Minoxidil As Treatment of Androgenetic Alopecia | The Hair Loss Show

Summary

In this episode of the Hair Loss Show, Dr. Vickram Jash and Dr. Russell Nudson explore minoxidil, a long-standing treatment for hair loss. They discuss its origins, mechanism of action, and effectiveness in stimulating hair growth. The doctors address common misconceptions, such as the necessity of twice-daily application and the difference between 5% and higher concentrations. They emphasize the importance of patience and compliance with the treatment, noting that minoxidil is a safe and valuable component of hair loss therapy, particularly when combined with other treatments like DHT blockers.

Takeaways

• 🌟 Minoxidil is a long-standing product for treating hair loss and was originally developed as a tablet for high blood pressure, with hair growth as a side effect.
• 🔍 Dr. Vicam Jash was involved in the original research trials for minoxidil as a topical lotion in Australia in 1984.
• 💊 Minoxidil works by stimulating hair growth but does not address the underlying cause of hair loss, such as androgenic alopecia.
• 🔄 The product affects the hair cycle, particularly by extending the anagen (growth) phase, leading to a decrease in shedding rate.
• 📈 Some users may initially experience increased shedding, but this is a temporary phase indicating the start of a new growth cycle.
• ⏱️ Patience is key with minoxidil, as noticeable benefits may take 4 to 6 months to manifest.
• 👉 Minoxidil is available over-the-counter, indicating its safety and rigorous testing.
• 📊 About 40% of users can expect a noticeable improvement in hair quality, primarily in terms of hair shaft thickness.
• 🔄 The 5% concentration of minoxidil is generally effective, with higher concentrations offering minimal additional benefits.
• 👩‍🔬 There are different formulations of minoxidil, including liquid and foam, with the foam being less greasy and causing less scalp irritation for some users.
• 💡 Compliance with minoxidil treatment is crucial, and its effects are reversible, meaning hair loss may resume if the treatment is stopped.

Q & A

What is the primary purpose of stimulation therapy for hair loss?

The primary purpose of stimulation therapy for hair loss is to stimulate the hair growth without addressing the underlying cause of hair loss, such as in male pattern baldness or androgenetic alopecia.

What was the original purpose of Minoxidil before it was used for hair loss treatment?

Minoxidil was originally designed as a tablet to treat high blood pressure, and its use for hair loss was discovered due to an unexpected side effect of increased hair growth in users.

Who were the initial researchers involved in the trials for topical Minoxidil in Australia?

Dr. Vicam Jash was one of the five doctors in Australia who were involved in the original research using Minoxidil as a lotion for balding scalps.

How does Minoxidil affect the hair growth cycle?

Minoxidil affects the hair growth cycle by elongating the anagen phase, which results in a decrease in shedding rate and more hairs growing at any one time.

Why might some people experience an initial increase in hair shedding when they start using Minoxidil?

The initial increase in hair shedding is due to the new hair growth pushing out the old hair as the treatment stimulates a new growth cycle, which is a temporary phase.

What is the general time frame for noticing the effects of Minoxidil on hair growth?

The effects of Minoxidil are typically noticeable after 4 to 6 months of consistent use, with improvements in hair quality and volume.

What is the recommended frequency of applying Minoxidil according to the script?

The script suggests that once a day is a reasonable frequency of use for Minoxidil, as it has an effect that lasts in the skin for about 21 hours.

Why might the 5% Minoxidil solution be preferred over higher concentrations like 7% or 10%?

The 5% Minoxidil solution is preferred because it provides a noticeable improvement in hair quality, and going to higher concentrations does not significantly increase the response due to the flat dose-response curve of the medication.

What are the two forms in which Minoxidil is available for topical application?

Minoxidil is available in two forms for topical application: a liquid solution and a foam.

What is the role of Minoxidil in the treatment of hair loss according to the doctors in the script?

According to the doctors, Minoxidil is a safe and effective stimulator of hair growth that can be used for various types of hair loss. It is considered a valuable part of a treatment program, although it may not address the root cause of hair loss in conditions like male pattern baldness.

