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I see that this and other forums are still full of guys roboticly parroting misinformation with regard to the long-term efficiacy of minoxidil. Some people obviously have big problems to understand very simple things, so I will repeat and explain them in detail.
First of all, does minoxidil regrow hair? YES.
So does it interfere with the process of balding? OF COURSE, IT DOES.
So how is it possible that it "can't maintain" existing hair? Now we hit a logical limit in some people's brains. In reality, all the propaganda about minoxidil not being able to maintain hair has a single source: It comes from a certain guy nicknamed Bryan, who is raving agaist minoxidil on hairlosshelp.com and ****************.
He himself has never used minoxidil on his own (he says that he did, but elsewhere he confeses that he was pretty sloppy with it) and randomly picks up graphs from studies that he has never read. In reality, the picture that we get from all minoxidil studies doesn't suggest that the effect of minoxidil would be fundamentally different from that of 5-AR blockers. The peak of regrowth is achieved after 1-2 years in the majority of patients, then the AVERAGE curve of haircounts slowly decreases (similarly like in patients on finasteride), but individual differences are large and certain individuals can experience continuous regrowth even after 5 years of treatment (similarly like finasteride users in the recent 10-years' study).
The longest minoxidil study to date comes from 1990 (Olsen et al.). You can look at this graph and see that although the average curve of haircounts declines after 1 year, the average user in this study would reach the baseline after ca. 15 years. This is quite in accordance with my experience and experience of other long-term minoxidil users, who keep their hair on minoxidil for 15-25 years.
As far as I know, the graph that Mr. Bryan and his followers use against minoxidil is an edited version of a graph from Price et al. (1999):
I can't help myself, but I see stabilization or at worst a very small decline after ca. 60 weeks of treatment. Even the small decline would be quite expectable, because in every sample, you have responders and non-responders. Even if 90% men in some random sample were keeping their hair unchanged, those remaining 10% non-responders would push the curve down. Further, cycles of hairs that simultaneously enter the growth phase at the beginning of any hairloss treatment will start to desynchronize in the following months/years. This may lead to a certain decrease of haircounts, but it may not necessarily mean a worsening of the state of hair, because the decrease in density is usually compensated by the increase in hair quality. (To be objective, this particular study examined hair weights, i.e. hair quality.) Furthermore, this study was based on only 17 men and I wouldn't put much weight on it, especially because it demonstrates a peak of regrowth after mere 4 months, which no other study before has showed.
Now, what I wanted to emphasize most: By using anti-hairloss treatments, you basically increase the resistance of your hair follicles against the effect of DHT. In some people, hair follicles are too sensitive or their DHT activity is too high, so they start to lose hair very early and the process is very fast. In others, it proceeds at a slower pace, over more hair cycles, and hence their experience hairloss at a later age. In ca. 15-20% men, MPB never occurs.
Currently, we have two basic options for hairloss: minoxidil and 5-AR blockers (finasteride, dutasteride). Considering that the effect of minoxidil and dutasteride is dose-dependent, it logically means that further hairloss on these treatments is not possible, once you reach a certain "optimal" dosage. It's so simple and this is my fundamental argument against all those whining losers repeating over and over some silly babbles about "trying to halt the inevitable".
Unfortunately, there is no sufficiently long-term study (20+ years) on 5% minoxidil, so we don't know, in what a percentage of men this dosage can prevent hairloss until the end of their lives. Anecdotal experience suggests that some men are still at or above baseline after 20-25 years.
The 5% version is undoubtedly suboptimal for many men and less effective than 5-AR blockers, but no comparative study of 10% or 15% minoxidil has been done (which is shameful and it shows, how much pharmaceutical companies care about the development of cure against hairloss).
Nevertheless, we have a biological model of Dominican pseudohermaphrodites showing that 75-80% suppression of DHT (via the lack of 5-AR II) is enough to avoid any hairloss completely. You can't achieve such a suppression with finasteride (in the majority of cases), but you can certainly achieve it with dutasteride that can suppress as much as 99% blood DHT. This speaks volumes. So much to all the mythmaking and misinformation infecting people's minds on internet forums.
