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Alopecia (young people)

Alopecia treatments: minoxidil

Kayla, Emma, Annie X and Grace had all tried using minoxidil for their alopecia areata. It can also be used for other types of alopecia such as telogen effluvium and androgenetic alopecia (male- and female- pattern baldness). Minoxidil is a topical treatment in a liquid, cream or mousse/foam form which is applied to the area of hair loss. It can be prescribed by doctors on a private prescription (but is not available as an NHS prescription) or bought online and over the counter in some shops and chemists. Brand names for minoxidil include Regain and Rogaine. Kayla tried a minoxidil product when she was 15 and living in New Zealand but is unsure whether it was prescribed by her doctor or if she bought it online.

Minoxidil can be applied to the skin to stimulate hair growth. Some people found minoxidil helped, but others couldn’t see a difference. Kayla says it was hard to tell if it helped because her hair loss and regrowth changed so much at the time. Annie X stopped using minoxidil after a while. As with topical steroids, she says it felt “wrong” to be “putting chemicals on the hair”.
 

Professor Moss talks about minoxidil and says it’s not often prescribed by doctors.

Professor Moss talks about minoxidil and says it’s not often prescribed by doctors.

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Minoxidil is widely thought of as a treatment for alopecia. It's not available on the NHS, because the evidence for it working effectively is not very good. In the UK, there's a body, the MHRA, which looks at different products and only allows them to be prescribed if there's evidence that they're effective and safe. And there isn't adequate evidence that minoxidil is effective. It's available over the counter, very expensive, in different concentrations. And it is popularly used. And patients who use it often say it has helped. But in general I think what it does is it produces a little bit of sort of fuzzy regrowth, as soon as you stop using it, the improvement stops, it's not persistent. And although in, in clinical trials where people have measured, you know, the minute hair growth - yes, they can say it works, produces some hair growth, but it does not often produce a cosmetically acceptable level of regrowth. So it doesn't make your hair all grow long again, it tends to just produce a little bit of regrowth to cover the area. For some people that's enough. But it's not reliable. And it's not very effective.
 

Grace’s doctor recommended she order minoxidil online and advised her on which strength product to go for.

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Grace’s doctor recommended she order minoxidil online and advised her on which strength product to go for.

Age at interview: 18
Sex: Female
Age at diagnosis: 10
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Minoxidil, something like that, and she was like, “We can, we can’t prescribe it to you, but you can buy it really cheap online.” So, I think I had the ladies one first, and then she was like, “No, don’t bother with that, get the men’s one,” and then I used that. I think that does work but it is quite a slow process because it's not very strong; cos you can buy it over the counter can't-, or even just in a drugstore, can't you? So, it's not really like-, I suppose it's not really like a proper, I don’t really know. It's not like a proper I don’t feel like I'm being prescribed something that I can take and it can-, it's going to do something, but I probably psychological as well, and subconscious that putting this on I do feel like it does work. 
No one talked about having experienced any side effects from using minoxidil. However, Emily researched minoxidil and thinks there can be more side effects for women using the treatment than for men. For the people we talked to, minoxidil was seen as quite an “easy” treatment: it could be bought from a shop, meaning that the person didn’t have to go to their doctors to get it prescribed, and used at home as part of a routine. Grace found it was quite a cheap treatment because she bought a bulk supply online. Emma says she would feel more comfortable using a topic treatment like minoxidil than something like oral steroids or steroid injections.
 

Emily talks about minoxidil being available in shops in different strengths for men and women.

Emily talks about minoxidil being available in shops in different strengths for men and women.

Age at interview: 20
Sex: Female
Age at diagnosis: 19
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So there’s minoxidil which is available branded in like Superdrug and Boots and stuff which is I think it’s 2.5% for women and 5% for men. And 5% is a high dosage, well a supposedly high dosage, but you could be prescribed higher dosages by like doctors. So I’ve done a lot of research. I’ve read a couple of papers about minoxidil 5% in treating alopecia in women, so I went into Boots and I said “Do you have one available for women? ‘Cos this one says it’s for men and I don’t want to necessarily…” I mean I don’t know if there’s a difference between the products for men and women. I know a lot of things there usually isn’t, but if it’s kind of a medical product I don’t want to be messing around with that kind of thing, especially if it affects hormones and stuff.” So I went in and they said, “No we don’t do 5% for women ‘cos it causes side effects, so get prescribed by your doctor or something.” So I don’t, I never really kind of looked into it any further in terms of being prescribed it because that kind of put me off strangely enough. But I have read things about women getting things like facial hair and stuff which I mean it’s interesting the kind of gendered thing about where hair is appropriate and where it isn’t, so women were like, “I’m really happy my hairs grown back, but I have facial hair now.” And men would be like, “Oh I have hair and facial hair now, everything’s great.” Which I found quite interesting. And it’s also interesting the fact that they don’t make that available to women because of the side effects of things like facial hair which I’m not sure if it’s on like a hormonal level that it affects things like that and that’s why they don’t prescribe it or if it’s because they think women having facial hair is such a bad side effect that it would be a bad product to market. So I found that quite interesting. I haven’t really, there’s not really much available in terms of like hormonal effects of it, but that’s definitely something that I found really interesting.
 

Emma tried prescribed topical steroids and shop-bought minoxidil. This helped when she had a small patch of alopecia, but doesn’t use either now.

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Emma tried prescribed topical steroids and shop-bought minoxidil. This helped when she had a small patch of alopecia, but doesn’t use either now.

Age at interview: 23
Sex: Female
Age at diagnosis: 14
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The steroid ointments, they, it was just like a really thin liquid that you just literally put on your s-, like the area and just massaged it in I think about three times a day. And that was like completely easy to use. I did use minoxidil as well, which I just bought from Boots. And I don’t know if that worked or the steroids I used. Bit of both. But that was fine to use as well. S-, and so, yeah. I’d say if you have a small patch of alopecia, I, I think, well, for me it worked. So, and I, and I know some of the girls said about trying it on, on your forehead because a few of them have had, you know, positive feedback from it. But, so I, I might try that because that’s not painful or anything. And I think that’s just a bit of lotion on your head. So I’ll give that a go again. You know, if it works it works. Cos as I say, it’s just, you know, a little tube that you get and just smother it on. So that’s quite easy.
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