What is the recommended treatment regimen for androgenetic alopecia using Minoxidil (minoxidil)?

Recommended Treatment Regimen for Androgenetic Alopecia Using Minoxidil

For androgenetic alopecia, topical minoxidil 5% solution should be applied twice daily (1 mL per application) directly to the scalp in the affected area for optimal results. 1

Application Protocol

Dosage and Frequency

• Apply 1 mL of 5% minoxidil solution twice daily (morning and night)
• Each bottle should last approximately one month when used as directed
• Nighttime application should occur 2-4 hours before bedtime to allow for complete drying 1

Application Technique

1. Part hair in the thinning/balding area
2. Use the dropper applicator to measure exactly 1 mL
3. Apply directly to the scalp (not the hair)
4. Spread the solution evenly across the affected area
5. Wash hands immediately after application 1

Expected Timeline for Results

• Initial results may be seen as early as 2 months with consistent twice-daily use
• Some patients may require at least 4 months before seeing noticeable improvement
• Temporary increased hair shedding may occur during the first 2 weeks of treatment (this is expected and indicates the treatment is working) 1
• Hair regrowth typically begins as soft, downy, colorless hairs before developing into normal hair 1

Important Considerations

Continuous Use Required

• Hair regrowth benefits will not last longer than 48 weeks in clinical trials 1
• If treatment is discontinued, newly regrown hair will be lost within 3-4 months 1

Compatibility with Hair Care Routines

• Use mild shampoo if washing scalp before application
• Hair styling products can be used, but apply minoxidil first and allow it to dry completely
• For hair coloring or perming:
  • Ensure all minoxidil is washed off before chemical treatments
  • Do not apply minoxidil on the same day as chemical treatments
  • Wait 24 hours after chemical treatments before resuming minoxidil 1

Efficacy Considerations

• Topical minoxidil 5% has been shown to be effective for androgenetic alopecia, with clinical cure rates of 52% in comparative studies 2
• Combination therapy with topical minoxidil 5% and topical finasteride 0.25% has demonstrated significantly higher efficacy than minoxidil monotherapy 3
• Recent research comparing oral minoxidil 5mg daily with topical minoxidil 5% twice daily found no significant superiority of oral over topical administration 4

Potential Side Effects

• Most common side effects are mild and include:
  • Scalp irritation
  • Unwanted facial hair growth (more common with oral formulations)
  • Temporary increased hair shedding initially 1

Contraindications

• Not for use by women (women should use 2% formulation)
• Not for use in individuals under 18 years old
• Not for use on red, inflamed, infected, irritated, or painful scalp
• Not for frontal baldness or receding hairline (only effective for vertex/crown balding) 1

Treatment Monitoring

• Assess response after 4 months of consistent use
• If no improvement is seen after 4 months, discontinue treatment 1
• Photographic documentation before and during treatment can help assess progress 5

Remember that minoxidil must be used continuously to maintain results, and stopping treatment will result in loss of newly regrown hair within 3-4 months.