Outlines

00:00

💊 Introduction to Hair Loss Treatments and Minoxidil

In this introductory segment, the hosts, Dr. Vickram Jash and Dr. Russell, welcome viewers to the Hair Loss Show, where they discuss various aspects of hair loss and its treatments. They delve into the topic of stimulation therapy as an alternative to addressing the root causes of hair loss, specifically mentioning minoxidil, a long-standing treatment option. Dr. Jash highlights Dr. Nudson's involvement in the original Australian trials of minoxidil as a lotion for balding scalps. The segment also touches on minoxidil's original purpose as a high blood pressure medication and its unexpected side effect of hair growth, leading to its use as a hair loss treatment. The hosts emphasize the safety and over-the-counter availability of minoxidil, suggesting its rigorous testing and widespread acceptance.

05:01

🌱 Minoxidil's Mechanism and Temporary Shedding Concern

This paragraph explains the mechanism of minoxidil, which involves extending the anagen phase of the hair growth cycle, thereby reducing hair shedding. The hosts discuss the initial increase in shedding that some users may experience when they start using minoxidil, reassuring viewers that this is a temporary phase indicating the onset of new hair growth. They stress the importance of patience, as the full benefits of minoxidil, including improved hair quality and volume, may take up to six months to become noticeable. The segment also addresses common misconceptions about minoxidil use, such as the necessity of its application frequency and volume, and clarifies that the treatment aims to stabilize hair loss before any improvement is observed.

10:03

📊 Minoxidil's Success Rates and Patient Feedback

The hosts present the success rates of minoxidil, noting that about 40% of users see a noticeable improvement in hair quality, primarily in terms of hair shaft thickness. They explain that an additional 40% of users maintain their current hair state without further deterioration, suggesting an overall positive outcome for 80% of patients. The paragraph also addresses how to determine if minoxidil is effective, advising users to discontinue the treatment temporarily to observe any changes in hair shedding. The hosts discuss variations in minoxidil concentration, such as the 5% and 7% options, and explain that the higher concentration does not necessarily yield better results, cautioning against marketing-driven misconceptions.

15:05

🔍 Minoxidil Application and Preparation Options

This segment provides practical advice on using minoxidil, including the recommended application frequency and volume. The hosts clarify that the product should be applied directly to the scalp, not the hair, and that it is available in two forms: liquid and foam. They discuss the benefits of the foam preparation, which is often better tolerated and less likely to cause scalp irritation or flakiness. The paragraph also touches on the absorption time for minoxidil, indicating that the foam version absorbs more quickly, allowing for more flexibility in post-application activities such as washing or exercising.

20:07

💡 Long-Term Use and Combination Therapy with Minoxidil

The final paragraph discusses the long-term use of minoxidil, acknowledging that while some patients use it consistently for years, others may be less consistent due to various reasons such as forgetfulness or discouragement. The hosts stress the importance of compliance and the role of minoxidil in combination therapy with other treatments, such as DHT blockers, for more effective hair loss management. They conclude by reiterating the safety and efficacy of minoxidil as a valuable component of hair loss treatment programs and look forward to discussing additional stimulators in the next episode.

Keywords

💡Hair Loss

Hair loss, also known as alopecia, is the primary theme of the video. It refers to the falling out of hair from the scalp, which can occur for various reasons. In the script, hair loss is discussed in the context of both men and women, and the focus is on understanding the causes and exploring medical and surgical treatments to address it.

💡Stimulation Therapy

Stimulation therapy is a method of treating hair loss by stimulating the hair follicles to promote growth. The script mentions that this therapy does not address the underlying cause of hair loss but is used to stimulate hair growth, particularly in conditions like androgenic alopecia.

💡Minoxidil

Minoxidil is a key concept in the script, identified as a long-standing product used for treating hair loss. Originally developed as a medication for high blood pressure, it was discovered to have the side effect of hair growth. The script discusses its use in both men and women, its mechanism of action, and its role as a topical treatment for hair loss.

