description
the exact mechanism of Minoxidil is uncertain, however, Minoxidil appears to work by gradually enlarging and lengthening hair follicles that have been shrinking due to androgenetic alopecia. Also, the growth phase may be extended allowing hair to reach a greater length before it falls out. These effects were thought to result from the increased cutaneous blood flow to the scalp area caused by the administration of Minoxidil, however, recent studies have shown that topical Minoxidil actually works by activating pghs 1 ( prostaglandin endoperoxide synthase - 1 ) which helps promote hair growth.

indications
Minoxidil is the most widely recommended treatment for androgenetic alopecia and is the first fda-approved medication used for cosmetic purposes. Patients who have a recent onset of androgenic alopecia respond best to topical Minoxidil. Topical Minoxidil is typically sold as a 2% or 5% solution with the 5% solution being somewhat more effective. Results of a recent 48 week study showed that 45% more regrowth occurred with the 5% Minoxidil solution compared to the 2% solution. Generally, it is accepted that topical Minoxidil works very well on the crown / vertex area of the scalp and to some degree at the front of the scalp - just not as well. This is because original Minoxidil test studies were only carried out on the crown / vertex of the scalp, therefore the only hair growth results that the manufacturer is allowed to claim by the fda is to state that Minoxidil will grow hair in the crown area of the scalp. However, this this does not mean that it should not be used on all areas of the scalp as it is likely to have a beneficial effect regardless of where it is applied. It is necessary to use Minoxidil for around 3 - 4 months to see evidence of regrowth and up to 6 months to fully evaluate if Minoxidil will prove effective in a particular case. Minoxidil also requires continual use in order to be effective. Once application of Minoxidil is ceased, new hairs grown during therapy may be expected to be lost after 3 - 4 months and progressive hair loss will continue.

dosage / administration
Minoxidil topical solution is for external use only. The recommended dosage is 1 ml twice daily applied to all thinning areas of the scalp. For ease of use, morning and night time application onto the clean, dry scalp is recommended. In the morning it is important that Minoxidil remains in contact with the scalp for around 4 hours for full absorbsion to take place, therefore, during this time do not swim, wash hair, allow rain to comeinto contact with the scalp or engage in heavy exercise that would cause sweat to wash away the Minoxidil. The night time application should occur 2 to 4 hours before going to bed to allow drying. Topical Minoxidil should not be applied more than twice a day. More frequent application or larger doses have no effect on hair growth. If a dose is missed, do not double up on the next dose, simply continue with the next dose as normal.
When applying topical Minoxidil 5% solution, make sure that the medecine comes into direct contact with the scalp. The medecine will not work if it is applied only on hair and does not reach the scalp. Mintop Forte topical 5% solution is equipped with a 1 ml measuring applicator. Once the bottle cap is removed, squeeze the bottle until the solution rises close to the rim. Then release it. 1 ml of solution will remain in the neck of the bottle while the rest will return to the bottle. Pour contents directly onto the centre of the affected scalp area(s) and spread it evenly with your fingertips.

side effects
the most common side effects with topical Minoxidil 5% solution are itching and irritation of the treated area of the scalp. Alcohol present in topical Minoxidil 5% solution may cause burning or irritation of the eyes. If topical Minoxidil 5% solution accidently gets into eyes, rinse with large amounts of cool tap water. Other adverse effects reported include unwanted non-scalp hair growth, local erythema and dry skin / scalp flaking. A moisturising shampoo will help with this problem if it occurs.

warnings and precautions
Patients who should not use topical Minoxidil 5% solution :

Women. topical Minoxidil 5% solution may cause facial hair growth. in addition, topical Minoxidil 5% solution may be harmful if used during pregnancy or breast-feeding.
Babies or children under 18 years old.
Where there is history of hypersensitivity to Minoxidil or ethanol.
Where there is history of treated or untreated hypertension.
Where there is use of occlusive dressings or other medicines on the scalp.
If a red, inflamed, infected, irritated or painful scalp is present ( including psoriasis and sunburn ).
If chest pain, rapid heart beat, faintness, dizziness, sudden unexplained weight gain and swollen hands or feet occurs.

use with caution
1. To avoid possible scalp irritation, all topical 5% Minoxidil solution should be washed off the hair and scalp before using colour or hair perm chemicals.
2. For best results, application of topical Minoxidil 5% solution and chemical treatment to hair on the same day should be avoided.
3. Do not use topical Minoxidil 5% solution for 24 hours after using any chemicals to make sure that the scalp has not been irritated by the perm or colour treatment. if no irritation occurs, continue use of topical Minoxidil 5% solution.

drug interactions
Certain topical agents are known to alter the stratum corneum barrier such as tretinoin or dithranol. This can lead to enhanced absorbsion of topical Minoxidil. Seek medical advice if you are taking prescription medications such as guanethidine or other drugs used for high blood pressure.