background

The active ingredient Minoxidil has a long history against hair loss. It was first developed as a tablet for the treatment of high blood pressure. After the therapy showed that hair growth was a side effect, the manufacturer finally developed the product for this application in the form of a solution and initially marketed it as a drug in the USA.

It is important to know that the active ingredient is relatively poorly soluble in water so that the clinical form of a solution with propylene glycol was already used for the first topical product. The active ingredient is more than 20 times more soluble in this solution, and propylene glycol also helps to transfer the active ingredient into the skin.

However, the form of the solution is not always pleasant to use in various respects, and the solution can run down the face and then spread over the pillow at night to other areas of the skin.

In addition, the excipient is irritating to some people’s skin, so that some users had to stop using the product again. The signs that sometimes appear at the beginning of the treatment are itching, dry skin and dandruff. These symptoms can be considered allergies by users, even if they are not real contact allergies.

A reaction to the active substance itself, on the other hand, is rather rare; the galenic formulation plays the most important role here.

But the solution is not unproblematic cosmetically either, especially for women. The finished appearance of the hair and problems with styling reduce the acceptance of the solution. It is assumed that due to the evaporation of the ethanol content in the formula, the salts of minoxidil and propylene glycol form a mixture.

Also, the fast and easy flow of the solution over the neighbouring skin areas is not optimal in the sense of a purposeful treatment.

Minoxidil foam as an alternative

In regard to this background, the manufacturer has also developed the product as a minoxidil foam, which, however, has to be applied in a similar way in the application. Another substance, glycerine, acts as a solubilizer in the foam. At least in the animal model, glycerine even showed a significantly better penetration promotion than the solution. The concentration in the sebaceous gland was almost 6% for the foam compared to 2% for the solution (5% dosage each).

Efficacy (studies)

In women, Minoxidil foam 5% were compared in a study against the 2% solution. A total of 113 women who received one of the two products for 24 weeks took part in the study conducted in Germany.
With regard to the number of hairs, the one-off application as the foam was at least similar to the solution. In terms of cosmetic properties, the foam was significantly more acceptable in terms of styling.

In addition, the application of the foam showed significantly fewer intolerances than the solution.

In men, a relatively small study was conducted with 17 patients treated with Minoxidil foam for six months.

Only twelve patients completed the study after six months, but nine of them reported a more or less large improvement. The hair count improved on average by about 15-20% (depending on whether automatic camera evaluation or eye evaluation was used).

It should not be forgotten that hair loss usually progresses and that even a standstill is an indication of the success of treatment with Minoxidil Foam.
This study also found better tolerability in men.

Shedding

Some users report that Minoxidil Foam has not reduced their hair loss but increased it. However, this is not a cause for concern, but rather an indication that the product is actually working. The background is relatively simple:
Hair growth takes place in different phases. The growth phase (also called anagen phase) is the longest phase and lasts about 10-15 months. This is followed by the transition phase (catagen phase), in which hair growth stops. The period for this is relatively short, about 2-3 weeks. The hair then enters the completely inactive resting phase (telogen phase), where the hair follicle is completely inactive until it finally falls out and is replaced by a new hair.
Minoxidil stimulates hair growth, the hair follicle starts producing new hair. It takes up space, which means that it has to remove the old hair. This gives the impression that suddenly more hair is falling out – although it actually means the exact opposite.
This hair loss is, therefore, a good sign and no cause for concern or reason to stop the treatment.

Application of Minoxidil foam

The product is packed in a special package. Therefore there are some special features to consider when applying the product, but they are not very difficult.

  •  there are arrows on the can and on the cap, which have to be placed on top of each other. Then the cap can be pushed backward.
  •  the hands should be clean and dry so that the foam does not run prematurely.
  • 1g of foam (about half a cap) is placed on a flat plate. Take care to hold the can vertically to prevent the foam from becoming liquid.
  • Apply the foam to the affected head with the fingertips, distribute and massage in briefly. Then wash the hands carefully and do not let the scalp get wet for the next 4 hours.

Also with Minoxidil foam, it is important that the product must be used permanently. The moment you stop applying the product, the effect will wear off, the activating effect on the hair follicles will wear off and hair loss will begin again.
As there are very inexpensive multi-packs available, the product is comparatively inexpensive and should be swiveling for most users.

Warnings and precautions for use

  • Minoxidil foam can ignite easily, therefore the product should not be used near before and should not be smoked.
  • The application should only be made on the normal healthy scalp, but not if the skin is reddened or inflamed.
  • There is no clinical experience of efficacy for receding hairline braces, but users also report success here.
  •  People with cardiovascular disease and high blood pressure should not use Minoxidil Foam.
  • Frequent application to the hair instead of the scalp can lead to increased dryness or stiffness of the hair.
  • Do not use together with other skin products.

Literature:

Ulrike Blume-Peytavi, Kathrin Hillmann, Ekkehart Dietz, Douglas Canfieldc, Natalie Garcia Bartels: A randomized, single-blind trial of 5% minoxidil foam once daily versus 2% minoxidil solution twice daily in the treatment of androgenetic alopecia in women. In: JAAED, December 2011Volume 65, Issue 6, Pages 1126–1134.e2
Hasanzadeh, Hournaz et al. “Efficacy and safety of 5% minoxidil topical foam in male pattern hair loss treatment and patient satisfaction.” Acta dermatovenerologica Alpina, Pannonica, et Adriatica 25 3 (2016): 41-44 .
Fachinformation Regaine Manner Schaum 5%, Stand Januar 2012