Oral Low Dose Minoxidil vs High-Dose Compounded Minoxidil

Below are the reasons why we recommend high-dose, compounded, topical minoxidil, in most cases, over low-dose oral minoxidil for male pattern hair loss.  However, a subset of men lack the scalp enzyme necessary to convert topically applied minoxidil to the active form.  Therefore, we recommend low-dose oral minoxidil in these men, because the activation enzyme present in the liver activates the minoxidil.  Although there are studies showing low-dose oral minoxidil is more effective than topical, these studies are comparing oral vs 5% topical minoxidil.  Our compounded 15-30% topical minoxidil is usually much more effective in most men than a systemic-wide SIDE EFFECT of an anti-hypertensive medication taken in low doses:

1. 1. Topical 15-30% minoxidil is much more powerful and works directly on the hair follicle NOT a side effect of systemic high blood pressure medication
   2. The study compares low dose oral minoxidil to OTC 5% minoxidil, NOT compounded 15-30% minoxidil topical
   3. That is low dose oral minoxidil compared to 5% topical minoxidil, we prescribe 15-30% compounded TOPICAL minoxidil
   4. Oral minoxidil is a SYSTEMIC anti-hypertensive medication that has a “side effect” of hirsutism, meaning hair growth all over the body, not just on scalp
   5. Topical minoxidil applied in HIGH concentration (15-30%)directly to the localized miniaturized hair follicles on the scalp is much more effective and powerful than a low dose of a system high blood pressure pill that just has a side effect of increasing total body hair thickness.
   6. 2.5mg daily taken orally has first pass effect through the liver which decreases the actual amount of minoxidil that is available at the hair follicle.  Compounded 15% to 30% topical minoxidil delivers 150 to 300 mg of minoxidil directly to the miniaturized hair follicles where the effects is needed.
   7.  In addition, we add additives to the topical compounded minoxidil, RA, AA, Progesterone which helps to enhance the effectiveness of the effects of minoxidil improving blood circulation to the follicle.
   8. HIGH blood pressure medication (anti-hypertensive) MAIN physiological function is to DECREASE blood pressure which could have deleterious effects on even healthy people or individuals with known and unknown heart issues or are on other blood pressure medication
   9. Oral minoxidil is contraindicated in men with heart disease, liver disease, kidney disease and those who are already taking high-blood pressure medication

HOW TO REQUEST A PHYSICIAN CONSULTATION FOR A MINOXIDIL PRESCRIPTION:

1. 1. Read About prescription strength Minoxidil compounded formulations to learn more about its indications and contraindications.
   2. Select the active ingredients in your individualized compounded formulation
   3. Select additional prescriptions for hair loss treatment: 5% minoxidil spray and/or 3% Acetyl-Glutathione with Biotin solution.
   4. Read and Agree to the Waiver of Liability.
   5. Accurately and truthfully complete and submit a medical consultation questionnaire
   6. Your medical consultation will be reviewed by one of our Physicians, and if approved you will be prescribed a Minoxidil formulation customized for you. This consultation is RISK-FREE, if the physician determines Minoxidil  is not appropriate for you, then there is no charge.
   7. You can select either “regular” service (3-7 days to process) or “express” 24 hour processing for an express service fee.
   8. If approved you will receive an email confirmation from Medical Wellness Center, and your prescription will be forwarded to Trinova Health Compounding pharmacy. Then the pharmacy will contact you to customize your compounded formulation and to arrange for medication purchase and shipment.
   9. The initial consultation fee for the physician evaluation is only $49.95 plus processing if you are approved for treatment, otherwise it’s free. If you find Minoxidil is working for you, yearly medical refill consultations are only  $75.00 plus processing for one year of refills.
      
   10. If you have any health concerns in any way, you should contact your own physician for further advice

Minoxidil: FAQ

WHAT IS MALE PATTERN HAIR LOSS?

Male pattern baldness,  androgenetic alopecia,  is a very common condition in which men begin to experience thinning of the hair on the scalp.  These changes often start slowly in men in their 20’s and often progress to a receding hairline and/or balding on the top of the head.  Male pattern baldness is believed to be hereditary and dependent on hormonal effects.  The primary cause of Male Pattern hair loss and baldness is due to Dihydrotestosterone (DHT) which is produced by 5-alpha reductase conversion of testosterone to DHT and leads to miniaturization of the hair follicle.

WHAT IS MINOXIDIL AND HOW DOES IT WORK?

Minoxidil is the active ingredient in Rogaine and it works at the level of the dermal papilla.  Minoxidil increases blood flow and works by gradually enlarging miniaturized follicles that have shrunk.  Also, Minoxidil appears to extend the hair’s growth phase thus giving the hairs an opportunity to reach a longer length before falling out.  With more follicles in the growth stage, it is possible to see improved coverage of the scalp.

