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HiGrow Minoxidil An antihypertensive vasodilator medication. It also slows hair loss and promotes hair regrowth in some people. Now off-patent, it is available over-the-counter for the treatment of androgenic alopecia. Medical uses[edit] Minoxidil, applied topically, is widely used for the treatment of hair loss. It is effective in helping promote hair growth in both males and females with androgenic alopecia.[1] About 40% of men experience hair regrowth after 3–6 months.[2]Minoxidil must be used indefinitely for continued support of existing hair follicles and the maintenance of any experienced hair regrowth.[3][4] It is the only topical product that is FDA approved for androgenic hair loss.[1] Treatments usually include a 5% concentration solution that is designed for men, and a 2% concentration solution for women.[5]Minoxidil has been approved for female use by the FDA.[6] The drug is available in the United Kingdom over-the-counter.[7] Its effect in people with alopecia areata is unclear.[8] Side effects[edit] Minoxidil is generally well tolerated, but common side effects include burning or irritation of the eye, itching, redness or irritation at the treated area, as well as unwanted hair growth elsewhere on the body. Exacerbation of hair loss/alopecia has been reported.[9][10] Users should discontinue treatment and seek medical attention right away if they experience any of the following serious side effects: severe allergic reactions (e.g. rash, hives, itching, difficulty breathing, tightness in the chest, or swelling of the mouth, face, lips, or tongue), chest pain, dizziness, fainting, tachycardia (rapid heartbeat), sudden and unexplained weight gain, or swelling of the hands and feet.[11] Temporary hair loss is a common side effect of minoxidil treatment.[12] Manufacturers note that minoxidil-induced hair loss is a common side effect and describe the process as "shedding". Alcohol and propylene glycol present in some topical preparations may dry the scalp, resulting in dandruff and contact dermatitis.[13] Some formulations of minoxidil substitute lipid Nanosomes in order to reduce contact dermatitis from the alcohol and propylene glycol vehicle.[14][15] Side effects of oral minoxidil may include swelling of the face and extremities, rapid and irregular heartbeat, lightheadedness, cardiac lesions, and focal necrosis of the papillary muscle and subendocardial areas of the left ventricle.[10] There have been cases of allergic reactions to minoxidil or the non-active ingredient propylene glycol, which is found in some topical minoxidil formulations. Pseudoacromegaly is an extremely rare side effect reported with large doses of oral minoxidil.[16] Mechanism of action[edit] The mechanism by which minoxidil promotes hair growth is not fully understood. Minoxidil is a potassium channel opener, causing hyperpolarization of cell membranes. Hypothetically, by widening blood vessels and opening potassium channels, it allows more oxygen, blood, and nutrients to the follicle. This may cause follicles in the telogen phase to shed, which are then replaced by thicker hairs in a new anagen phase. Minoxidil is a pro-drug activated by sulfation via the sulfotransferase (SULT1A1). Several studies demonstrated that the activity of sulfotransferase in hair follicles predict minoxidil response in the treatment of hair loss.[17][18][19] Minoxidil is less effective when there is a large area of hair loss. In addition, its effectiveness has largely been demonstrated in younger men who have experienced hair loss for less than 5 years. Minoxidil use is indicated for central (vertex) hair loss only.[20] Minoxidil is also a vasodilator.[21] Two clinical studies are being conducted in the US for a medical device that may allow patients to determine if they are likely to fail minoxidil therapy.