The best thing about a visit to the salon is that you’re not only leaving with a fresh, new ‘do. If you’re lucky you’ll also leave with some expert hair tips. At my last visit with celebrity hairstylist Paul Labrecque at his Palm Beach salon he told me about minoxidil pills and how they’re helping hair-loss sufferers from losing even more. “What they’ve found is you get more effective results with a low dose of the drug taken internally,” Labrecque told me. “Before, you could only use it topically, but now they say when you take it orally it you get much faster results.” This was news to me but not new information as the drug has become increasingly popular for off-label use in treating hair loss.
According to recent findings published in the Journal of the American Academy of Dermatology, studies in which patients received Low Dose Oral Minoxidil (LDOM) as their primary therapy, reported increased hair growth and decreased shedding. Minoxidil has been around for decades and oral minoxidil was originally used to treat hypertension. The topical formulation was approved by the Food and Drug Administration for the treatment of male androgenetic alopecia and female pattern hair loss in the late 80s and early 90s, however patient compliance has been an issue as many users find it difficult to maintain the routine over time or cite cost as a major obstacle.
New York dermatologist Julie Russak, MD says she prescribes LDOM off label to her patients, but before starting any hair-loss treatment a careful evaluation must be done to determine the cause. “Hair loss, hair thinning and hair aging is a very multifactorial process and unfortunately there is no magic pill that can solve all the problems,” she says. “LDOM is an additional tool in our armamentarium that we can offer our patients now to help to combat hair loss when appropriate.”
Wayne, NJ facial plastic surgeon and hair restoration specialist Jeffrey B. Wise, MD says he’s not at all surprised by the findings as he has also had success prescribing the drug to good candidates. “We commonly prescribe low dose oral minoxidil in conjunction with oral finasteride or dutasteride, Platelet-Rich Plasma therapy, low-level light therapy and supplements such as Nutrafol,” he explains. “We have found that patient compliance to topical minoxidil is extremely poor and only a handful of patients actually stick with it. With comparable efficacy, patients can usually adhere to taking a pill once a day.”
The studies reviewed in the JAAD found the drug to be safe and well-tolerated when taken at very low doses (starting doses are 0.5 mg/day for women and 1.25 mg/day for men), but it does have potential side effects like low blood pressure, heart palpitations and headaches. “Patients must be counseled about rare side effects of oral minoxidil,” adds Dr. Wise. “But this therapy is widely employed by doctors and is quite safe.”