Minoxidil Overview

1) Conditions Studied for Minoxidil

Minoxidil has been primarily studied for the following conditions:

• Androgenetic alopecia (pattern hair loss)
• Alopecia areata (spot baldness)
• Hypertension (as an antihypertensive medication)

2) Efficacy in Treating Conditions

Minoxidil has been shown to be effective in treating certain conditions:

• It is known to promote hair regrowth in individuals with pattern hair loss, with better results seen in younger patients who have been losing hair for a shorter period.
• It can also be moderately effective for alopecia areata, although results can be variable.
• As an antihypertensive, it is usually reserved for severe hypertension that does not respond to other treatments.

3) Health Benefits

Minoxidil offers several health benefits:

• It can improve self-esteem and quality of life by reversing or slowing hair loss.
• When used for hypertension, it can reduce the risk of heart attacks, strokes, and kidney problems associated with high blood pressure.

4) Potential Downsides

While beneficial, minoxidil also has some downsides:

• It can cause unwanted hair growth if applied improperly or if it spreads to other areas of the skin.
• Some users may experience irritation, redness, or dryness of the scalp.
• As an oral medication for hypertension, it can cause side effects like water retention, tachycardia, and nausea.
• Continuous use is necessary to maintain hair growth benefits, and hair loss may resume if treatment is stopped.

5) Genetic Variations and Minoxidil

The effectiveness and safety of minoxidil can be influenced by genetic variations:

• Some individuals have genetic variations that affect the enzyme sulfotransferase, which is responsible for converting minoxidil into its active form. People with higher enzyme activity may respond better to minoxidil treatment for hair loss.
• There is ongoing research into the genetic predictors of minoxidil response, but currently, it is not standard practice to perform genetic testing before prescribing minoxidil for hair loss.

Minoxidil Research Summary

Role of Minoxidil in Hair Growth

Minoxidil is a well-known hair growth stimulant that operates by opening ATP-sensitive potassium channels in hair follicles, specifically targeting the Kir6.1/SUR2B channel form. It enhances hair growth through the mediation of adenosine, which activates intracellular signaling for VEGF production. Studies have confirmed that minoxidil significantly increases scalp microcirculation, which begins within 15 minutes of application and lasts for at least an hour.

Long-term Efficacy and Treatment Outcomes

Clinical trials have demonstrated that continual use of minoxidil is necessary to maintain hair growth in individuals with androgenetic alopecia (AGA). Discontinuation of treatment leads to the loss of benefits gained, often reverting to pre-treatment levels within several months. Long-term studies suggest that a 5% concentration of minoxidil is more effective than lower concentrations, with twice-daily application yielding better results than once-daily use. However, some patients may discontinue treatment due to minimal cosmetic improvement or dislike of the application method.

Combination Therapies and Comparative Studies

Research comparing the efficacy of minoxidil with other treatments, such as oral finasteride and ketoconazole, indicates that combination therapies might offer enhanced benefits in treating AGA. The combination of minoxidil with tretinoin has been studied as well, with findings suggesting that tretinoin may increase the absorption and efficacy of minoxidil.

Effectiveness in Women

Minoxidil has been shown to be an effective treatment for female pattern hair loss, with 5% topical minoxidil providing significant improvements in hair count and patient satisfaction. It is considered a safe and convenient alternative to lower concentrations and other treatments, although further comparative studies are recommended.

Conclusion

Minoxidil is a key player in the treatment of hair loss disorders due to its ability to stimulate hair growth and improve hair characteristics. Its continuous use is crucial for maintaining the benefits, and higher concentrations tend to offer greater efficacy. Both men and women with AGA can experience positive outcomes, and combination therapies with other drugs are an area of ongoing research.

References:

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5. Minoxidil-induced hair growth is mediated by adenosine in cultured dermal papilla cells: possible involvement of sulfonylurea receptor 2B as a target of minoxidil
6. Minoxidil stimulates cutaneous blood flow in human balding scalps: pharmacodynamics measured by laser Doppler velocimetry and photopulse plethysmography
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53. Sulfotransferase 1A1 (SULT1A1) polymorphism and susceptibility to primary brain tumors
54. Multi-ethnic SULT1A1 copy number profiling with multiplex ligation-dependent probe amplification
55. Ethanol up-regulates phenol sulfotransferase (SULT1A1) and hydroxysteroid sulfotransferase (SULT2A1) in rat liver and intestine
56. Role of Oral Minoxidil in Patterned Hair Loss
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60. Effect of hormone metabolism genotypes on steroid hormone levels and menopausal symptoms in a prospective population-based cohort of women experiencing the menopausal transition
61. Novel enzymatic assay predicts minoxidil response in the treatment of androgenetic alopecia
62. Association between SULT1A1 Arg213His (rs9282861) Polymorphism and Risk of Breast Cancer: A Systematic Review and Meta-Analysis
63. Comparison of oral minoxidil, finasteride, and dutasteride for treating androgenetic alopecia
64. Pharmacogenetics of human sulfotransferases and impact of amino acid exchange on Phase II drug metabolism
65. Arginine residues in the active site of human phenol sulfotransferase (SULT1A1)
66. UGT2B17 and SULT1A1 gene copy number variation (CNV) detection by LabChip microfluidic technology
67. Sulfotransferase 1A1 as a Biomarker for Susceptibility to Carcinogenesis: From Molecular Genetics to the Role of Dietary Flavonoids
68. Genetic polymorphisms and linkage disequilibrium of sulfotransferase SULT1A1 and SULT1A2 in a Korean population: comparison of other ethnic groups
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70. Mechanism of action of minoxidil in the treatment of androgenetic alopecia is likely mediated by mitochondrial adenosine triphosphate synthase-induced stem cell differentiation
71. Oral minoxidil use in androgenetic alopecia and telogen effluvium
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77. Serum Levels of Androgen-Associated Hormones Are Correlated with Curative Effect in Androgenic Alopecia in Young Men
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100. Relationship of SULT1A1 copy number variation with estrogen metabolism and human health
101. Role of ATP-sensitive potassium channels in the piracetam induced blockade of opioid effects
102. Pharmacogenetics of human cytosolic sulfotransferases
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107. All-trans retinoic acid induction of sulfotransferases
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111. SULT1A1 genetic polymorphisms and the association between smoking and oral cancer in a case-control study in Brazil
112. Pilot study: genetic distribution of AR, FGF5, SULT1A1 and CYP3A5 polymorphisms in male Mexican population with androgenetic alopecia
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114. Influence of SULT1A1*2 Polymorphism on Plasma Efavirenz Concentration in Thai HIV-1 Patients
115. Copy number variation in sulfotransferase isoform 1A1 (SULT1A1) is significantly associated with enzymatic activity in Japanese subjects
116. Tretinoin enhances minoxidil response in androgenetic alopecia patients by upregulating follicular sulfotransferase enzymes
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121. Sulfotransferase SULT1A1 Arg213His polymorphism with cancer risk: a meta-analysis of 53 case-control studies
122. Human dehydroepiandrosterone sulfotransferase pharmacogenetics: quantitative Western analysis and gene sequence polymorphisms
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131. Sulfation of minoxidil by human liver phenol sulfotransferase
132. A Study to Compare the Efficacy of Platelet-rich Plasma and Minoxidil Therapy for the Treatment of Androgenetic Alopecia

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