MINOXIDIL

Minoxidil for hair is available as a 5% topical solution. It is a clear, colourless or slightly yellowish solution with a characteristic alcohol odour, packaged in 60 ml bottles fitted with two types of applicators: a standard spray and a spray with an applicator for small areas.

Topical minoxidil is indicated for:

• Androgenetic alopecia in men, which manifests as progressive thinning of the hair at the crown.
• Diffuse reduction in hair density in women, typically manifesting as generalised thinning of the hair.
• Slowing the progression of hair loss and stimulating hair growth, as this is a maintenance treatment, not a curative one.

It is important to know how to apply Minoxidil. The standard dosage regimen for Minoxidil Minorga 50 mg/ml is 1 ml of topical solution twice daily, in the morning and in the evening.

The solution should be applied directly to the affected area and then massaged in gently. The hair must be dry at the time of application. Wash your hands immediately after application. The hair may be combed or styling products used only after the solution has dried completely. 

Minoxidil is contraindicated in the following situations:

• Hypersensitivity to minoxidil or the excipients (propylene glycol, ethanol).
• Acute dermatological conditions of the scalp: dermatitis, sunburn, severe inflammation.
• Pregnancy and breastfeeding, unless specifically recommended by a doctor.
• Age under 18 years.
• Alopecia areata, scarring alopecia or patchy hair loss.
• Hair loss due to serious endocrine causes (e.g. hyperprolactinaemia, Cushing’s syndrome), without prior medical assessment.

The use of minoxidil requires a number of precautions:

• Patients with cardiovascular diseases (arrhythmias, heart failure, hypertension) must undergo a medical assessment before starting treatment.
• Minoxidil may cause a temporary increase in hair loss during the first 2–6 weeks, a phenomenon considered normal.
• Avoid applying to broken or irritated skin.
• The solution contains alcohol, which may cause eye irritation; in the event of accidental contact, rinse the area immediately with cold water.
• The product is flammable and must be kept away from sources of heat.
• Do not inhale and do not apply to other parts of the body.

The use of minoxidil may cause headaches, which is the most commonly reported side effect. Some patients may experience itching, redness, rashes, dermatitis, dryness or flaking of the scalp, as well as changes in hair texture or colour. 

In a smaller number of users, symptoms such as breathing difficulties, muscle pain, peripheral oedema or local discomfort may occur. Palpitations, a rapid heartbeat or chest pain may rarely occur and, in very rare cases, arterial hypotension may occur.

Although clinical data are limited, it is believed that topical minoxidil may exacerbate orthostatic hypotension when used concomitantly with systemic vasodilators.

Concomitant use with other irritating topical treatments applied to the scalp is not recommended.

Excessive application does not improve efficacy and may increase the risk of adverse reactions.
In the event of accidental ingestion, systemic effects may occur: tachycardia, fluid retention, hypotension. Treatment consists of: diuretics, beta-blockers or intravenous saline solution, as medically advised. Sympathomimetics are contraindicated.

The medicine must be kept out of the reach of children to prevent accidental use. It must be stored at room temperature, away from sources of heat or open flames, as it is a flammable product. The bottle must be kept tightly closed to prevent evaporation and deterioration of the solution. 

• PubMed, Minoxidil and its use in the treatment of hair disorders: an analysis
• Wiley Online Library, Applications and efficacy of minoxidil in dermatology
• NIH, Minoxidil
• Oxford Academic, Could oral minoxidil be a game-changer for androgenetic alopecia? A comprehensive review and meta-analysis comparing topical and oral minoxidil for the treatment of androgenetic alopecia