💡Androgenic Alopecia

Androgenic alopecia is a type of hair loss that is linked to male hormones and is common in both men and women. The script refers to this condition when discussing the limitations of stimulation therapy, as these therapies do not address the root cause of hair miniaturization in androgenic alopecia.

💡Hair Cycle

The hair cycle is a natural process involving the growth, rest, and shedding of hair. The script explains how minoxidil affects this cycle by elongating the anagen phase, which is the growth phase of hair, leading to a decrease in hair shedding and an increase in the number of hairs growing at any given time.

💡Over-the-Counter Medication

An over-the-counter medication is a type of drug that can be purchased without a prescription. In the script, minoxidil is mentioned as transitioning from a prescription medication to an over-the-counter product, indicating its safety and widespread acceptance for use in treating hair loss.

💡Potassium Channels

Potassium channels are part of the mechanism by which minoxidil is believed to work, although the exact process is not fully understood. The script mentions that minoxidil's effect on potassium channels is part of how it stimulates hair growth, but the specifics are beyond the scope of the discussion.

💡Shedding Rate

The shedding rate refers to the rate at which hair naturally falls out. The script discusses how minoxidil can decrease the shedding rate, which is beneficial for those experiencing hair loss, as it means more hairs are growing at any one time.

💡Dose Response Curve

A dose-response curve illustrates the relationship between the dose of a drug and its effect. The script uses this concept to explain that increasing the concentration of minoxidil from 5% to higher percentages does not significantly increase its effectiveness, indicating a flat response beyond the 5% mark.

💡Compliance

Compliance in the context of the script refers to the consistency and adherence to a treatment regimen. It is discussed in relation to the long-term use of minoxidil, with some individuals using it for many years, while others may have issues with consistency due to various reasons such as forgetting or getting discouraged.

💡Topical Solution

A topical solution is a type of medication that is applied directly to the skin. The script mentions that minoxidil is available as a topical solution, which can be applied directly to the scalp to stimulate hair growth. It is also contrasted with an oral form, which requires a prescription.

💡Oral Minoxidil

Oral minoxidil refers to the form of the medication that is taken by mouth, originally used for high blood pressure. The script mentions that an oral form of minoxidil can also be used for hair loss, but it requires a prescription and is typically used at a lower dose that does not affect blood pressure.

Highlights

The Hair Loss Show discusses medical and surgical treatments for hair loss in both men and women.

Stimulation therapy is introduced as a method to stimulate hair growth without addressing the underlying cause of hair loss.

Minoxidil, a long-standing product for hair loss, was originally developed to treat high blood pressure but had hair growth as a side effect.

Dr. Vicam was one of the initial doctors involved in the Australian trials for minoxidil as a topical treatment for hair loss.

Minoxidil's mechanism of action is not fully understood but involves potassium channels and is considered a safe therapy.

Minoxidil is available over-the-counter, indicating its safety profile after rigorous testing.

Minoxidil works by elongating the anagen phase of the hair cycle, reducing shedding rates.

Some patients may initially experience increased shedding when starting minoxidil, but this is a temporary phase indicating new hair growth.

Patients should expect to use minoxidil for at least 4 to 6 months before noticing significant benefits.

The success rate of minoxidil shows 40% of users notice an improvement in hair quality, mainly by increasing hair shaft diameter.

An additional 40% of users maintain their hair condition without further deterioration when using minoxidil.

Minoxidil can be used for various types of hair loss, not just androgenetic alopecia.

The recommended dosage of minoxidil is once a day, and the amount should cover the entire area of hair loss.

Higher concentrations of minoxidil, such as 7%, do not necessarily provide better results than the standard 5%.

Minoxidil is available in two forms, liquid and foam, with the foam being better tolerated and less greasy.

The foam preparation of minoxidil absorbs quicker through the skin than the liquid, allowing for more flexible application timing.

Oral minoxidil is available by prescription for those who prefer not to use a topical solution.

Compliance with minoxidil treatment can be an issue, with many users stopping treatment due to lack of immediate results.

Minoxidil can be combined with other hair loss treatments, such as blockers, for a comprehensive treatment approach.