First of all, does minoxidil regrow hair? YES.
So does it interfere with the process of balding? OF COURSE, IT DOES.
So how is it possible that it "can't maintain" existing hair? Now we hit a logical limit in some people's brains. In reality, all the propaganda about minoxidil not being able to maintain hair has a single source: It comes from a certain guy nicknamed Bryan, who is raving agaist minoxidil on hairlosshelp.com and ****************.
He himself has never used minoxidil on his own (he says that he did, but elsewhere he confeses that he was pretty sloppy with it) and randomly picks up graphs from studies that he has never read. In reality, the picture that we get from all minoxidil studies doesn't suggest that the effect of minoxidil would be fundamentally different from that of 5-AR blockers. The peak of regrowth is achieved after 1-2 years in the majority of patients, then the AVERAGE curve of haircounts slowly decreases (similarly like in patients on finasteride), but individual differences are large and certain individuals can experience continuous regrowth even after 5 years of treatment (similarly like finasteride users in the recent 10-years' study).
The longest minoxidil study to date comes from 1990 (Olsen et al.). You can look at this graph and see that although the average curve of haircounts declines after 1 year, the average user in this study would reach the baseline after ca. 15 years. This is quite in accordance with my experience and experience of other long-term minoxidil users, who keep their hair on minoxidil for 15-25 years.
As far as I know, the graph that Mr. Bryan and his followers use against minoxidil is an edited version of a graph from Price et al. (1999):
I can't help myself, but I see stabilization or at worst a very small decline after ca. 60 weeks of treatment. Even the small decline would be quite expectable, because in every sample, you have responders and non-responders. Even if 90% men in some random sample were keeping their hair unchanged, those remaining 10% non-responders would push the curve down. Further, cycles of hairs that simultaneously enter the growth phase at the beginning of any hairloss treatment will start to desynchronize in the following months/years. This may lead to a certain decrease of haircounts, but it may not necessarily mean a worsening of the state of hair, because the decrease in density is usually compensated by the increase in hair quality. (To be objective, this particular study examined hair weights, i.e. hair quality.) Furthermore, this study was based on only 17 men and I wouldn't put much weight on it, especially because it demonstrates a peak of regrowth after mere 4 months, which no other study before has showed.
Now, what I wanted to emphasize most: By using anti-hairloss treatments, you basically increase the resistance of your hair follicles against the effect of DHT. In some people, hair follicles are too sensitive or their DHT activity is too high, so they start to lose hair very early and the process is very fast. In others, it proceeds at a slower pace, over more hair cycles, and hence their experience hairloss at a later age. In ca. 15-20% men, MPB never occurs.
Currently, we have two basic options for hairloss: minoxidil and 5-AR blockers (finasteride, dutasteride). Considering that the effect of minoxidil and dutasteride is dose-dependent, it logically means that further hairloss on these treatments is not possible, once you reach a certain "optimal" dosage. It's so simple and this is my fundamental argument against all those whining losers repeating over and over some silly babbles about "trying to halt the inevitable".
Unfortunately, there is no sufficiently long-term study (20+ years) on 5% minoxidil, so we don't know, in what a percentage of men this dosage can prevent hairloss until the end of their lives. Anecdotal experience suggests that some men are still at or above baseline after 20-25 years.
The 5% version is undoubtedly suboptimal for many men and less effective than 5-AR blockers, but no comparative study of 10% or 15% minoxidil has been done (which is shameful and it shows, how much pharmaceutical companies care about the development of cure against hairloss).
Nevertheless, we have a biological model of Dominican pseudohermaphrodites showing that 75-80% suppression of DHT (via the lack of 5-AR II) is enough to avoid any hairloss completely. You can't achieve such a suppression with finasteride (in the majority of cases), but you can certainly achieve it with dutasteride that can suppress as much as 99% blood DHT. This speaks volumes. So much to all the mythmaking and misinformation infecting people's minds on internet forums.
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