Ask HN: Minoxidil trial results, is it worth it?

Paper on sci-hub: https://sci-hub.hkvisa.net/10.1067/mjd.2002.124088

My understanding as a Minoxidil user is that it's mostly a preventative measure to prevent further hair loss. It certainly can regrow some hair, there's plenty of evidence of that, but it's definitely a limited amount. It certainly won't give a bald man a full head of hair.

You can't just compare the before hair count to after, because presumably if you didn't use it you would have lost even more hair in that time. Unfortunately you can't know how much that would have been - but just say you would otherwise have been down to 140 h/cm^2 in that time, then the effect is 28 h/cm^2 instead of 18.

Even if the amount of hair stayed the same, if it prevented more balding it would be helping. Whether it's worth it or not is up to you.

Minoxidil simply extends the anagen (growth) stage of the hair follicles by strengthening them and improving blood flow to the scalp.

If your head was a bathtub, this would be like turning up the tap.

However, male pattern baldness (androgenic alopecia) is usually caused by the hormone DHT, which is a byproduct of testosterone. DHT can shrink hair follicles causing hair loss, and that’s primarily what you’re fighting against.

You can help prevent testosterone from being converted to DHT by inhibiting the enzyme 5-alpha-reductase. The typical prescription for this is 1.25mg of finasteride, taken orally.

Back to the bathtub analogy, this would be like putting in the plug.

When taken together, this treatment is fairly effective for most people, although side effects can be somewhat common with finasteride (eg low libido) so do more research if you go down this route.

Hairs per cm^2 is one metric (per the mentioned numbers) an 11% increase. By ridiculous, I presume a connotation of "not material" or "not worth the effort" (and for some, it isn't, because they don't respond to the treatment).

Returning to metrics, another could be the diameter of each hair, which impacts the aesthetic quality. 151 hairs per cm^2 doesn't visually present the same for all individuals with that exact density (due to thinness/thickness of each follicle). Other treatments can be paired with it simultaneously, which may further improve results.

It really says numbers like 151/168 hairs/cm2? That sounds way higher than native, non-balding density of the human scalp. I think most people have like 100/cm2 tops. You will not be visibly balding until you get to around 40/cm2 or so. Depends on hair calibre too.

In any event, +18/cm2 is actually a good amount in terms of cosmedic effect.

I have taken both topical and oral minoxidil for years. I have also researched many anecdotal cases of minoxidil use. Some people have a tremendous response to it. The side effects are generally negligible.