Transcripts

[Music]

welcome to the hair loss show Dr Russell

nudson and Dr vicam J aash discuss

issues relating to hair loss and the

medical and surgical treatment of hair

loss in both men and

women hi everyone my name is Dr vickram

jash I'm Dr Russell nson and welcome to

the hair loss show and this is episode

number seven so if you've been with us

up till now we've gone through uh the

causes of hair loss and what happens and

the difference between hair loss and

shedding and we've sort of outlined what

the uh the methodologies are of of

treatments so we talked about blockers

and now we're going to move on to the

other side of the equation which is

stimulation therapy now as we talked

about in the last episode stimulation

therapy uh is designed to do exactly

what it says it just stimulates the hair

it doesn't address the underlying issue

certainly in things like male patent

hair loss androgenic alopecia why the

hair is miniaturizing in the first place

these uh stimulators don't really

address that uh issue but what they're

doing is they are stimulating the hair

so the first thing we want to talk about

is one is a product that's uh been in

the market for for many years uh and

until uh for a long time was this you

know was the only therapy really we had

for for hair loss and that is

minoxidil so minoxidil I mean you know

lot about minox don't you cuz uh you

were certainly um one of the initial the

doctors who were involved in the trials

and with minox aren't you that's correct

vicam so in 1984 I had the privilege of

being one of the five doctors in

Australia that did the original research

in Australia using monoxil as a lotion

to apply to Bolding scalps so the

background to the story is that monoxil

was originally designed as a tablet to

treat high blood pressure and one of the

unusual side effects that It produced uh

in the method of action that that it the

utilizes was that people became Haier so

80% of people using oral minoxidil in

the dose that they were using for high

blood pressure noticed increase in hair

generally so basically on the arms the

legs the chest the face you name it that

they got hairy it was kind of like a

werewolf syndrome if you're like

but curiously they also noticed that

some of the mild patients who were

baling got some uh reversal of their

Bolding using oral minoxidil so this

stimulated the idea uh for the

pharmacology company to investigate

whether you could just stimulate the

hairs you want to stimulate so in that

scenario you put it into a topical

lotion and you only apply it where you

want the hair to work now so This

research was started in

1984 and we kind of have an idea how it

partly works but still 35 years later we

don't really exactly know how it works

it has something to do with potassium

channels but it's really Beyond uh you

know either my level of knowledge or

your level of knowledge to go any deeper

than that but it certainly does have an

effect so we did the research on both

men and women Australian had the first

women's trial in the world for using

topical monoxil for the female patent

hair loss it came on the market in

Australia 1989 as a prescription

medicine and it's safe that's the

important thing to notice this is a safe

therapy it lasted as a topical therapy

only for about 10 years be on

prescription before it became an

over-the-counter medication so the first

thing I want to tell you about the

medicine is that it's an

over-the-counter medicine you can buy it

from the chemist I think that highlights

its safety profile is so if anything's

available over the counter it's gone

through the very rigorous testing and it

is and they was a prescription for a

while but when they realized nobody was

getting harmed they knew they could

downgrade it from a prescription

medicine to an over-the-counter

medication so this is an important thing

for people to know so

minoxidil how we don't know exactly how

it works but it does two things that we

really want to focus on number one it

has an effect upon the hair cycle

remember we talked about the hair cycle

where we have the growth phase which we

call the antigen cycle so what monoxil

does is it elongates it lengthens the

antigen cycle so the way that becomes

noticeable to patients is that they

decrease their shedding rate now the

advantage of that is that if you Fe that

you have a hair loss problem or an

excessive shedding problem then being

able to slow down the shedding rate is

good because first you're less worried

that's right and number two it means

more hairs are growing on your head at

any one time than otherwise would be the

case that said I've got to tell you that

one thing that does make people nervous

is that there is a percentage of

patients when they start using monox all

then in the first month or two months

they notice an increase in shedding rate

they think my golly this is supposed to

save my hair and yet it's making it fall

out even faster well the reassuring

thing about this is number one it's a

temporary phase number two it tells you

that when hairs finish growing and they