HOW DOES PRESCRIPTION STRENGTH MINOXIDIL DIFFER FROM ROGAINE?

Minoxidil is the active ingredient in Rogaine the over-the counter preparation.  Rogaine contains only 2 – 5% Minoxidil and is 60%  alcohol which is very drying and damaging to the hair shaft.  Minoxidil effectiveness is dose dependent and the higher the dose the better the hair regrowth.  Therefore prescription strength 12.5% to 30%  Minoxidil is many times more potent than Rogaine and it is not drying and damaging to the hair shaft as is OTC Rogaine.

WHAT IS THE DIFFERENCE BETWEEN MINOXIDIL 5% – 30% COMPOUNDED FORMULATIONS?

All Minoxidil preparations compounded  by Trinova Health Compounding Pharmacy are formulated with micronized Minoxidil  which means the Minoxidil has been ground down from its normal crystals into very fine particles which can be more easily put into higher strength formulas.   These Minoxidil preparations are made without alcohol which is drying and irritating to the scalp and found in high concentrations in over the counter Rogaine.

In addition, you have the option customizing the Minoxidil cream or lotion with additives that promote hair growth and increase the effectiveness of the formulation.  The Minoxidil can be compounded with 0.025% Retinoic Acid (RA)  which can initiate cell growth and differentiation, Azelaic Acid (AA) which is a 5 alpha reductase inhibitor (decreased DHT which is responsible for male pattern hair loss), 0.1% finasteride, 1.3% Biotin, 0.1% Vitamin E, Progesterone 0.25%, 1% Grape Seed extract(may stain skin and surfaces), and Hydrocortisone is a steroid which helps decrease any scalp irritation.  If you have glaucoma, increased intraoccular pressure, or sensitive to steroids the formulation must NOT be compounded with hydrocortisone.  The formulations are formulated in a Propylene-Glycol base, but you can request individuall customization.  Also, you can choose Dimethyl-isosorbide(DMI) to be added to the formulation as an enhancer.

WILL MINOXIDIL WORK FOR ME? WHAT ARE THE INDICATIONS?

Minoxidil is prescribed online for MEN 18 years or older experiencing gradual thinning and hair loss on the top of the head(vertex) – ANDROGENETIC Male Pattern Baldness. Clinical trials have shown Minoxidil to be effective in regrowing hair on the top of the head but not proven efficacious in frontal hair growth. The response to Minoxidil varies greatly for each person and can not be predicted. Minoxidil has been clinically proven and FDA approved as a treatment for male pattern hair loss and is dose-dependent.  Therefore, prescription-strength 15% cream or 12.5% lotion is significantly more effective than over-the-counter 2 – 5% Minoxidil, Rogaine.

CAN MINOXIDIL BE USED ALONG WITH PROPECIA OR AVODART?

Treating male pattern hair loss with multiple modalities – topical Minoxidil and systemic 5-alpha reductase inhibitors Propecia or Avodart may work synergistically to enhance the effectiveness of treatment and promote hair regrowth. Topical prescription-strength Minoxidil works by increasing blood flow and enlarging miniaturized follicles and extending the hair’s growth phase.   Propecia and Avodart, both 5 alpha-reductase inhibitors, work by inhibiting the enzymatic conversion of testosterone to DHT. DHT is responsible for the miniaturization of the hair follicles in the balding areas. Therefore topical Minoxidil and systemic Propecia or Avodart work synergistically on the key factors in the development of androgenetic male pattern baldness. Propecia and Avodart decrease levels of DHT responsible for the miniaturization of hair follicles, while Minoxidil works to increase blood flow to the area and enlarge and restore the follicles that have been miniaturized.

Although Minoxidil can be used as a sole treatment modality, combining topical Minoxidil with systemic DHT inhibitors – Propecia  or
Avodart would maximize the effectiveness of both,  and result in the best opportunity to slow hair loss and regrow new hair.

Avodart or Propecia prescriptions are available through Medical Wellness Center

HOW LONG BEFORE I SEE RESULTS?

Hair grows only about ½ inch per month, therefore patients start to notice results after the first 3 months of treatment. It takes time to see improvement. Initially one may start to notice very fine, soft, colorless hairs. With further use, the new hairs will gradually become thicker and the same color as the other hairs on your scalp. Up to 12 months of use may be needed to see your best results from Minoxidil. Also, for those just starting to have hair thinning, using Minoxidil in the early stages will yield the most dramatic results.

HOW LONG DO I HAVE TO USE MINOXIDIL?

The underlying predisposition to baldness is always present. Therefore, if a patient discontinues the use of Minoxidil, he will gradually lose the new hair that grew in response to Minoxidil treatment and will experience the progression of his underlying predisposition to baldness.  Newly regrown hairs will probably be lost in 3 – 4  months after stopping medication use.

