How Long Can One Safely Take a Break from Minoxidil?

[TheLastHairbender]

Hmm, several interesting things going on there. My hair gets a grey tint to it after minoxidil dries sometimes, and I'm only 27, but I haven't had any fully gray hairs come in. I have heard of this kind of thing, but fortunately haven't had to look into it very much. I'm sure you can find information about minoxidil and gray hairs having been discussed on one forum or another. Hopefully you can find some MSM, it's not a very serious or dangerous product so it should be available over-the-counter in most locations, if it is available at all.

Good luck, stick to the regimen even though it seems like times are tough! Let us know when the minoxidil starts working again...remember that you're trying to shift a large number of follicles back into anagen phase, which can take some time; getting through the telogen phase can take months, and it seems like much of your hair is 'on the same schedule', so to speak. So the downside of having it all in full terminal hair form all at once is that you'll have brief periods where most of it goes back to the recessionary phase all at once. You just have to stick to the plan and get through it, and you'll see the anagen explosion once again. Best wishes for you!

 

[Stefan_88]

i actually asked it to my dermatologist. She said something interesting and gave me an example of Minoxidil shedding in the first 3 months and shedded hairs come back by 6th month and added that i should give 3 months too.

 

[TheLastHairbender]

Yeah, each hair follicle is on a natural cycle of a year or two of growth (anagen), then a couple months of rest (catagen & telogen). The start of each cycle is independently distributed among follicles so the overall appearance of the hair remains consistent, with about 80% of hairs in the anagen phase at any point in time for a normal adult. Many think that minoxidil causes a greater percentage of hairs to be in anagen at any one time, making the distribution of cycle stages more highly correlated across hair follicles, resulting in periods of high density during widespread anagen and low density during periods of widespread telogen, which we observe as good results for 6-12 months, shedding and patchiness for 2-3 months, then good results for another 6-12 months, etc. It's kinda like: rather than have 70% coverage all the time, minoxidil induces you to have 90% coverage for awhile, then only 50% coverage for awhile, akin to making your scalp like a manic-depressive. The relative changes in coverage and the length of the growth and recessive periods seems to vary from person to person - I find it beneficial on average for me personally.

Another factor that plays into this is physiological and mental stress, known to shift more hairs away from anagen and into the telogen phase, an effect opposite to what minoxidil endeavors to accomplish. So stick to the plan and try to take it easy!

 

[Stefan_88]

By the way, What do you think about anti-inflammatory drugs? Some italian doctors were prasing
Idrocortisone and saying its very useful for hairs and also works as anti-inflammatory.

Thanks again. i think that i have to wait for 3 months.

 

[TheLastHairbender]

Hey Stefan, it seems like an interesting topic lately. Sent you a PM because I'm really not an expert on those treatments yet.

 

[Stefan_88]

Thanks for the post. im reading it now. As far as i remember, Members on german forums uses topical PGD2 agents and say that they have good re-growth.

The article is really useful, considering im a bit weak on PGD2 subject. Really appreciated

 

[TheLastHairbender]

Yes, the comments I sent you were inspired by those discussions taking place on the German forums. It's an interesting subject, but too early to be actionable in an assuredly safe way, despite several reports that people have experienced hair regrowth using the cetirizine formulation. It looks encouraging for the future, but the current method of using tablets meant for oral administration, over 90% of which is other ingredients, as the base for a topical application is not known to be safe or effective over anything more than the immediate term. So my advice would be to stick with what we know works and what we know is safe for topical use, but it's interesting and encouraging to read nonetheless. Good luck!

 

[Stefan_88]

im with you on PGD2 subject. There is no need to try it. if more people tries it and get results, we can try after them. its very risky now.

 

[TheLastHairbender]

Well some methods are more sensible at present than others - bimatoprost, for example, seems very promising and has already passed FDA Phase I safety trials (http://clinicaltrials.gov/ct2/show/NCT01189279) and submit its Phase II results just last month (http://clinicaltrials.gov/ct2/show/NCT01325337), currently pending approval. (In fact the Phase I trials were conducted here on the very street I live on, at Celerion less than 2 miles away, using 28 volunteers from this neighborhood.)

My reference was specifically to the method of crushing up 50 zyrtec pills, dissolving them in 100ml ethanol and PG, and applying the concoction as a topical daily. Although the idea of cetirizine as a PGD2 inhibitor & PGE2 stimulator is promising, in my opinion that method of preparation is definitely not ready for prime time.

