Here is an interesting article on the effects of minoxidil on the hairline!



By: PATRICIA REIMAN
Dermatology Times

Durham, N.C. -- Objective evidence now shows that topical minoxidil (Rogaine) is effective in frontal areas of the scalp, and not just in the vertex area in male-pattern hair loss (MPHL).

"This drug works in all areas of the balding scalp," said Elise Olsen, M.D., professor of medicine, division of dermatology, Duke University Medical Center, Durham, N.C.

Dr. Olsen and colleagues have gathered data from a review of global photographs of men with MPHL treated with two different concentrations of topical minoxidil.

Dr. Olsen explained that previous research using target area hair counts had shown minoxidil to be effective in the vertex area of the scalp. Now the use of global photographs shows minoxidil's effectiveness in treating frontal-area hair loss as well.

"Using global photographs to look at the frontal area treated with minoxidil had not been done previously," she said.

The researchers set out to document hair growth with minoxidil applied in the frontal region of the scalp -- the area where men are keenly aware of their hair loss every time they look in the mirror.

Of note are the visible improvements seen in the frontal areas after just 16 weeks of treatment.

"As early as 16 weeks, you could separate out each of the treatment groups [from placebo]. Most hair growth promoters don't work that quickly to see a response so early on," she said.

The multicenter, double-blind, placebo-controlled study evaluated a total of 252 balding men. All had Hamilton-Norwood patterns III-V hair loss. Each man's hair loss was documented and classified at baseline by global photographs of the frontal and vertex scalp areas.

The three treatment arms of the study consisted of 139 men using a 5 percent topical minoxidil solution, 142 using a 2 percent topical minoxidil solution, and 71 on vehicle alone (placebo). The men applied 1 mL of solution twice daily to the entire top of the scalp, including the vertex and frontal areas.

Polaroid photographs were taken at baseline and again at weeks 16, 32, and 48. Electronic images of the photographs were evaluated by an independent panel of three blinded, board-certified dermatologists experienced in doing photographic reviews.

The panel members compared each man's photos from weeks 16, 32, and 48 to his baseline photo. They then independently classified the hair growth as "no change," "slight increase," "moderate increase," "great increase," or "slight decrease," "moderate decrease," or "great decrease." At the study's end, the three judges' scores were combined into a final classification for each patient.

Results at 48 weeks (study conclusion) show that visible, photographically evident improvements were seen in the frontal scalp regions of 51 percent of men using 5 percent minoxidil, 42 percent using 2 percent minoxidil, and 13 percent of placebo users. Among these men, moderate to great increases in hair growth were seen in the frontal scalp regions of 19 percent of men using 5 percent minoxidil, 10 percent using 2 percent minoxidil, and 3 percent of placebo users.

"Most patients might think topical minoxidil only works in one part of the scalp," Dr. Olsen said, adding that the current package insert states minoxidil's effectiveness in the vertex region but does not address the frontal region.

"Limitations in terms of claims of efficacy are related to the research methods used." She said patients must understand that the FDA will not allow package-insert claims of hair growth in scalp areas not specifically targeted from the outset of the study. So it may help to explain to men that although minoxidil's efficacy in MPHL was previously shown by hair counts done only in the vertex region, global photographic evidence now proves minoxidil's effectiveness in the frontal region as well.

"Now we have objective evidence that shows minoxidil indeed works in other parts of the scalp, including the frontal area, as shown on global photographs," Dr. Olsen said.

Dr. Olsen has no financial interest in minoxidil, but has been a principal investigator on topical minoxidil-related MPHL trials in the past and is a consultant for Pharmacia.
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The way rogain works, it makes sense that it would work on the hairline-- maybe not as much as the crown, but it should work. As far as tranplanted hair, it is good to use rogain on the hairline once a day, I've done this and not only does it help "jump start" the growth, but also after the new FU are growing it seems to allow an additional benefit for the orginal hairs.