WHEN & HOW DO I USE  MINOXIDIL?

Minoxidil prescription strength cream or lotion/gel is applied once daily in the evening to a dry scalp. Allow sufficient time for the Minoxidil to be absorbed into the scalp and dry before going to bed. Do not get scalp or hair wet for 4 hours after applying Minoxidil. Only apply Minoxidil to the scalp in the hair loss area. Do not get in eyes. Wash hands after applying. Using Minoxidil more frequently or in higher doses will NOT make it work better or faster. If you miss a Minoxidil dose, just continue with your next dose in the evening.  DO NOT use a double dose of the medication.

• • Only apply to the areas of hair loss on the scalp.
  • Do NOT apply to any other part of the body.
  • Do NOT use more frequently than prescribed.
  • Always wash your hands after use.

CAN I CONTINUE TO USE SPRAYS, MOUSES, GELS and STYLING AIDS WITH MINOXIDIL?

There is no need to change your usual hair care routine when using Minoxidil.  It is best to use Minoxidil on a dry scalp at night and to allow it to dry and absorb thoroughly before going to bed to prevent spread on the pillow and bedding.  Do not wet hair for 4 hours after applying Minoxidil to scalp.    If you do need to apply styling aids after applying Minoxidil, wait for the Minoxidil to dry completely before applying any styling aids.

CAN I HAVE MY HAIR CHEMICALLY TREATED – PERMANENTS? TINTS? RELAXED? – WHILE USING MINOXIDIL

There is no evidence that chemical treatment of hair changes the effect of Minoxidil.  However, chemical treatments can result in scalp irritation.  Therefore the night before you plan to chemically treat your hair do NOT apply Minoxidil.  Also do NOT apply Minoxidil to the scalp for at least 24 hours after any chemical treatment to your hair to ensure no irritation occurs.  If you experience any irritation, sensitivity or scalp redness after a chemical treatment, wait until the scalp is 100% healed before applying Minoxidil. Do NOT make up for missed doses.

WHAT IS THE MOST IMPORTANT INFORMATION I SHOULD KNOW ABOUT MINOXIDIL?

• Minoxidil is prescribed ONLINE for MEN only, although unlike Propecia or Avodart, it has also been approved for women who are experiencing male pattern hair loss.  Minoxidil is NEVER prescribed for women online because, in women, male pattern hair loss can be a sign of a serious or life-threatening underlying medical condition from hormonal problems to even cancer.
• Pregnant women should NOT use OTC Rogaine or prescription strength Minoxidil.
• Minoxidil is indicated as a topical treatment for male pattern hair loss which occurs gradually and runs in families.  If you experience sudden hair loss, or you are experiencing patchy areas or hair loss or hair loss from medication or after pregnancy Minoxidil is NOT for you.
• Minoxidil is for TOPICAL use ONLY!  Minoxidil is to be applied to the areas of hair thinning on the scalp only. Never take Minoxidil by mouth.

WHAT ARE THE SIDE EFFECTS OF MINOXIDIL?

The most common side effects are itching and other skin irritations of the treated area of the scalp.  Minoxidil should ONLY be applied to the scalp.  The risk of side effects increased if applied to other parts of the body.  Always WASH hands after use

Do not get in eyes – if accidentally gets in eyes flush with water immediately and if irritation persists seek immediate medical attention in an emergency room.

Stop using the formulation and seek emergency medical attention if you experience an allergic reaction such as difficulty breathing, closing of the throat, swelling of the lips, tongue or face.

STOP USING MINOXIDIL AND SEE YOUR DOCTOR IF YOU GET:

• Unwanted facial hair
• Chest pain
• Rapid heartbeat
• Faintness and/or dizziness
• Sudden, unexplained weight gain
• Swollen hands or feet
• Redness or irritation on treated areas of scalp

In order to proceed to the medical consultation, you must proceed to the next section and read the complete list of contraindications. Then you must verify that you do not have any of the contraindications and understand that any pregnant or potentially pregnant woman must not use Minoxidil.  Minoxidil is NEVER indicated for hair loss due to childbirth.  Under NO circumstance do we prescribe Minoxidil to any woman or child under the age of 18 .

**Medical Wellness Center is not affiliated or associated with Trinova Health pharmacy or any other pharmacy.  Trinova Health is a privately owned pharmacy and is completely independent of Medical Wellness Center.   Medical Wellness Center provides customized treatments based on over 20 years experience treating male pattern hair loss. We forward the compounded hair loss prescriptions to Trinova Health Compounding pharmacy because of the integrity and reliability of this United States based, privately owned, local pharmacy, and that this pharmacy only uses FDA approved ingredients.