Minoxidil + Finasteride Rx
Minoxidil is used as treatment for male hair loss. It is a vasodilator that increases blood flow to the scalp, as well as being a potassium channel opener which allows more oxygen, blood, and nutrients to reach the hair follicle.
Oral minoxidil may be a great alternative for those who don’t respond well to topical minoxidil, or have issues with some of its side effects (scalp irritation, brittle hair), cost, product residue, or application frequency.
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What is Minoxidil?
Minoxidil is one of two FDA-approved treatments for hair loss and has been approved for both men and women. Originally developed as an oral drug to treat high blood pressure, however, when patients started reporting unwanted hair regrowth after 3+ months of use, its manufacturers decided to reformulate it into a topical and begin testing it on men with androgenetic alopecia. Nowadays, minoxidil comes in both topical and oral forms, however, only the topical form is FDA-approved for hair loss.
What is Finasteride?
Finasteride’s primary medical use is in managing benign prostate hyperplasia (BPH). However, owing to its ability to reduce DHT, it's frequently prescribed off-label by many physicians to combat male pattern hair loss, also known as androgenic alopecia (AGA). These drugs inhibit the enzyme type 2 5α-reductase which catalyzes the conversion of testosterone to dihydrotestosterone. The overactivity of this enzyme causes an increase in dihydrotestosterone (DHT) which is associated with the emergence of androgenetic alopecia (AGA).
How does Minoxidil and Finasteride work together?
Minoxidil works by stimulating blood flow to the scalp, increasing nutrient and oxygen delivery to hair follicles. This can potentially promote hair growth and prolong the hair growth phase (anagen phase). On the other hand, finasteride targets the hormonal component of hair loss by reducing the levels of dihydrotestosterone (DHT), a hormone known to shrink hair follicles in individuals genetically predisposed to hair loss.
When used in combination, these medications complement each other's actions. Minoxidil's ability to improve blood circulation to the scalp can potentially enhance the delivery of finasteride to the hair follicles, maximizing its effectiveness in inhibiting the effects of DHT. In turn, the reduction of DHT levels by finasteride may complement the growth-promoting effects of minoxidil by preventing further hair follicle shrinkage.
One study shows that the combination of Minoxidil and Finasteride was shown to have clinically significant improvement in terms of hair growth as compared to Minoxidil (5%) alone.
Studies
Journal of clinical & experimental dermatology researchTitle: A New Topical Formulation of Minoxidil and Finasteride Improves Hair Growth in Men with Androgenetic Alopecia
Key Takeaways
Minoxidil and Finasteride was shown to have clinically significant improvement in terms of hair growth as compared to Minoxidil (5%) alone.Department of Trichology, CUTIS Academy of Cutaneous SciencesTitle: Topical minoxidil fortified with finasteride: An account of maintenance of hair density after replacing oral finasteride
Key Takeaways
84.44% maintained a good hair density with topical minoxidil-finasteride combinationOf the five patients who discontinued oral finasteride for 8-12 months, four demonstrated good improvement in hair density when treatment was resumed with topical minoxidil-finasteride combination.Additional Links & Studies
Is topical minoxidil solution effective on androgenetic alopecia in routine daily practice?
Minoxidil: a review of its pharmacological properties and therapeutic use
Clinical utility and validity of minoxidil response testing in androgenetic alopecia
Novel enzymatic assay predicts minoxidil response in the treatment of androgenetic alopecia
Finasteride: A Review of its Use in Male Pattern Hair Loss
A Systematic Review of Topical Finasteride in the Treatment of Androgenetic Alopecia in Men and Women
Long-Term Effects of Finasteride on Prostate Cancer Mortality
Response to Microneedling Treatment in Men with Androgenetic Alopecia Who Failed to Respond to Conventional Therapy
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Meet the Team
Hair Loss Medical Advisors
William Rassman
MD, Founder of the New Hair Institute (NHI)
Heidi Goodarzi, M.D.
Medical, Surgical, and Cosmetic Dermatologist
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