 

[Stefan_88]

Yet BİM is very expensive compared to Minoxidil though its said that its the stronger growth stimulant than Minoxidil.

 

[TheLastHairbender]

Yeah and cost may not come down anytime soon pending approval as a pharmaceutical for treating androgenic alopecia. Although the original patent expired last month (#6403649), Allergan holds extension patents for use as a topical formulation for eyelash hypotrichosis that don't expire until 2022 (#7388029) and 2024 (#7351404), and further extensions may be granted for specific use in AA. So unless you prefer mixing your own topicals with a powder clandestinely sourced from a lab willing to overlook US patent laws, the high, on-patent price of bimatoprost may persist for quite a while. To me, it's still a welcome scenario, though. I would prefer a market to purchase effective topicals even at a high price, as compared to having no market or a market not regulated for consumer safety.

Hope things are going well with your minoxidil usage Stefan!

 

[Stefan_88]

BİM would be handy for temples. it would be less expensive just for the use on temples.

Regarding my regimen, still no visible improvement yet. it has been almost 2 months after shedding period ends.

 

[Stefan_88]

Update

My hairs looks a little better compared to hairs after the shedding period. My hairs were horrible and thin 2 months ago. Now some parts of my hairs looks still thin yet some parts looks thicker and thickening up.

Last week i went to see my dermatologist, i asked her if my shedding hairs enters telogen phase, she said to me that ''they enter anagen phase and it takes 3 months to make them visible on your scalp''

just 2 months passed after my shedding period ends. i reckon that i need to give 1-1.5 months to see some results.

Btw, im shedding 5-6 hairs or sometimes more during Minoxidil application. All of them are 1 cm or less length hairs, (while my hairs are now 2 cm) i need to massage Minoxidil to every point of needed area,maybe im a bit harsh on massage, otherwise, some parts doesnt get Minoxiidl enough. While, i dont think massage is not a problem, sometimes, i massage less and gently, but i still see some kind of hairs. This is why im thinking that that hairs are falling out, because they are less thicker and fuller than other hairs.

 

[TheLastHairbender]

Yeah I notice this type of thing too - it's not always full-size old-looking hairs shedding off, sometimes it seems like fresh hairs shed off as well, like ones that are slightly more developed than tiny vellus hairs, but not nearly of terminal size yet. As far as I can tell it doesn't seem to be related to any aggressive handling of the scalp and hair, they just seem to shed out onto my laptop just like any others. Unfortunately I don't know enough about the tendency of individual follicles to shed their hairs; it's possible that there is some idiosyncrasy involved - that it's not just several-year-old catagenized hairs that would be expected to be shed, maybe that's only 80% of a normal adult's regular shed and the other 20% are early anagen and terminal hairs with some defect at the shaft or something. Without better knowledge of the determinants of hair shedding at the follicular level we can only speculate, and to my understanding medical science cannot provide such precise insight into the process at the present time. For example - we know that people shed more hairs during periods of high physiological stress, conjectured to be due to an increase in circulating cortisol which induces telogen effluvium and the shedding of hairs. But why are only some hairs shed and not all hairs uniformly? Perhaps the shed hairs are only those beyond some threshold in age, maturity, androgenization, blood delivery, etc. The point is that while we do know the proclivity of the scalp as-a-whole to shed hair under varying sets of circumstances, we don't yet have a good model of any individual follicle's tendency to shed its hair, beyond the knowledge that the likelihood is increasing with time and maturity. The observation that some hairs are naturally shed earlier and at lesser stages of maturity than others is evidence that our understanding of this topic remains incomplete. Until researchers are able to model individual follicles' shedding patterns histologically I think we're constrained to interpreting the nature of shed hairs as the outcome of a probabilistic process and thus resist the urge to attribute significance to the existence of some heterogeneity among those that fall out. As long as the departed are predominantly terminal hairs, I don't think some early anagen hairs in the mix can be taken as evidence of anything in particular.

It is puzzling though, seeing what appears to be freshly grown hairs dropping out already. I've noticed this as well over time and wondered if it was indicative of anything. I'm still curious, when looking at several of the shed hairs on my desk, why some are thin little wisps - so blonde and thin they're almost transparent - while others are stout, stiff and a deep, dark brown color, even when both come from a shaking out of the same part of the top of my scalp. Are they falling out at different stages of the life cycle? Does minoxidil or finasteride only work on some, but not all, follicles? I would really like to know. If you peruse the research papers on hair growth cycles, you'll find that none of them go so far as to describe the shedding of hairs according to any particular characteristics, whether prematurely or otherwise.

