Introduction

Minoxidil shampoo is a hair loss product which contains minoxidil as the primary active ingredient. It appears to be a very convenient hair loss treatment because it eliminates any additional tasks for users by integrating it with the daily shower routine. Nonetheless, the biggest question is: does it work? This blog will answer this question with scientific evidence. It also discusses different brands of shampoo with minoxidil and their possible side effects. Furthermore, this blog also discusses some superior alternatives.

Does It Work?

Minoxidil was developed in the 1970s as a potential therapeutic drug for hypertension but was observed to cause abnormal hair growth as a side-effect. It was later exploited for its hair-growth inducing properties and has since been marketed as a topical solution/lotion for the reversal of alopecia.

Minoxidil is typically prescribed in the form of a lotion or solution and is meant to be applied topically twice a day. Each application (~1mL) is meant to last for at least 2 to 4 hours to be effective. The shampoo on the other hand, has an extremely limited contact-time with the scalp. Indeed, it is instructed to be lathered and rinsed thoroughly into one’s hair for 1 minute, followed by a leaving-in period of 2 minutes. 3 minutes is an extremely restrictive period of time, thus a shampoo fortified with minoxidil is unlikely to be effective in reversing alopecia. This is because Minoxidil works by opening potassium channels on the smooth-muscle cells of the arteries which supply the hair follicles on the scalp. This improved microcirculation supplying the hair follicles leads to more robust hair growth. Whilst Minoxidil solution/lotion could achieve this effect due to the 4-hour leave-in period, the shampoo variant is extremely unlikely to benefit users due to the insignificant leave-in period of 3 minutes.

Available Products

There are not many such shampoos available on the market. Currently, Foligain Advanced Hair Regrowth Shampoo is the only one we can find. This shampoo has 2% Minoxidil and 2% Trioxidil.  Trioxidil is a proprietary blend of niacin, vitamin B6, folate, biotin, zinc and copper. The instructions for this product stipulate that the shampoo be massaged into the hair for 1-2 minutes and left in for a period of 3 to 4 minutes. Furthermore, the manufacturers recommend that this product be used at least 3 to 5 times per week.

There used to be another one – the Polaris NR-02, which was discontinued in 2017.  This shampoo contains finasteride, in addition to minoxidil. Although both minoxidil and finasteride are proven ingredients for hair regrowth, the short contact of the ingredient with the scalp does not give scalp sufficient time to absorb them to be effective. This is probably the main reason why this shampoo was discontinued.  You can read more details about this shampoo here.

Results

Although the scientific literature is rife with randomized controlled trials and observational studies regarding the efficacy of Minoxidil solution/lotion for alopecia areata and even facial hair growth, there are virtually no studies to date that have been primarily scoped to Minoxidil containing shampoo. Indeed, a comprehensive search of medical databases such as PubMed and Embase with the term “Minoxidil shampoo” yields no results. Instead, a plethora of studies on ketoconazole shampoo is yielded. Although there is no evidence for Minoxidil containing shampoo, we believe that it has an insignificant effect on hair growth. The active compound in Minoxidil - 2,4-diamino-6 piperidino-pyrimidine-3-oxide, requires time to be absorbed by the hair follicles as well as to be metabolized by enzymes present in the follicles themselves to the active metabolic derivate (minoxidil sulfate).

Possible Side Effects

Due to the short period of contact of the scalp/skin, the pathological side effects of a shampoo with minoxidil are expected to be minimal, except that you may get rashes or skin irritation due to allergic reaction with minoxidil or other ingredients such as propylene glycol (PG) in the product.

Meanwhile, you will definitely experience the following side effects:

(1). Your wallet will get thinner for nothing.

(2). Your hope for recovering your hair will shrink.

(3). The most serious side effects among all is that it delays the treatment of your hair loss with the right products and make it more difficult to treat.

If you have made up your mind to use shampoo for your hair loss issue, you don’t need to feel hopeless, because there is a type of shampoo that is proven to work.

Ketoconazole Shampoo – A Better Alternative

Patients with alopecia who are looking to purchase a therapeutic shampoo for their hair loss should consider better alternatives such as ketoconazole shampoo. Ketoconazole shampoo has been unanimously recognized as a universal treatment for dandruff, seborrheic dermatitis as well as in androgenetic alopecia (male pattern baldness). One landmark study in 1998 showed that 2% ketoconazole shampoo was equivalent to topical minoxidil treatment in promoting the density, size and proportion of hair follicles in patients with male pattern baldness [1]. In other words, the ketoconazole shampoo which was only used two to four times weekly by participants over 21 months performed just as well as in participants who used once-daily minoxidil lotion for the same duration. Although ketoconazole shampoo has been evaluated head-to-head with minoxidil lotion/solution, there have been no studies in the literature which have looked at ketoconazole shampoo versus minoxidil shampoo. However, we strongly believe that ketoconazole shampoo will strongly outperform the shampoo with minoxidil. This is because unlike minoxidil lotion/solution which is indicated for daily use twice-daily and has a leave-in period for 2 to 4 hours, while the shampoo with minoxidil has an extremely limited and insignificant leave-in period of mere minutes.

