What's the difference between 2% minoxidil solution and 5% minoxidil foam when it comes to women's hair loss?

Thinning hair, starting at the centre part and then continuing throughout the scalp, is the main symptom of female pattern hair loss, a condition shared by 40% of women¹. No matter how normal or common it is, hair loss is never fun, and it's especially difficult for women, likely because it's usually associated with age. This makes it all the more frustrating that most medications and treatments are targeted towards men.

The first medication approved to treat women's hair loss was a 2% minoxidil topical solution that is applied directly to the scalp twice-daily². In more recent years, a 5% once-daily minoxidil topical foam has become available^3–5. Requiring half the number of applications, the 5% foam no doubt offers a less time consuming and more convenient option. Maybe more importantly though, does the 5% foam work as well, or possibly better than the 2% solution?

A previous clinical trial has concluded that once-daily 5% minoxidil topical foam had a similar effect as compared with the twice-daily 2% solution for stimulating hair growth in women experiencing pattern hair loss⁵. Recently, results from a new phase III trial which compares the two products on 322 women has become available⁶.

Once-daily 5% minoxidil topical foam was used by 161 women for 52 weeks with the same number of women given twice-daily 2% minoxidil topical solution for the same duration. Both products induced hair regrowth similarly with an increase in about 24 hairs/cm² in the target area by 24 weeks into treatment. An expert panel review also concluded that there was an overall modest improvement for both treatment groups. The majority of improvement was seen prior to 12 weeks of treatment and lasted throughout the 52 week study period.

Side effects were mild and similar between treatments as well. In the once-daily 5% minoxidil foam group, there was one report each of brittle/breakable hair, hypertension, skin irritation and itching. In the twice-daily 2% minoxidil topical solution group, there was one report of itchy rash and eczema. There were reports of stinging/burning, skin reddening, dryness and inflammation in both groups.

Therefore, according to this recent study, you are likely to see the same results whether you choose the foam or the solution.

Article by: Dr. J.L. Carviel, PhD, Mediprobe Research Inc.

References

1. Santos Z, Avci P, Hamblin MR. Drug discovery for alopecia: gone today, hair tomorrow. Expert Opin Drug Discov. 2015 Mar;10(3):269–92.


2. Price VH. Treatment of hair loss. N Engl J Med. 1999 Sep 23;341(13):964–73.


3. 5% Minoxidil: Treatment for Female Pattern Hair Loss [Internet]. [cited 2016 Jul 27]. Available from: http://www.skintherapyletter.skin.ca/2014/19.6/2.html


4. Olsen EA, Whiting D, Bergfeld W, Miller J, Hordinsky M, Wanser R, et al. A multicenter, randomized, placebo-controlled, double-blind clinical trial of a novel formulation of 5% minoxidil topical foam versus placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol. 2007 Nov;57(5):767–74.


5. Blume-Peytavi U, Hillmann K, Dietz E, Canfield D, Garcia Bartels N. 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. J Am Acad Dermatol. 2011 Dec;65(6):1126–34.e2.


6. Blume-Peytavi U, Shapiro J, Messenger AG, Hordinsky MK, Zhang P, Quiza C, et al. Efficacy and Safety of Once-Daily Minoxidil Foam 5% Versus Twice-Daily Minoxidil Solution 2% in Female Pattern Hair Loss: A Phase III, Randomized, Investigator-Blinded Study. J Drugs Dermatol JDD. 2016 Jul 1;15(7):883–9.

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Flame Hair

There are some amazing tricks that can be performed with fire. For instance you create the illusion of breathing fire using flammable fuels. You could also make handheld fireballs, my personal favorite, by using a lower temperature flame. But what you don't want is flame hair.

Flame hair is a term used to describe hair breakage¹. Hair breakage is common in hair conditions such as centrifugal cicatricial alopecia, a permanent form of hair loss². Injuries, due to hair pulling, damage and inflammation can cause breakage^1,3.When a hair is pulled, a wavy, cone-shaped hair, also called a residue can remain behind³. This uniquely shaped residue is referred to as flame hair due to its match-like characteristics (e.g., thin, short and has a distal tip)¹. Flame hair can be commonly found in trichotillomania patients, a hair pulling disorder³. This has been found in a recent study, where hair characteristics (e.g., broken hairs, coiled hairs etc.) were examined in 370 patients with varying hair conditions (e.g., trichotillomania, alopecia areata and tinea capitis) ³. Flame hairs were found in 25% of trichotillomania patients (n=44)³.

Along with trichotillomania, flame hair has also been found in other hair conditions. In an additional study that consisted of 454 patients with 11 different scarring and non-scarring hair loss conditions flame hair was discovered¹. Flame hairs were found in all patients who had chemotherapy-induced alopecia (n=6) and radiotherapy-induced alopecia (n=2)¹. In traction alopecia (hair loss due to extended force) and central centrifugal cicatricial alopecia patients, it was rare to find flame hair (4% and 3%, respectively)¹.

Hair breakage might be an early sign of a hair condition (e.g., central centrifugal cicatricial alopecia)⁴. With breakage difficult to spot, you may need a hairstylist's assistance to keep track of any new hair breakage developments⁵. You can also talk to a Sure Hair representative for more information.

Article by: Sarah Versteeg MSc, Mediprobe Research Inc. 

1. Miteva M, Tosti A. Flame Hair. Skin Appendage Disord. 2015 Sep;1(2):105–9.


2. Mhaskar S, Kalghatgi B, Chavan M, Rout S, Gode V. Hair breakage index: an alternative tool for damage assessment of human hair. J Cosmet Sci. 2011 Apr;62(2):203–7.


3. Rakowska A, Slowinska M, Olszewska M, Rudnicka L. New trichoscopy findings in trichotillomania: flame hairs, V-sign, hook hairs, hair powder, tulip hairs. Acta Derm Venereol. 2014 May;94(3):303–6.


4. Callender VD, Wright DR, Davis EC, Sperling LC. Hair breakage as a presenting sign of early or occult central centrifugal cicatricial alopecia: clinicopathologic findings in 9 patients. Arch Dermatol. 2012 Sep;148(9):1047–52.


5. Gathers RC, Jankowski M, Eide M, Lim HW. Hair grooming practices and central centrifugal cicatricial alopecia. J Am Acad Dermatol. 2009 Apr;60(4):574–8.

 

 

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