A Traditional Drug is Being Used by Doctors to Promote Hair Regrowth

A growing number of physicians specializing in treating hair loss have been prescribing low-dose medications to their patients who suffer from male and female pattern hair loss, a natural process that occurs with age.

Dermatologist Dr. Brett King from Yale said there is "an endless selection of inadequate hair growth procedures," often available for "substantial expenditure." And yet, "people are desperate," he continued, "which is why such hair growth remedies continue to develop."

The advertising and their inflated promises are everywhere: Specialized shampoos and treatments can stimulate hair growth, but they can set you back hundreds or even thousands of dollars. Numerous dermatologists who focus on hair loss say that the vast majority of these products are ineffective.

However, according to him and other physicians, there is a procedure that can restore hair in many patients while only costing a few pennies per day. Minoxidil is a well-known and time-tested medication for hair loss that is currently being administered differently. It is currently being administered in the form of very low-dose capsules, as opposed to being applied directly to the scalp.

Although an increasing number of dermatologists are making low-dose minoxidil pills available to their patients, the majority of patients and many medical professionals are still unfamiliar with this medication. Because the Food and Drug Administration has not granted approval for it to be used in this manner, it must be administered off-label, which is a regular procedure in the field of dermatology.

Dr. Adam Friedman, a professor at George Washington University and the chair of the department of dermatology there, is quoted as saying, "I call ourselves the off-label bandits; it's a term I'm pleased to embrace." He stated that dermatologists had been trained to understand how medicines function, allowing them to experiment with medications that were not on the label. In dermatology, it is frequently easy to tell if a treatment is working or not. Does a rash go away on its own or not?

Dr. Robert Swerlick, who is both a professor and the chair of the department of dermatology at Emory University School of Medicine, agrees.

He explained it this way: "I tell people that the majority of the things we do are off-label because there is nothing on-label." He offered a comprehensive list of illnesses, such as skin pigment disorders, inflammatory skin disorders, and unrelenting itching, for which the FDA does not approve conventional treatments.

Rogaine is a lotion or foam that is applied to the scalp. The active ingredient in Rogaine is minoxidil, which was first licensed for men in 1988 and later for women in 1992. Several decades ago, the medication unintentionally discovered the treatment for increased hair growth with the medication. Patients who took high-dose minoxidil pills to treat high blood pressure frequently observed that the medicines caused the hair to sprout all over their body. This led to the discontinuation of this treatment. Therefore, the company that made it formulated a minoxidil lotion, which they finally christened Rogaine, and got it approved to regrow hair on balding heads. Minoxidil is currently available in generic form.

However, dermatologists report that the lotion or foam does not seem to be very beneficial for some patients. This may be due to the fact that the patients cease using the medication. Many people, particularly women, find that they cannot stand how the sticky stuff feels when it is left in their hair, therefore, they give up using it. Because it needs to be applied directly to the scalp, the hair gets in the way.

The company that currently owns Rogaine, Johnson and Johnson did not reply to requests for comment on the matter.

Some people discover that it does not work for them at all. It is necessary for sulfotransferase enzymes, which may or may not be present in sufficient amounts in hair roots, to convert minoxidil to an active form before it can be used. When the substance is ingested, its inactive state is immediately transformed into its active form.

However, this is not the reason why the low-dose pills were found in the first place. Instead, the discovery was made by chance around a decade and a half ago.

A professor of dermatology at the University of Melbourne in Australia named Dr. Rodney Sinclair had a patient who suffered from female pattern baldness. Rogaine was effective for her, which was not the case with the majority of his patients; nevertheless, she did experience an allergic reaction on her scalp as a result of taking the medication. She detested the fact that it appeared like the hair on the crown of her head had become sparser. If she stopped taking it, her hair would return to its previous state.

"So it seemed like I was in a bind," Dr. Sinclair stated. "The patient was highly determined, and the one thing we knew was that if a patient has an allergy to a treatment that is topically given, one approach to desensitize is to give very modest dosages orally," the doctor said. "The patient was really motivated."

Dr. Sinclair attempted to accomplish this by chopping the minoxidil pills into quarters. It was a surprise to him that the low amount caused her hair to grow, but it did not affect her blood pressure, which was the primary goal of the greater dose of the drug.

He gradually decreased the dose until he reached effective doses that were equal to one-fortieth of a tablet, at which point he started prescribing the medication on a regular basis. The medication is still administered to the initial patient.

Dr. Sinclair presented his findings at a conference held in Miami in 2015 and stated that low doses of minoxidil induced hair growth in one hundred different ladies.

He reported the findings in 2017 and mentioned that further research was required, including studies in which some patients would be randomly allocated to take minoxidil and others would be given a sugar pill. However, that has not taken place. He claims to have cared for more than 10,000 people at this point.

Recently, a growing number of physicians specializing in treating hair loss have been prescribing low-dose medications to their patients who suffer from male and female pattern hair loss, a natural process that occurs with age.

A dermatologist at the Johns Hopkins School of Medicine named Dr. Crystal Aguh commented that the practice is "just starting to see a boom in popularity." "At conferences, we are increasingly sharing our success stories with one another."

She went on to say that medical professionals who do not specialize in the treatment of hair loss "would not be familiar with oral minoxidil," with the exception of its use as an infrequently administered treatment for high blood pressure that comes with a warning label stating that it can lead to issues with the patient's heart. However, she and others claim that the cautionary statement refers to far greater doses.

Dr. Aguh cautioned that minoxidil would be ineffective in treating excessive hair loss. "It will not work, for instance, on a man who is mostly bald and has a shiny scalp," the author says. There is nothing that can be brought back." She went on to say that the ideal patient is not completely bald but has lost a significant amount of hair, enough so that even an untrained eye would notice it.

Minoxidil pills' use for hair loss treatment is still considered off-label because a comprehensive trial leading to FDA approval has not been conducted. And dermatologists agree that this is likely to continue to be the case.

Dr. King stated that the expense of using oral minoxidil is quite low. There is no need to do clinical research that would cost tens of millions of dollars because there is no motivation to do so. That research will in point of fact, never, ever be completed. "

Patients who take a low dose of minoxidil may experience an increase in the growth of stray hairs on their faces and chins. To combat this issue, some dermatologists, such as Dr. Sinclair, have begun prescribing very low dosages of spironolactone, a medication that is often used to treat high blood pressure but which also inhibits the production of some androgens, hormones related to sexual function.

Patients who do not wish to take an unapproved treatment for their hair loss have two FDA-approved options: over-the-counter medicines that some dermatologists consider ineffective or prescription medications.

Rogaine and finasteride are two examples of these medications. Finasteride is a generic prescription given in greater doses to males to treat a benign enlarged prostate. It is exclusively licensed for men as a treatment for hair loss. In addition to this, it has been connected to sexual dysfunction.

                 Doctors prescribe off-label drug to battle hair loss l GMA