Over The Counter Medication For Hair Loss – Some dermatologists are prescribing this blood pressure medication for hair loss—but is it safe?
According to NYU Langone Health, hair loss is a fact of life for many men and many women—more than 80% of men and less than 50% of women will experience hair loss. Many people turn to topical treatments such as creams, shampoos, oils and gels that promise to regrow hair or stop the problem from getting worse.
Over The Counter Medication For Hair Loss
Minoxidil is an ingredient that has been used for over a decade and is generally safe and well tolerated. But its effectiveness is variable, says Sandeep Sattur, MD, a hair restoration surgeon at the Hair Center for Hair Loss Center in Mumbai, India. Also, this form of minoxidil can come with some unpleasant side effects, among other negative aspects.
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Now, for better treatment, some dermatologists are prescribing minoxidil for hair loss. Although the US Food and Drug Administration (FDA) has not approved this drug for hair loss, doctors are free to prescribe oral minoxidil for off-label use. Here’s what you need to know if you or a loved one are experiencing hair loss and are interested in whether minoxidil might be an option.
In the late 1960s, the FDA approved the first topical version of minoxidil to treat male pattern baldness. Since then, the FDA has also approved minoxidil for female hair loss, making it available in high concentrations and cleared for sale without a prescription.
In short, topical minoxidil, applied to the scalp once or twice a day, promotes hair growth or reduces hair loss.
These skin treatments usually contain 2 or 5 percent minoxidil as an active ingredient.
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According to data from the Center for Drug Evaluation and Research (PDF), several clinical trials of topical minoxidil in men and women have shown that it can help increase hair density in areas of hair loss. . Some studies have shown that extra-strength versions (which use a concentration of 1 percent of the drug) are more effective than the original formula (which uses a concentration of 1 percent).
But as we said, topical minoxidil has its disadvantages For example, it may take several months to see results, and any new hair growth may disappear when the treatment stops. Also, topical minoxidil does not work for all types of hair loss—for example, it is unlikely to help patients with thinning hair, even if they have had the condition for a while before starting the treatment. And it can have side effects, from unpleasant skin rashes to itching, scarring and inflammation, according to the Mayo Clinic.
Oral minoxidil actually preceded topical minoxidil, and was approved as a prescription drug for hypertension or high blood pressure, according to the Mayo Clinic. First approved by the FDA in the late 1970s as a drug to treat high blood pressure, or high blood pressure, minoxidil drugs often have an unexpected side effect: excessive hair growth. The American Academy of Dermatology (AAD) notes that drug developers quickly saw the potential in these side effects and turned minoxidil into a medical treatment for hair loss.
“These days it is rare to treat hypertension with minoxidil,” says Juan Jimenez Cauhe, a dermatologist at the Ramón y Cazal University Hospital and trichologist at the Grupo Pedro Zen Hospital in Madrid. According to the American Heart Association, it is only recommended for cases of high blood pressure when the patient does not respond to other drugs or when kidney failure occurs.
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“For the past seven years, it has been used to treat various types of hair in small quantities,” he added. More on that later
The term “off label”, or “not approved”, can mean different things according to the FDA. This may mean that the manufacturer produces a drug in a different form (for example, orally vs mouth), or in a different way. dosage, or to treat a disease or condition not approved by the FDA.
Minoxidil is currently approved by the FDA as an oral medication to treat high blood pressure and as a medication for hair loss. But the drug is not currently approved by the FDA when taken by mouth—and any prescription for it is called “off-label.”
To date, there is no high quality research to support oral minoxidil for hair loss. But some small studies have shown that oral minoxidil can help with hair loss and may be more effective for some patients than topical treatments.
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For example, a small observational study of 100 women with hair loss showed that a daily pill containing 0.25 milligrams (mg) of minoxidil and 25 mg of spironolactone was safe and effective. But the study did not use a control group, so the results are not shown because of the drug
The next review, published in July 2020 in the Journal of the American Academy of Dermatology, looked at 17 studies with 634 patients. The review suggests that oral minoxidil is an effective general and alternative medicine. well to topical minoxidil, although the researchers added that larger, controlled studies are needed.
Sattur points out that most of these studies range from 0.25 mg to 5 mg – less than the dose for high blood pressure. (High blood pressure is usually 5 to 40 milligrams for adults and children over 12 years old.)
“The limited number of small sample studies that have been published do not agree on the optimal dose,” Sattur said. The lack of a standard dosage means that it is unclear what amount of minoxidil (if any) is safe when taken for off-label purposes.
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Side effects are generally less of a concern with topical treatments, because they target one area of the body, than with systemic medications such as pills, which only work on one part of the body.
According to the Mayo Clinic, common side effects of topical minoxidil may include itching or skin rash, while rare side effects may include acne, inflammation, swelling, blurred vision or chest pain.
But the safety picture of oral minoxidil for hair loss is less clear, as it has not been tested in the rigorous clinical trials required for FDA approval. For example, we don’t know if low-dose oral minoxidil for hair loss can have a negative effect on blood pressure in people without high blood pressure, Sattur says: “It needs to be tailored to each patient based on changes in blood pressure.” blood and heart. sick.” “
What we do know is that minoxidil tablets have a black box warning from the FDA (PDF) because they can increase the risk of pericardial effusion, which is the medical name for the accumulation of excess fluid around the heart.
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Other side effects in some patients who take low doses of oral minoxidil for hair loss include dizziness, heart palpitations and water retention, said Dr. Jimenez Cau. While these side effects should disappear when patients stop taking the drugs, the potential for these problems should be given to patients who have been prescribed by a medical provider, who has the patient’s current medical condition and history. medical, adds Jimenez-Cahu.
Women who are pregnant or breastfeeding should not use minoxidil, the AAD warns, because traces of the drug can pass into breast milk. Other hair loss medications, including finasteride, are not FDA approved for female hair loss but can be used for this purpose as long as patients are not pregnant or planning to become pregnant.
According to the AAD, patients have several treatment options for pattern hair loss other than minoxidil. Treatment options are different for men and women, in part because some interventions can cause pattern hair loss. pregnant or breastfeeding.
Experts say that anyone considering treatment for hair loss for the first time should start with FDA-approved options before considering minoxidil tablets. These include topical minoxidil, which is sold as a brand name product and has many generic versions.
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Dr., hematologist and hair transplant surgeon in St. James, Dublin.
“In my opinion, the benefit-risk ratio of oral minoxidil compared to topical minoxidil – and the evidence available for oral minoxidil is not of the highest quality – does not justify the routine use of oral minoxidil in pattern hair loss,” said Sattur. Topical minoxidil is also the first line of therapy.”
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