stop being attached to the skin they sit

there till something tugs them out when

you put monoxil in the system and you

start the next grow cycle it pushes the

old hair out so the reason that people

go through this temporary increase in

shedding is because the new hair is

pushing the old hair out so that's a

good thing it not a bad thing I know but

what we're what I see and what I'm sure

you see is that people go oh you know

what I tried minoxidil topical minoxidil

and it made my hair loss worse and I was

like you know this is just this is

horrible this is not for me and then

they gave up and walked away and the

problem with that is that they've

invested in the monoxil they've tried it

for a few weeks they've had all the

downsides of it which is that initial

shedding without the benefit without the

benefit and so you know we all what we

say to all our patients if if you're

starting on an oxal listen be prepared

for that shedding and power through it

because the good stuff is coming you

know a few weeks after so that leads

into the whole concept of stimulators in

that if you remember from our discussion

on the podcast about the hair cycle when

a hair sheds out a replacement hair

doesn't come through for 3 months so

realistically when you're using

stimulation therapy you can't expect the

response to happen in weeks it's going

to happen over a period of months so for

monoxil specifically we would say to you

if it is 4 to 6 months before you're

really going to notice whether you're

getting a benefit or not the first thing

you might notice is a reduction in

shedding even if you have that little

bit of increase in shedding but for you

to notice an improvement in the quality

of your hair and therefore the volume of

your hair forget it it's not going to

happen in under four months and you'd be

very lucky if you're one of the people

to get it at four months it's more in

the second six months so you've got to

power through as you said and be patient

so people who come and say to us that

they've tried M oxal and it didn't work

there are two questions we asked them

number one is how long did you use it

for because they may not have used it

for long enough and number two I asked

them to Define failure because what they

mean is they didn't grow any extra hair

but if I say to them well but did you

get worse while you were using monoxy I

said well no and I said then my next

question is well what happened when you

stop using minox I say oh thinner so I

say the first goal of stimulation

therapy is to make sure that you're not

deteriorating that's an acceptable

result it may not be your favored result

but it's an acceptable result and this

is something we talk about all the time

isn't it with with medical therapy uh

and I know you say this I say is that

the goal of medical therapy at the

Baseline is stability if we can maintain

stability you and I are going to be

high-fiving our patients all day long

isn't it that's right because even if

the p isn't ecstatic they're not going

backwards this is like leaking bucket

therapy right you know we've got to stop

this leak coming out of the bucket so

obviously the second phase which takes

longer for people to notice is whether

they're going to get Improvement so if

you ask what are the percentage success

rate of these things there is again it's

a complicated thing so let's walk you

through it in bite-size chunks first if

you look at the trials about 40% of

people that used monoxil topically were

able to get a noticeable Improvement in

the quality of their hairs now if we

break down that 40% into what that

actually means it is mostly about

increasing the diameter of the shaft of

the hair so a weaker hair is becoming a

stronger hair and that's what's

producing the notable Improvement there

is a little bit of an increase in the

number of hairs that will grow at any

one time but the major benefit of using

monoxil is to increase the thickness of

the hair shaft so that's the first thing

that people need to understand that's

what we're trying to achieve so if we

look at it from therapy we're saying you

need to be on it because we're going to

stimulate the hairs and we're going to

try and keep them now what I said before

is that monoxil can be used for any type

of hair loss not just boldness in men or

female patent fitting uh for people that

have had uh malts which is like

synchronized shedding that maybe after

the birth of a child maybe after a fever

Maybe maybe after a change of medication

maybe after an acute stressful event um

even conditions like alip alpc areata

where the immune system switches off the

hair follicle we can stimulate the hair

follicle to see if we can get it to come

back faster so that's the benefit of of

using the the therapy so yes 40% of

people over time will notice an

improvement there's another 40% of

people who just notice that they're not

getting worse at least in the short term

you know 1 to two years so that's the

second benefit of it so maybe 80% of our

patients are going to use uh minoxidil

and somee of success with some degree of

