Minoxidil

Help the follicle stay growing

Each follicle alternates between a growth phase, a transition phase and a resting phase before hair loss. In androgenetic alopecia, sensitive follicles gradually miniaturize and produce finer hair. Minoxidil promotes growth-promoting functioning and can improve the diameter as well as visibility of the hair produced. It acts on existing follicles, without making new ones.

The transition of certain resting follicles to a new cycle helps to understand the transitory loss at the beginning: old hairs can fall out before the next ones become visible. This shift is not an obligation to obtain a result. The absence of shedding does not allow us to conclude that the medication is not working, any more than a marked fall guarantees significant future regrowth.

A molecule that must be activated

Minoxidil is transformed into minoxidil sulfate by enzymes called sulfotransferases, found particularly in the skin. This conversion contributes to its biological activity. Studies have found a relationship between the activity of these enzymes in the follicles taken and the response to treatment. This provides a possible explanation for some of the differences between two people who use the same product.

This track doesn't sum it all up. The stage of loss, the follicles still present, the correct application and regularity also count. An enzyme test is not a guarantee of regrowth, and increasing the concentration yourself does not necessarily resolve a weak response. Before concluding, it is more useful to check the diagnosis and use with the professional who accompanies you.

More than blood circulation

The complete hair mechanism remains imperfectly understood. Minoxidil sulfate acts in particular on potassium channels, and cellular work is exploring several signals linked to growth. A study on dermal papilla cells showed an increase in the expression of VEGF, involved in vascularization. This experimental result provides a clue, without demonstrating that simply increasing circulation would be enough to reproduce the effects of the drug.

The shortcut “the blood circulates better, so the hair grows back” leaves out a large part of the biology of the follicle. It does not allow the same benefit to be attributed to a massage or to a product that heats the skin. The clinical effectiveness of minoxidil is based on the results obtained with its studied formulations, not just on an attractive theoretical explanation.

Why the results require further action

Minoxidil does not eliminate the predisposition to alopecia and does not directly reduce DHT production. As long as it is used, certain follicles benefit from support in their growth. After stopping, this effect disappears and the gains are gradually lost; the solution instructions mention a return to the initial state in three to four months. You must therefore think about the routine over time before starting.

finasteride intervenes on another mechanism by reducing DHT. A combination may be relevant in certain situations, and a comparative trial found more improvements with both treatments than with each alone. This potential benefit is accompanied by constraints and risks specific to each drug. Minoxidil can also be used alone: ​​the combination is discussed according to the objective and medical profile.

Oral use, beard and eyebrows: distinct uses

Orally, the drug exposes the entire body. The 2024 trial notably observes excessive hair growth and headaches among the adverse effects; blood pressure, history and other treatments must enter into the decision. Never drink a solution intended for the scalp. A possible oral prescription uses a suitable preparation and medical monitoring, not an artisanal conversion of the number of drops.

On the beard and eyebrows, trials have studied local applications, notably at 3% for the beard and 2% for the eyebrows. These off-label uses may be of interest, but their decline remains lower than that of hair treatments. The data does not guarantee that gains will be maintained after stopping; concentration and protocol must be adapted with a dermatologist, without automatically repeating those of the scalp.