I used Minoxidil post-op on my recipient area (hairline and forelock) and I do think it helped.

I still utilize Minoxidil at the front of the scalp (if it ain't broke, don't fix it, right?) and I have no plans on stopping.

I use the recommended 1mL on the crown and top of the head and another 1mL at the hairline and forelock. Sure, this doubles my Minoxidil consumption but since I use the 5% Wal-mart brand it isn't very expensive anyway.

Anyway, I figured I'd share my success with this regimen with anyone else curious.

-Robert

I had to stop using the 5% daily. After about a week it gave me terrible headaches and really irritated my scalp. I may try again with the 2% solution.

Dandare,
I also had a problem with 5% Minox irrating my scalp, and brother did it ever itch! Dr Feller suggested using Minox for the recipient area for faster growth, so I use 2%. Even Dr Shapiro now recommends using it for a few months for faster growth.

MDM,
I was using it post-op as per Dr. Shapiro's instructions, but I would wake up in the early morning hrs with my head pounding, massive shedding of my hair and irritation of the scalp. I just hated the 5% solution.

ROgaine seems to have a lot better results on the hairline than the crown for those of us who have used it there. It does great for the temple area that is prone to receeding. I use it 2x a day on the crown and 1x a day on the hairline/temple-- 5% . If you can only tolerate 2%, then still use that as it also has benifits.

That is unfortunate that the 5% is intolerable to you guys. Like Smoothy said, try the 2%. It still yields benefit.

I only get one small reaction from my minoxidil application. A slight "numb" feeling in the scalp right after application. I don't know if its from the minoxidil itself or from the massage of the applicator that I use but it's not unpleasant.

Anyone else get this?

-Robert

quote:

Results at 48 weeks (study conclusion) show that visible, photographically evident improvements were seen in the frontal scalp regions of 51 percent of men using 5 percent minoxidil, 42 percent using 2 percent minoxidil, and 13 percent of placebo users. Among these men, moderate to great increases in hair growth were seen in the frontal scalp regions of 19 percent of men using 5 percent minoxidil, 10 percent using 2 percent minoxidil, and 3 percent of placebo users.

How can members of the placebo group show an increase in hair? I'm sure there are lots of explanations involving perception of growth or various shedding or resting phases. But it begs the bigger question of how accurate are the results of the other test groups?

I don't doubt that minoxodil works. My point is that test results can be interpreted in many different ways.

Also, what are global photographs?

BobC,
I'm no medical researcher, but I think what you are referring to is called a "placebo effect". Look on the info packet contained with most prescription drugs and you'll probably see the results of the tests on the drugs. I think they will list side effects associated with the drug and patients not taking the drug, but a placebo, will state they have side effects. Anyone more knowledgeable (and can spell better) please chime in.

dandare,

I think you're right. But to me, a placebo effect means that you feel better (not sick any longer), even though you've only taken a "sugar pill". I don't see how a placebo can actually grow hair. If it were simply mind over matter, we'd all be trying to think ourselves out of baldness.

Bob C,

I can see your confusion, but due to the fact that hair grows in cycles and different hairs all grow on their own cycles, the hair count of an individual can change, literally, from week to week as hair fall out and grow in. Quite basically, it is for that reason (and, of course other outside factors) that the placebo is used to maintain a baseline reading.

-Robert

how come it took them this long to figure that rogaine works on the frontal scalp?

if they were doing tests on the crown with rogaine to finally say that rogaine works on the crown years ago, why didnt they test the front hairline at the sametime?

Sometimes i hear people say that they took propecia or utilised rogaine etc, just after having a HT and then they stopped taking it?

Is there some benefit post transplant in using those meds for the short term? such as limiting shock loss?



One thing that scares me, is that propecia causes shedding, and then after a while the hair will grow back. What happens if you only take it long enuff for the hair to shed and then stop taking it, will it leave you bald?