|
How
can minoxidil be used to treat baldness
Minoxidil is the generic name for products originally developed
by UpJohn and called Rogaine in the USA or Regaine in Europe and
elsewhere. Rogaine and Regaine are the trade marks of UpJohn Inc.,
USA. Rogaine and Regaine are exactly the same but simply packaged
in differently. The FDA would not allow UpJohn to call their product
Regaine in the USA as it implies hair regrowth (Re-Gain) whereas
the FDA regards Minoxidil as a hair loss prevention drug. UpJohn
had to change the name to Rogaine before receiving the FDAs approval
to sell the product in the USA.
First introduced in 1988, Rogaine was originally only available
on prescription and used under the supervision of a doctor. However,
extensive trials by UpJohn convinced the FDA to pass Minoxidil as
acceptable to sell over the counter direct to the public. Rogaine
or Regaine 2% concentration is widely available throughout the USA
and Europe and it is the only proven hair loss treatment available
without prescription.
For many years Minoxidil was only available as a 2% concentration
and exclusively from UpJohn as they held the patent rights. The
patent ended in 1996 and since then several other drug companies
have started to produce and sell Minoxidil 2% under many different
brand names at a lower price than UpJohn. As of 3 July 1998, the
distributors of 2% Minoxidil registered with the Federal Drug Administration
are; Alpharma, Bausch and Lomb, Copley Pharm, Hi Tech Pharma, Morton
Grove, Sight Pharms, Teva, and of course Pharmacia and Upjohn. These
manufacturers/distributors supply pharmacies and supermarkets with
Minoxidil in a wide variety of packaging as retailers require.
In response to losing the patent on Minoxidil 2% UpJohn embarked
on clinical trials of a 5% concentration solution. This is now available
over the counter in the USA as Rogaine extra strength. UpJohn retains
a new patent on this 5% concentration. However, it is possible to
buy 5% Minoxidil solutions from other manufacturers. The solution
usually has extra ingredients to distinguish it from UpJohn's product
and circumnavigate any patent lawsuit brought by UpJohn.
Minoxidil for hair loss is used as a topical application. The drug
is dissolved in a mixture of water, alcohol and glycol which is
applied to bald regions of the scalp as directed by the manufacturers.
For men it is believed most effective for hair regrowth on the vertex
rather than for treating hair loss at the temples.
Minoxidil is a stable and inactive drug. When it is applied to
the scalp and penetrates into the skin it must be converted to an
active, but unstable, product called Minoxidil sulphite. Our body
produces a catalyst called sulfonyl transferase that converts the
stable inactive Minoxidil into the unstable active Minoxidil sulfite.
Minoxidil sulfite activates potassium channels in cells and this
leads to hair growth.
The exact molecular mechanism operating in the cells that results
in hair growth is not known. Some have suggested that minoxidil,
as a known vasodilator, dlilates the blood vessles around hair follicles
and the increased nutrient supply permits increased hair growth.
However, this is an unlikely explanation as other vasodilator drugs
do not promote hair growth and studies have shown no significant
changes in scalp blood supply when using minoxidil.
Topical minoxidil apparently induces an increased rate of DNA synthesis
in follicular cells in early anagen, but not in nonfollicular cells
such as fibroblasts or epidermal keratinocytes. Minoxidil induces
a significant increase in DNA synthesis in all hair follicle cells
in a dose-specific manner. Recently, researchers at L'Oreal suggested
that minoxidil works by activating PGHS 1 (prostaglandin endoperoxide
synthase-1) which may help promote hair growth.
How
can minoxidil be used to treat baldness references
- Uno
H, Cappas A, Brigham P. Action of topical minoxidil in the bald
stump-tailed macaque. J Am Acad Dermatol. 1987 Mar;16(3 Pt 2):657-68.
- Mori
O, Uno H. The effect of topical minoxidil on hair follicular cycles
of rats. J Dermatol. 1990 May;17(5):276-81.
- Baker
CA, Uno H, Johnson GA. Minoxidil sulfation in the hair follicle.
Skin Pharmacol. 1994;7(6):335-9.
- Kurata
S, Uno H, Allen-Hoffmann BL. Effects of hypertrichotic agents
on follicular and nonfollicular cells in vitro. Skin Pharmacol.
1996;9(1):3-8.
- Buhl
AE, Waldon DJ, Baker CA, Johnson GA. Minoxidil sulfate is the
active metabolite that stimulates hair follicles. J Invest Dermatol.
1990 Nov;95(5):553-7.
- Kurata
S, Uno H, Allen-Hoffmann BL. Effects of hypertrichotic agents
on follicular and nonfollicular cells in vitro. Skin Pharmacol.
1996;9(1):3-8.
- de
Boer EM, Bezemer PD, Bruynzeel DP, Nieboer C. Does topical minoxidil
increase skin blood flow? A laser Doppler flowmetry study. Acta
Derm Venereol. 1988;68(3):271-4.
- Uno H, Cappas A,
Schlagel C. Cyclic dynamics of hair follicles and the effect
of minoxidil on the bald scalps of stumptailed macaques. Am
J Dermatopathol. 1985 Jun;7(3):283-97.
- Bunker CB, Dowd PM. Alterations in scalp
blood flow after the epicutaneous application of 3% minoxidil
and 0.1% hexyl nicotinate in alopecia. Br J Dermatol. 1987 Nov;117(5):668-9.
|