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can this be why some of us do not respond well to minoxidil? Excuse me if it is not the right session to publish this. I have translated it into English and there may be errors. I pass the link in English.
https://www.karger.com/Article/Pdf/488011
Minoxidil was introduced on the market in the 1980s, originally as an anti-hypertensive drug whose effect was due to the opening of potassium channels in the cell membrane of vascular smooth muscle cells and subsequent vasodilation. The side effect of hypertrichosis and improvement of baldness in men led to further investigation of its topical use for the treatment of male and female pattern baldness.
Minoxidil stops hair loss and induces the regeneration of mild to moderate hair in patients suffering from common baldness. To achieve this, minoxidil must be converted into its active metabolite minoxidil sulfate by the enzyme sulfotransferase, present in the liver and in the outer sheath of the hair follicle bulbs.
Some in vitro studies with minoxidil sulfate have shown that its effectiveness is 14 times greater than that of the minoxidil base; however, minoxidil sulfate has a molecular weight of 289.3 g / mol, while the minoxidil base weighs 209.3 g / mol, a difference of almost 40%. Since molecular weight is a determining factor for the degree of transcutaneous penetration, this may present a problem of absorption of minoxidil sulfate compared to the topical minoxidil base.
All clinical studies evaluating the efficacy of minoxidil for the treatment of male and female pattern baldness were performed with minoxidil base, not with minoxidil sulfate.
The minoxidil sulfate, in addition to the problem of its high molecular weight is usually unstable in aqueous solution, which decreases its bioavailability in the hair follicle and increases the problem of irritation to the scalp. Therefore, the efficacy of minoxidil sulfate compared to minoxidil base for the treatment of common baldness may be compromised and may not be the same as the efficacy found in the clinical trials performed with the minoxidil base.
The activity of sulfotransferase is not the same in all individuals. Minoxidyl sulfate represents an advantageous alternative compared to minoxidil base for individuals with low sulfotransferase activity, as demonstrated by the association between the response to minoxidil base and the degree of sulfation of minoxidil.
However, to compensate for the lower response, minoxidil sulfate should be used in higher concentrations (10-15%) due to its reduced transcutaneous absorption capacity and packaging in small volumes, due to its high degree of degradation.
In fact, a Swiss retrospective study in 44 patients with common baldness (13 men with common baldness class III and higher according to the Hamilton-Norwood scale and 31 women with common baldness class I-III according to the Ludwig scale) who did not responded to the cure with 5% minoxidil base twice a day initiated for a minimum of 6 months, reported an increase in hair growth of 97.7% with a 10% minoxidilsulfate solution used once a day for a period of average treatment of 4.09 months.
The treatment was well tolerated by the patients, but 6.8% suffered irritation, erythema and folliculitis of the scalp. No significant adverse effects have been reported.
Without prejudice to the use of the minoxidil base as the first option for the treatment of common baldness, the highest formulation of minoxidil sulfate could be used in patients who do not respond to the minoxidil base. For this purpose, there is a new enzymatic assay that can predict the response to minoxidil.
https://www.karger.com/Article/Pdf/488011
Minoxidil was introduced on the market in the 1980s, originally as an anti-hypertensive drug whose effect was due to the opening of potassium channels in the cell membrane of vascular smooth muscle cells and subsequent vasodilation. The side effect of hypertrichosis and improvement of baldness in men led to further investigation of its topical use for the treatment of male and female pattern baldness.
Minoxidil stops hair loss and induces the regeneration of mild to moderate hair in patients suffering from common baldness. To achieve this, minoxidil must be converted into its active metabolite minoxidil sulfate by the enzyme sulfotransferase, present in the liver and in the outer sheath of the hair follicle bulbs.
Some in vitro studies with minoxidil sulfate have shown that its effectiveness is 14 times greater than that of the minoxidil base; however, minoxidil sulfate has a molecular weight of 289.3 g / mol, while the minoxidil base weighs 209.3 g / mol, a difference of almost 40%. Since molecular weight is a determining factor for the degree of transcutaneous penetration, this may present a problem of absorption of minoxidil sulfate compared to the topical minoxidil base.
All clinical studies evaluating the efficacy of minoxidil for the treatment of male and female pattern baldness were performed with minoxidil base, not with minoxidil sulfate.
The minoxidil sulfate, in addition to the problem of its high molecular weight is usually unstable in aqueous solution, which decreases its bioavailability in the hair follicle and increases the problem of irritation to the scalp. Therefore, the efficacy of minoxidil sulfate compared to minoxidil base for the treatment of common baldness may be compromised and may not be the same as the efficacy found in the clinical trials performed with the minoxidil base.
The activity of sulfotransferase is not the same in all individuals. Minoxidyl sulfate represents an advantageous alternative compared to minoxidil base for individuals with low sulfotransferase activity, as demonstrated by the association between the response to minoxidil base and the degree of sulfation of minoxidil.
However, to compensate for the lower response, minoxidil sulfate should be used in higher concentrations (10-15%) due to its reduced transcutaneous absorption capacity and packaging in small volumes, due to its high degree of degradation.
In fact, a Swiss retrospective study in 44 patients with common baldness (13 men with common baldness class III and higher according to the Hamilton-Norwood scale and 31 women with common baldness class I-III according to the Ludwig scale) who did not responded to the cure with 5% minoxidil base twice a day initiated for a minimum of 6 months, reported an increase in hair growth of 97.7% with a 10% minoxidilsulfate solution used once a day for a period of average treatment of 4.09 months.
The treatment was well tolerated by the patients, but 6.8% suffered irritation, erythema and folliculitis of the scalp. No significant adverse effects have been reported.
Without prejudice to the use of the minoxidil base as the first option for the treatment of common baldness, the highest formulation of minoxidil sulfate could be used in patients who do not respond to the minoxidil base. For this purpose, there is a new enzymatic assay that can predict the response to minoxidil.