Glad to hear things are already looking a little better for you. Because it's so soon I'm sure there's more improvement yet to come.

 

[Dr Tom]

Very interesting thread.

I have a lot of experience with bimatoprost - I started a company using it for eyelash treatment in 2007. Naturally this has led plenty of people to me for its use with hair loss.

It is expensive due to the patent.

If you are using it on a particular area, mix it with minoxidil. Put enough minoxidil on the palm of your hand to cover the area you want to target. If it is a large area, split it into sections about no larger than the size of your palm. Add 1 drop of bimatoprost to the minoxidil and quickly mix it through the minoxidil, then apply it over the area.

Do this daily for 6 months, then drop down to either every second day or three times a week.

As I said, that is from my experience and is not from independent clinical trials. It isnt a wonder treatment but I think it is a worthwhile addition to minoxidil and ketoconazole (+ finasteride for men).

 

[Bowser]

great to have your input Dr Tom!

 

[Stefan_88]

Firstly, Unfortunately, BİM is not a option for me because of customs. if im able to buy it in the future, i'll try it out.

Secondly, Regarding shedding periods, its really very hard to accept. i had the same kind of shedding during my shedding period. i was seeing many hairs on my pillow, on my laptop, in the shower, almost everywhere. i hope it stops and never happens again. i feel disapointed during shedding periods.



@TheLastHairbender Hows your regimen going lately? i agree with every point you said about that kind of hairs. i have same kind of hairs, yellow and thin. They never shed and stay same though many months passed. How could it be possible?

 

[TheLastHairbender]

Hey Dr. Tom, thanks for the input. Your reference to "1 drop of bimatoprost"...do you mean one drop of a .03% bimatoprost solution? Were you making your own or using the .03% solution for ophthalmic application off-label? It seems to me that if you're already using a liquid minoxidil it would be more efficient to simply add bimatoprost to the liquid, at a rate of .3-1mg per mL to yield a .03 - .1% solution, with less possibly wasted on the hands or worse yet, getting into the eyes. What do you think?

Stefan - where are you located? I'm sure bimatoprost can make it anywhere with the right attitude. The ~$1000 per gram cost is a more understandable deterrent, but using only about 1mg/day, the cost really isn't bad either - 1g would last year nearly 3 years. I just don't like the supply inconsistency, having to jump through so many hoops to attain a product of questionable quality and without guaranteed repeatability. So for those reasons I understand the hesitation.

Regimen is going well though - finasteride and minoxidil seems to be all I need.

Not bad coming from this:

 

[Stefan_88]

First off, i have to say that WOW, great improvement. i assume that you'll thickening up the frontal area more in the coming months. i talked with my dermatologist yesterday and talked about sheddings. She said that shedding baby hairs is great for treatment, that hairs will return stronger and fuller in 3 months, that can be repeated depents on minuturation of that hairs.

Anagen-Catagen-Telogen-Shedding- Anagen

However some members of Hair loss forums claims, Anagen-catagen-telogen-shedding-telogen-anagen period which is wrong. i'd like to know Dr.Tom's opinion about this. i'd be pleased if he mentions his opinions about it.

Second off, i live in Ankara, Turkey now. However my girlfriend is half italian and goes to italia every summer. i asked her to buy BİM for me from pharmacies in italia, yet she told me that she couldnt find it.

 

[TheLastHairbender]

Thanks for the kind words. I'd actually like to thicken up the treatment-resistant hair on the vertex if possible but other than that it's really just about maintenance over the long-term now. For the purpose of thickening the vertex I'm thinking about trying a course of 4% miconazole nitrate first due to easier availability but retain the option for bimatoprost if the miconazole doesn't pan out. It seems like both are ideal treatments for targeting a small, specific region as I'm trying to do.

Bimatoprost can be obtained as part of the many group buys organized on this site and others, although you'd be dealing with the problem of costly quality testing or relying on the good intentions of others. Purchasing the commercially available Latisse or Lumigan products would be a terribly expensive proposition for hair loss though - in the US, 5mL of Latisse is roughly $150, and by prescription only. I don't know what would be more difficult: paying $450 per week for the treatment or convincing my doctor that I really need to have longer eyelashes. Fortunately I think cost is decreasing and availability is increasing with respect to time.