2% and 5% Strength Minoxidil
When Minoxidil was first approved by the US FDA to treat hair loss in 1988, it came in a 2% topical solution format under the brand name Rogaine. The product had already been used for many years prior to approval as an off-label hair loss treatment. In 1997, the FDA approved a higher strength version of Minoxidil in the form of a 5% topical solution that could only be obtained via a prescription, although that requirement was soon thereafter waived in 1998. After Rogaine’s patent ran out, newer generic versions of Minoxidil have come onto the market. More importantly, the topical version (thought still available) has been superseded by a drastically superior foam version that does not run down onto one’s face (sometimes leading to tiny hair growth on the forehead!) or cause major itching.
I hated using topical Minoxidil, but love using the foam version as it acts like a mild gel and is not messy like the topical version. Minoxidil 5% foam has definitely helped my hair. Moreover, within an hour of foam application, I find that my hair feels significantly thicker and fuller. I am certain that this is not a placebo effect. While you are supposed to use Minoxidil twice a day, many people just use it once a day. Note that Minoxidil is also used by females and women’s 5% Rogaine foam was launched in 2014. Also of significance, Minoxidil still remains one of only two ingredients (the other being Finasteride) that have ever been FDA approved to treat hair loss.
15% Extra Strength Minoxidil
While 5% Minoxidil was initially considered to be a high strength version of the product, this is no longer true. A number of companies sell 15% (and in some cases, 10% Minoxidil) versions of the product, but I have never tried those. I assume most of these companies will require a prescription before they can sell it to you (and maybe it might even be illegal for them to sell in some countries such as the US). Minoxidil was originally used as a blood pressure medication, so if you ever use such a high strength product, buyer beware and make sure you measure your blood pressure regularly since the topical product does get absorbed systemically. When on Minoxidil 5% to treat hair loss, some people have complained about various side effects such as skin problems, an increase in body hair, water retention and more. Such side effects will probably be exacerbated when on 15% Minoxidil.
Two of the better known companies that currently sell Minoxidil 15% are Xandrox (based in Canada) and MinoxidilMax. While the latter has some bad pages on its site with missing information, their 10 most popular questions section at the bottom of the home page is worth a read.
Dr. Richard Lee — Minoxidil 15% plus Azelaic Acid
The original high strength Minoxidil guru was a US-based doctor by the name of Richard Lee. I heard about his name on a regular basis on hair loss forums throughout the 2000-2010 period. He compounded an extremely popular high-strength 15% version of Minoxidil in the 1990s and added azelaic acid to it due to the latter’s anti-DHT (dihydrotestosterone) properties. Since he got an online presence very early on in the internet’s infancy, Dr. Lee’s business took off with a flourish and he had zero competition. However, in 2011, the at-the-time 72-year-old Dr. Lee started having problems with the US FDA and had to close his Regrowth LLC company. Case details here.
An interesting old Discovery Channel video with Dr. Richard Lee in there:
Dr. Oscar Klein — Minoxidil 15% plus Tretinoin (Retin-A)
Another US-based doctor by the name of Dr. Oscar Klein also became extremely popular for selling a reputable 15% Minoxidil based product that also contained Tretinoin (more widely known in the hair loss world by its trade name Retin-A). While Dr. Klein unfortunately passed away in 2014, his Hair Growth MD company still sells his Remox brand products.
A video of Oscar Klein from a 2003 NBC interview:
Even Higher Strength Minoxidil
Polaris Research Labs’ NR-10 product contains 16% Minoxidil. However, the company’s website does not mention where it is headquartered, but does say that the product is not available for sale in the US. I would try to learn more about this company before considering them.
The Medical Wellness Center online pharmacy supposedly offers up to 30% Minoxidil content lotions and creams. Belgravia Centre in the UK offers “high strength” Minoxidil. Please check with a physician before ordering such products to ensure legality and safety.
You can also go to local compounding pharmacies and they might be able to compound 20% or higher Minoxidil for you. However, this may not be particularly safe for long-term use, and there is a good chance that 20% will not be any more effective than 15%.
Minoxidil in the News Recently
One of the reasons I chose to write this post is because Minoxidil has been in the news recently, with companies either experimenting using it in their main product offering (Follica) or actually using it (RiverTown Therapeutics). Moreover, oral Minoxidil is also back in the news.
Sometimes it is easy to forget that the combined effects of Finasteride and Minoxidil (see before and after photos) have essentially been a cure for hair loss for numerous people, especially when used in the earlier stages of hair loss.