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Minoxidil 5% vs. 10%: Which one works best?

As an FDA-approved treatment that tackles hair loss, Minoxidil promotes hair growth amongst those with androgenic alopecia. In other words, it’s ideal for hereditary hair loss. While some guidelines are suggesting that you can use one-percent Minoxidil to treat alopecia areata; you should only do so under the supervision of a doctor.

While studies reveal that the 5% solution works better than the 2%, those who use this hair loss treatment regularly are often left wondering whether they can go a step further, double the concentration, and see better results still. We’re going to examine whether 10% Minoxidil will work better than 5%, how the treatment works, and whether it’s safe for your type of hair loss.

What is Minoxidil and how does it work?

Minoxidil began its life as a blood pressure medication. During the seventies, a team of dermatologists noticed that one female patient who had struggled with hair growth experienced a sudden increase after her cardiologist prescribed the drug. While the medical world isn’t sure how Minoxidil achieves this, it’s believed that the same properties that allow it to act as a vasodilator also encourage the hair follicles on the scalp to widen.

As well as widening hair follicles, Minoxidil increases blood flow to the scalp. As we rely on good blood flow for the delivery of nutrients and oxygen, plus the removal of waste products, there’s a chance that enhanced blood flow plays a role in Minoxidil’s efficacy through nourishing the hair follicles.

Minoxidil also encourages your hair growth stages to flow smoothly. If you suffer from hereditary hair loss, your scalp’s follicles spend more time in the Telogen stage of growth. Telogen is the stage where the follicles stay dormant. In other words, they’re not working to make your hair grow. Those who use Minoxidil find that their scalp’s follicles shift towards spending more time in the Anagen growth phase, which is where hair growth and thickening takes place. With less time spent in Telogen and more time spend in Anagen, hair begins to regrow.

Does 10% Minoxidil work better than the 5% solution?

In 2002, a study published by the American Academy of Dermatology highlighted how men using the 5% Minoxidil solution experienced better growth than those using weaker solutions. Overall, 393 men aged between 18-49 took part, and they received 48 weeks of Minoxidil therapy overall. To measure the study’s effects, researchers examined the impact on hair growth themselves and issued a questionnaire to the participants.

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As the trial was ‘randomized,’ the participants did not know which solution they were using. This is important for a couple of reasons. First, there’s a chance that those using the stronger solution would be more likely to comply than those using the weaker one, as they would expect better results and would, therefore, feel more driven to apply it. Second, factors such as stress play a role in hair loss too. For example, when we produce too much cortisol, our testosterone levels rise, which then makes androgenic hair loss worse. By eliminating the chance that the men in the weaker solution group could feel stressed about the results, the researchers also reduced the likelihood that cortisol was skewing the outcome.

Trial’s conclusion

The trial demonstrated that men who took the stronger solution experienced better self-perceived hair growth, and the scientists were able to measure better growth too. Considering what we’ve mentioned above about the study’s strict conditions, it’s fair to assume that a stronger Minoxidil solution leads to better hair growth.

Two years later, a similar study investigated whether stronger Minoxidil would produce the same benefits for women. This time, the scientists used a placebo. While the 5% solution resulted in better measurable and self-perceived growth than the placebo group and the 2% group, the 2% group only reported better quantifiable increase than the placebo group. However, together both of these findings suggest that:

  • The use of Minoxidil is effective.
  • The stronger the concentration, the better the effects.

Do we know whether 10% Minoxidil is even better still?

Unfortunately, few studies have examined whether 10% Minoxidil is better than the 5% solution. However, the one that has produced the following results:

  • Women experienced moderately better growth.
  • Men experienced an excellent improvement in hair growth.

While this study had fewer participants than the ones comparing 5% and 2% solutions, the way the physicians addressed growth progress was the same. It’s also worth noting that they used a derma roller, which creates pin-prick-like wounds in the participant’s head. This may have affected the absorbency rate, and therefore may have accelerated the hair growth cycle. However, it makes more sense to assume that the pattern of increased hair growth each time a stronger Minoxidil solution is used means that the 10% solution works best.

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Is it safe to use Minoxidil?

All three of the studies highlighted an increase in side effects each time participants used a stronger solution. However, these side effects were ‘local’ rather than ‘systemic.’ In other words, patients were more likely to experience skin irritation if they used a stronger solution. They wouldn’t, however, experience a decrease in blood pressure. It’s important to note this, as Minoxidil’s original use was to lower blood pressure.

WebMD has noted that there are rare instances where Minoxidil absorbs through the skin and causes the following side effects:

  • Unwanted facial hair growth
  • Dizziness
  • Palpitations
  • Edema
  • Unusual and rapid weight gain
  • Tiredness
  • Difficulty breathing

If you take Minoxidil and notice any of these side effects, contact a medical professional for further advice.

Similarly, certain individuals need to consult with their doctor before using topical Minoxidil:

  • People with cardiovascular disease
  • Those who have eczema or dermatitis
  • Kidney disease
  • Liver disease

As with many medications, if you’re pregnant, breastfeeding, or if you have a history of an allergic reaction to the drug; you shouldn’t take it at all.

In summary, while there’s plenty of evidence suggesting we could experience better hair growth through taking 5% Minoxidil over 2%, few studies examine whether 10% is better than 5%. Cumulatively, though, we can see that each piece of research suggests that the higher the dose, the better the results. If you do choose the stronger option, watch out for side effects and discuss them with a doctor immediately if they arise.

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Written by Robert B. Brown

Dermatologist. Researcher. Writer. There are only two things more important than my beard in life; My wife and my two kids. I'm a guy full of surprise. If you don't hear me talk about my hair or beard, it's probably because I am watching the UFC.

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