success and then people say to me well

you know how do I find how do I know if

it's working I said well probably the

only way to be sure is to stop it and

see what happens so if you stop the

therapy and you stop stimulating the

hair with Minoxidil if you notice an

increase in shedding some four to8 weeks

later then you know that was having an

impact upon the hair cycle right so

sometimes you have to withdraw to the

therapy to be sure about the therapy now

the next thing we need to talk about is

what's written on the box it says one

mill to be used twice a day now there's

a reason why it says that it's because

that's what we did in the trial in 1984

that's what we submitted to government

in

1985 and so the therapeutic Goods

Administration said yes you can bu you

can Market it for a mill twice a day

that doesn't

address two critical factors number one

is how long does the effect last in the

skin the answer is 21 hours so

realistically it only has to be used

once a day if you want to use it twice a

day that's fine you're not going to do

any harm but realistically EAS to be

used once a day the second thing is

addressing the one mil the reason that

one mil was the number was that they

were trying to standardize how everybody

in the trial was being treated but but

again in real life situations some

people have a small area of hair loss

some people have a large area of hair

loss so if you have a small uh area of

hair loss like you would put a cream on

a rash you just cover the area and the

amount is the amount if you got a larger

area you use a larger amount so it

really doesn't matter about measuring it

to the one mill you don't have to stick

to the one M you just need to cover the

area you're trying to treat so those are

two things I want to emphasize number

one is once a day is a very reasonable

uh uh frequency of use number to treat

the entire area you want don't just

worry about the one meal answer cool so

there's a couple of other things you

know so you know sometimes we get a lot

of feedback from patients who are who

are on minoxidil who are trialing

minoxidil and so here's a few things

that we commonly go here I'm on 5%

monoidal I hear there's a 7% monoidal 7%

must be better than 5% all right now

that sounds like a logical thing until

you understand what we call a dose

response curve which means if you

increase the dose do you increase the

response the positive response so with

monoxil it works like this yes it works

up to about 5% here right at the 5% Mark

you're getting this response if you go

to 7% you might get that response if you

go to 8% you might get that response if

you go to 10% you might get that

response it's almost a flat line right

so basically the reason behind this is

marketing because people believe that

Solutions work better so don't be fooled

by that if really 7% or 6% or 8% or 9%

was better than 5% why isn't it

available at the chemist seriously why

isn't it available it is so as you can

see you know 5% is applicable across the

board yes theoretically there's an

advantage to 7% but it's absolutely

minuscule and you're not you know it's

not going to be noticeable by most

people and the same is true with the

inverse because there is a a version so

if you look at minoxidil which is rain

or regain that you might see at the at

the chemist there is a men's version of

it and there's a female version of it as

well so for men mostly they will use 5%

for women you can use 5% or 2% now the

reason that we have these two different

ones is because some women are very

fearful of getting increased facial hair

from absorption through the skin using

the 5% and the interesting fact is that

if you start on 5% you get a quicker

response than if than you start on the

2% it's not necessarily a better

response so what you can do in this

situation is if we have women who are

using 5% and they're noticing a little

bit of increased facial hair we can

downgrade them to to 2% to help that

because that's reversible by the way

that increased stimulation is reversible

which also tells you if you stop the

therapy you lose the effect so it is a

reversible effect in all cases so you

can often maintain somewhat on 2%

after you've started on on them for 5%

so that's okay so the difference between

the pink box and the blue box is that

marketing pink to the women seems to

work better than than than just marking

the blue men's version so that again is

a marketing principle not necessarily a

science principle the other thing that

we commonly see is people come and say

oh look I've started minoxidil I really

don't like it it makes my hair greasy or

I'm getting really skitchy sorry itchy

flaky scalp and that comes down to the

preparation and in fact oxal comes in

two preparations there's a liquid and

there's a foam and the liquid is the the

base preparation is propylene glycol and

that can cause uh itchiness and Flaky

scalp uh in about 30% of uh people that

use that so um I generally sort of say

to people look there are two options the

foam is sometimes a lot uh better

