar;16(3 Pt 2):688-95. Link to Pubmed

4. Olsen EA, Weiner MS, Amara IA, DeLong ER. Five-year follow-up of men with androgenetic alopecia treated with topical minoxidil. J Am Acad Dermatol. 1990 Apr;22(4):643-6. Link to Pubmed

5. Hordinsky MK, Shank J. Three percent topical minoxidil therapy for female androgenetic alopecia. Clin Dermatol. 1988 Oct-Dec;6(4):213-7. Link to Pubmed

6. Jacobs JP, Szpunar CA, Warner ML. Use of topical minoxidil therapy for androgenetic alopecia in women. Int J Dermatol. 1993 Oct;32(10):758-62. Link to Pubmed

7. DeVillez RL, Jacobs JP, Szpunar CA, Warner ML. Androgenetic alopecia in the female. Treatment with 2% topical minoxidil solution. Arch Dermatol. 1994 Mar;130(3):303-7. Link to Pubmed

12Jul/110

Minoxidil Mini-Series: Part 2 – From Blood Pressure to Baldness

In Part 2 of the Avacor® Hair Regrowth Blog “Minoxidil Mini-Series” we will trace the path of minoxidil through the 1970s and 1980s as reports of hair growth led a potent blood pressure (BP) medication to be proposed as a treatment for male pattern baldness (MPB).

Minoxidil was first synthesized in the 1960s by William Anthony and Joseph Ursprung of The Upjohn Company (US Patent No. 3,461,461) and was initially prescribed as a vasodilator for lowering blood pressure in patients with hypertension.1

A few years later, some doctors began to note an unintended effect in patients taking the drug: hair growth.

Early Reports of Hair Growth

Compared to other antihypertensive treatments available at the time, such as propranolol and hydralazine, a 1972 study found that oral minoxidil therapy (later known as Loniten®) provided a significant improvement in blood pressure reduction.2 However, the authors also observed hypertrichosis (excessive hair growth) in five of the eight patients who were treated with the drug for more than two months.

Many subsequent publications during the 1970s confirmed these initial reports of increased hair growth with minoxidil, with observations such as: “side effects included increased hair growth.” 3

This effect may not have been particularly surprising since another vasodilator, diazoxide, had been associated with hypertrichosis in the early 1960s.4 Although chemically unrelated to minoxidil, diazoxide relaxes blood vessels by a similar mechanism (activation of ATP-sensitive potassium channels).

Reversal of male pattern baldness by minoxidil…

In the early 1980s, isolated case reports began to emerge that described the “reversal of baldness” by minoxidil.5,6 One patient’s experience was particularly compelling:6

“Within four weeks dark-brown hair (the normal color for this patient) grew over the area of the scalp that had previously been devoid of hair visible to the naked eye and had made up the major portion of his scalp except for the sides and back of his head. By eight weeks these new hairs were approximately 1.3 cm (0.5 in) long. The density of hair and the hair-shaft thickness were equal to those of the areas of this patient's scalp that were normally not subject to balding.”

One prescient report of minoxidil causing “excessive hair growth” on the “temples and forehead,” which was published before the other two reports on baldness, even proposed its use as a topical treatment for androgenetic alopecia:7

“The high incidence of hypertrichosis produced by both diazoxide and minoxidil suggests the possibility that an effective topical formulation might stimulate local hair growth in early male-pattern alopecia…”

The drug’s maker, Upjohn, was already well-prepared to capitalize on the new indication that was being proposed for its drug. By February, 1979, the company had already received a patent covering the use of topical minoxidil compositions for growing hair.

The Upjohn Company Patents Minoxidil for Alopecia

“The invention claimed is: 1. A method of treating humans for alopecia…”

Upjohn was granted two critical U.S. patents covering the use of minoxidil for treating male pattern baldness:

US Patent No. 4,139,619 claimed a “topical composition” that could be used for “increasing the rate of terminal hair growth in mammalian species” and “conversion of vellus hair to growth as terminal hair.”

US Patent No. 4,596,812 claimed a “method of treating humans for alopecia which comprises topically applying to the human scalp an effective amount of a solution containing 6-amino-1,2-dihydro-1-hydroxy-2-imino-4-piperidinopyrimidine and a solvent.”

These patents laid the foundation for the successful commercialization of minoxidil as a treatment for male pattern baldness, under the trade name Rogaine®.

In the next installment of the Avacor Hair Regrowth Blog “Minoxidil Mini-Series,” we will describe the clinical trials that proved minoxidil’s effectiveness against alopecia in men and women, as well as the approval by the FDA of minoxidil as the first treatment for male pattern hair loss. Check back here soon for Part 3 – Efficacy in Clinical Trials.

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1. Gilmore E, Weil J, Chidsey C. Treatment of essential hypertension with a new vasodilator in combination with beta-adrenergic blockade. N Engl J Med. 1970 Mar 5;282(10):521-7. Link to Pubmed

2. Gottlieb TB, Katz FH, Chidsey CA 3rd. Combined therapy with vasodilator drugs and beta-adrenergic blockade in hypertension. A comparative study of minoxidil and hydralazine. Circulation. 1972 Mar;45(3):571-82. Link to Pubmed

3. Jacomb RG, Brunnberg FJ. The use of minoxidil in the treatment of severe essential hypertension: a report on 100 patients. Clin Sci Mol Med Suppl. 1976 Dec;3:579s-581s. Link to Pubmed

4. Okun R, Russell RP, Wilson WR. Use of diazoxide with trichlormethiazide for hypertension. Arch Intern Med. 1963 Dec;112:882-8. Link to Pubmed

5. Seidman M, Westfried M, Maxey R, Rao TK, Friedman EA. Reversal of male pattern baldness by minoxidil. A case report. Cutis. 1981 Nov;28(5):551-3. Link to Pubmed

6. Zappacosta AR. Reversal of baldness in patient receiving minoxidil for hypertension. N Engl J Med. 1980 Dec 18;303(25):1480-1. Link to Pubmed

7. Burton JL, Marshall A. Hypertrichosis due to minoxidil. Br J Dermatol. 1979 Nov;101(5):593-5. Link to Pubmed

7Jul/111

Minoxidil Mini-Series: Introduction

Of all the products sold to combat hair loss and regrow hair, only two have ever been approved by the U.S. Food and Drug Administration (FDA) for regrowing hair: minoxidil and finasteride.

Minoxidil is available for both men and women as a topical treatment, while finasteride (Propecia®) comes in pill form and is not currently indicated for use by women. Minoxidil was first approved by the FDA for hair regrowth in 1988 and continues to be one of the most effective known treatments for androgenetic alopecia (AGA) to date.

In the next few Avacor® Hair Regrowth Blog posts we will recount the history of minoxidil, from its origins as a prescription blood pressure medication to its current use as an over-the-counter hair growth treatment.

We will highlight some of the clinical trials that have shown minoxidil’s effectiveness in stopping hair loss and regrowing hair (for both men and women), explain some of the benefits and limitations of using minoxidil, and describe some potential side effects you might experience.

Stay tuned to the Avacor Hair Regrowth Blog in the next few days for Part 2 of the “Minoxidil Mini-Series”: From Blood Pressure to Baldness.