New study proves oral minoxidil is an overrated hair loss treatment

Summary

The video critically examines the growing popularity of oral minoxidil for hair loss treatment, particularly in comparison to topical minoxidil. The speaker highlights a recent Brazilian study that compares the two forms, finding no significant difference in efficacy between oral and topical minoxidil. Despite the hype surrounding oral minoxidil, the speaker argues that it offers no superior hair growth benefits and comes with increased risks of cardiovascular side effects. The video concludes by reaffirming the speaker's preference for topical minoxidil, the FDA-approved and clinically proven treatment for hair loss.

Takeaways

• 📈 Oral minoxidil has gained significant popularity, especially after a New York Times article highlighted its use for hair loss treatment.
• 🤔 The speaker remains skeptical about oral minoxidil, focusing on concerns over its safety profile rather than its efficacy.
• 🔍 A new study from Brazil directly compares oral minoxidil and topical minoxidil for treating male androgenetic alopecia.
• 🧪 The study used 5 mg of oral minoxidil daily and 5% topical minoxidil applied twice a day over a 24-week period.
• 📊 Results showed no statistically significant difference in hair growth between oral and topical minoxidil, particularly when measuring terminal hair counts.
• 🧠 The primary endpoint, measuring absolute changes in hair counts, showed no clear advantage for oral minoxidil over topical minoxidil.
• 💊 Higher doses of oral minoxidil, such as 5 mg, approach dosages used for hypertension, raising concerns about potential cardiovascular side effects.
• 📸 Photographic assessments suggested a slight improvement in the vertex area for oral minoxidil, but this result was not conclusive.
• 💡 The speaker suggests that the perceived superiority of oral minoxidil may be due to better adherence or a placebo effect, rather than actual increased efficacy.
• 🚫 The speaker concludes that topical minoxidil remains the safer and equally effective option for hair regrowth, recommending against oral minoxidil due to its risks.

Q & A

What is the main purpose of the video?

The main purpose of the video is to analyze and compare the efficacy of oral minoxidil and topical minoxidil for treating androgenetic alopecia in men, based on a recent randomized clinical trial.

What was the dose of oral minoxidil used in the study, and how does it compare to typical dosages?

The study used 5 milligrams of oral minoxidil once per day, which is at the high end of what is considered low-dose for hair loss. This dose is close to the amount used to treat high blood pressure, and higher than the 2.5 mg or 1 mg doses that are more commonly used for hair loss.

What were the two treatments compared in the study?

The study compared 5% topical minoxidil applied twice daily with 5 milligrams of oral minoxidil taken once daily.

What were the primary and secondary endpoints of the study?

The primary endpoint was to measure the difference in terminal hair counts in the frontal and vertex areas of the scalp. Secondary endpoints included total hair counts, before-and-after photographic assessments, and side effect profiles.

What were the main findings of the study regarding the efficacy of oral versus topical minoxidil?

The study found no statistically significant difference in hair regrowth between oral and topical minoxidil, although oral minoxidil showed a slight advantage in the vertex area in percentage change. Overall, the results suggest that oral minoxidil is not superior to topical minoxidil.

Did the study report any significant side effects for either treatment?

The only significant side effect difference was that more men experienced hypertrichosis (excessive hair growth) in the oral minoxidil group, and more men had scalp eczema in the topical minoxidil group. There were no serious cardiovascular side effects reported, but the small sample size makes it difficult to detect rare side effects.

What did the author mention about the limitations of the study?

The author noted that the study was conducted during the COVID-19 pandemic, which could have affected the results due to increased telogen effluvium (shedding) caused by the virus. Additionally, the study's small sample size may not be sufficient to detect rare but serious side effects.

Why does the author think oral minoxidil might not be as effective as some believe?

The author suggests that the hype around oral minoxidil might be due to better adherence, placebo effects, and the fact that some users are combining it with other hair loss treatments like finasteride or dutasteride, making it difficult to attribute results solely to oral minoxidil.

What does the author recommend instead of oral minoxidil for hair loss treatment?

The author recommends sticking with topical minoxidil, as it is FDA-approved for hair loss and has a well-established safety and efficacy profile.

What is the author's overall stance on the use of oral minoxidil for hair loss?

The author is skeptical of oral minoxidil due to its potential safety risks and lack of proven superiority over topical minoxidil. He believes that the convenience of oral minoxidil does not outweigh the increased risk of side effects.

What alternative strategies does the author suggest for those who are poor responders to topical minoxidil?

The author suggests using topical tretinoin to upregulate the sulfotransferase enzyme, or using higher concentrations of topical minoxidil (10% or 15%) for those who do not respond well to the standard 5% formulation.