Readily Available Ketoconazole Shampoos

As the better alternative to minoxidil shampoos, the Hair Covet Hair Restoration Shampoo and the Lipogaine Big 3 Shampoo represent novel solutions for sufferers of male pattern baldness. The Lipogaine Big 3 Shampoo combines the proven therapy of ketoconazole with that of biotin, niacin and copper tripeptides. Biotin, also known as Vitamin B7 is a water-soluble vitamin which is essential in multiple metabolic pathways and is clinically prescribed for hair and nail conditions[2]. Niacin which is an organic compound and variant of vitamin B3 is a naturally occurring derivative which has been shown to increase hair fullness and thickness in women with alopecia [3]. The Lipogaine Big 3 Shampoo synergistically combines these ingredients in order to confer the benefits of ketoconazole, niacin and biotin in an easy to use shampoo solution that is free of harsh industry-grade chemicals which are commonly found in minox shampoos (e.g. propylene glycol or ethylene glycol). The Lipogaine Big 3 Shampoo is available for purchase at Lipogaine official site.

The Hair Covet Hair Restoration Shampoo is a slightly more comprehensive shampoo which combines a staggering 7 ingredients – biotin, saw palmetto, niacin, black castor oil, caffeine, argon oil and finally, ketoconazole. Saw palmetto has an inhibitory effect on the enzyme by 5α-reductase. This enzyme converts male testosterone into DHT. By inhibiting by 5α-reductase, saw palmetto reduces the overall level of testosterone, leading to improvements in hair density and the thickness of hair follicles. As a natural extract of the berries of the palm tree, saw palmetto is advocated by trichologists who endorse its utility in the treatment of alopecia [4]. Argon oil is extracted from the kernels of argan fruits in Morocco and keep the hair moisturized – this is important, as it prevents drying of the scalp which can impede hair growth and luster [5]. The Hair Covet Hair Restoration Shampoo is available for purchase here.

Even though these shampoos don’t contain minoxidil, they are invariably more effective in promoting hair growth and hair thickness than those shampoos that have it. Even though these shampoos have the same leave-in period of 2-3 minutes, they are many-fold more effective than minoxidil shampoos as evidenced by the landmark 1998 study mentioned earlier. In fact, a more recent study in 2011 showed that ketoconazole shampoo (also known as Nizoral shampoo) resulted in significant growth of hair in patients in as little as 90 days [6].

Conclusion

Although minoxidil itself is a proven treatment for hair regrowth and it is the most popular treatment for hair loss, a shampoo with minoxidil is unlikely to be effective because it can’t be effectively absorbed by the scalp in such a short period of time during a shower. Ketoconazole shampoo is a much better option.

To maximize hair regrowth, it is recommended to use a ketoconazole shampoo such as Hair Covet Hair Restoration Shampoo and a leave in topical minoxidil solution.

References

1.    Pierard-Franchimont, C., et al., Ketoconazole shampoo: effect of long-term use in androgenic alopecia. Dermatology, 1998. 196(4): p. 474-7.

2.    Patel, D.P., S.M. Swink, and L. Castelo-Soccio, A Review of the Use of Biotin for Hair Loss. Skin appendage disorders, 2017. 3(3): p. 166-169.

3.    Draelos, Z.D., et al., A pilot study evaluating the efficacy of topically applied niacin derivatives for treatment of female pattern alopecia. J Cosmet Dermatol, 2005. 4(4): p. 258-61.

4.    Murugusundram, S., Serenoa Repens: Does It have Any Role in the Management of Androgenetic Alopecia? Journal of cutaneous and aesthetic surgery, 2009. 2(1): p. 31-32.

5.    Gavazzoni Dias, M.F.R., Hair cosmetics: an overview. International journal of trichology, 2015. 7(1): p. 2-15.

6.    Rafi, A.W. and R.M. Katz, Pilot Study of 15 Patients Receiving a New Treatment Regimen for Androgenic Alopecia: The Effects of Atopy on AGA. ISRN dermatology, 2011. 2011: p. 241953-241953.