tolerated in a lot of people and it's

like comes in a mousse can you shake it

and you squir a bit into the into the

cap and then you can just use your

finger or or a cotton butt just to to

paint it on and the other key there is

that it is there is absolutely no point

in applying the monoxil to the hair

right the monoxil has to be on the scalp

it doesn't do anything if you soak your

hair in monoxil because the hair is not

going to the hair is effectively dead

rope and therefore is not going to

absorb and you're not going to get any

benefits so painting it onto the scalp

is important so foam I find is better

tolerated in a lot of it's less grezy

because it doesn't have the PG yeah

right it's pg3 which is the reason they

developed it was because you know not

just the Dermatological reaction the

flaking that Vic was talking about but

also women finding they were having

styling issues with it so this is why

they developed a PG free uh version of

it to do that but the chemistry is

interesting too because the foam absorbs

quicker through the skin than the lotion

so the lotion takes 60 to 90 minutes to

absorb through the skin the foam takes

10 minutes to absorb through the skin so

when people are saying well when can I

wash my hair afterwards or when kind of

get sweaty afterwards um as long as you

have applied the lotion maybe 90 minutes

before washing or sport you're going to

be okay as long as you put it on 15

minutes before uh with the foam for 15

minutes before uh sport or washing

you're going to be okay you don't really

have to keep it on for 4 6 8 hours and

wash it out the next morning it really

will absorb through a lot quicker than

that cool so in summary minox really

really it's been around for a long time

very safe really good stimulator of hair

growth it comes in um a liquid and a

foam and the 5% is applicable for most

people and most people don't react don't

react um and the other thing to not note

that you don't need to take it twice a

day once a day is perfectly fine um if

you take it you know start taking it be

aware that there is going to be an

initial shedding phase after using some

people which you may experience some

shedding absolutely and but power

through that and then uh the growth will

will come after that and um it can you

can take it as an oral form as well okay

but that's back to prescription medicine

so oral monoxil is something that's

increasingly being used because people

don't like necessarily to use a topical

solution in amongst their hair uh for

styling reasons so you can use a much

lower dose uh rather than the tablet

that was used for high blood pressure in

fact we use such a low dose that it

doesn't affect the blood pressure but

again you'd have to have that prescribed

by a doctor somebody who knows what he's

talking about like a specialist who

works with hair loss would understand

this rather than the general

practitioner they would be very

reluctant to do this so it's a very

useful medication for any type of hair

loss and it has a role in the treatment

of boldness um and most people might

start with this first but it's a

short-term therapy for Bolding in my

opinion because for most people it's not

targeting the problem which is the DHT

buildup and the f IC it doesn't have

that effect so it's slowing things down

without necessarily stopping what are

your thoughts on compliance I mean how

you've used it for a long

time uh have you seen people going oh

yeah I've been on monoidal once a day I

use it every night and I've been on it

for 20 odd years yes there are people

like that but the truth of the matter is

most people waver in waver out they stop

for different reasons they forget they

get discouraged right because they're

expecting it to be better when in fact

it's stable

and often they come to me and say yeah I

realized when I stopped that I got worse

so maybe I should start back on it again

but is there something better the answer

is there's no 100% answer for anything

in hair loss uh but it is a very useful

medicine and I rank it just behind using

in boldness I rank it behind using

blockers first uh and other types of

hair loss are rank at number one and and

this is going down another rabbit hole

but you can combine therapy can't you

the blockers and stimulators we'll talk

about that at the end because there is

there are certain conditions where it

makes sense to combine a blocker and a

stimulator but certainly I want you to

know it's safe I want you to know it

works pretty well and that it's a very

useful part of

a treatment program for virtually any

type of hair loss uh there are sometimes

you might under use it shortterm but

mostly you're going to have to use it

long term perfect okay I hope that's

been of use to you or I think that's

great I mean I think we've got covered a

lot with M oxidal so yeah I think that's

uh fantastic and we'll uh on the next

episode we'll go through some of the

other uh stimulators um uh for for hair

loss okay but we'll see you next episode

thank you see you

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then