So, choose how y'all are living, hope everything is nova and you're all having a prime week. So, anyone who has done even the most minuscule amount of research on the subject of hair loss probably knows about minoxidil at this point. Topical minoxidil was the very first FDA

approved treatment for androgenic alopecia, and to date it remains the only FDA approved treatment for hair loss available over the counter. As finasteride still requires a prescription, it is also the only FDA approved treatment for hair loss that is also approved for women. As such,

minoxidil has become widely available, and ever since going off patent in the 1990s, the drug has become very cheap and can be purchased in most stores in nearly every region of the world. It is also widely available online. So, when comparing the two available FDA approved

treatments for androgenic alopecia, minoxidil is definitely the other sibling of the two. Unlike finasteride, which was developed for the specific purpose of treating androgen-dependent problems, like androgenic alopecia of course, but also for other androgen-dependent

problems like benign prostatic hypertrophy, minoxidil's hair loss benefits were truly discovered by complete accident. Minoxidil was originally FDA approved as an oral blood pressure medication in 1979 called Loniten. Loniten has since been replaced

by much safer blood pressure medications, but one very curious side effect that was noticed from patients who were on Loniten was hypertrichosis, which is hair growth all over the body as well as the scalp. So, researchers then hypothesized that maybe just maybe they could

formulate a topical variety of minoxidil that can be applied locally to the scalp in order to promote hair growth while also avoiding the dangerous and potentially life-threatening side effects of oral minoxidil. Their hypothesis fortunately was ultimately proven to be correct and this led to

minoxidil becoming the first FDA approved treatment for hair loss and to this day its use as a hair loss treatment has far overshadowed its use as a blood pressure medication where it is very rarely prescribed due to its well-documented cardiovascular dangers.

So like I said, minoxidil is definitely the odd sibling of hair loss treatments compared to finasteride because while finasteride targets hair loss through a familiar mechanism, which is the suppression of the 5-alpha reductase enzyme, which stops the conversion of testosterone

into dihydrotestosterone, DHT, minoxidil's mechanism of action still isn't fully understood even though there are several interesting theories out there. In the end though, we know it works and since it works differently from finasteride, this allows the two treatments to be stacked

together for very effective therapeutic intervention which will work for the overwhelming majority of people provided they get on treatment before their hair is too far gone. Like any other drug, minoxidil does have a very small risk of side effects, but these side effects

aren't nearly as overblown as finasteride's despite this there still exists some fear-mongering and misinformation about topical minoxidil's potential risk. One of the most common things you hear anecdotally from online hair loss forums and subreddits is users

claiming that minoxidil caused their face to prematurely age by causing wrinkles which made them look older. This is of course a concerning thing to hear from anybody, of course, because nobody wants to have to choose between their skin health and their hair health.

Although, if you ask me, I still would rather have wrinkly skin and keep my hair than have youthful skin and be bald because bald people with smooth skin just end up looking like adult babies if you ask me. So, despite these claims mostly being just anecdotal, as I already

discussed, I still think they are worth looking into and doing some research on. So let's go ahead and go balls deep as we usually do and find out once and for all if minoxidil saves hair but only at the cost of turning your face into

leather. So, to best examine this, we have to take a look at where this idea initially came from. As it turns out, it appears that all this concern about minoxidil and skin aging comes from an article which was published in 2004, which talks about the

possible mechanisms of minoxidil's beneficial effects on hair growth. Now, minoxidil has several possible effects on hair growth and, like I said, the precise way it works is still speculative. But one of minoxidil's known effects is an effect on collagen

production. Collagen, as many people know, is one of two important proteins in the skin. The other important protein is called elastin. Collagen gives skin its firmness, while elastin gives skin its elasticity. Both proteins break down with aging, so that is why eventually old people end up with loose, sagging skin.

Collagen is important for wound healing, and there are specialized cells called fibroblasts which produce collagen. Scar tissue is also made of collagen, but if you have ever had a wound that produced a big scar, you'd see that scar tissue is tougher and less flexible than normal skin. That's because scar tissue is lacking the other important protein in skin, which is elastin.

Unlike collagen, elastin is only synthesized during childhood. At the end of childhood, you basically have all the elastin you are ever going to have. So in aging, there are factors like sun damage, negative lifestyle factors such as smoking and alcohol, as well as various diseases that cause damage by destroying elastin. And once elastin is gone, you never get it back again. That's right, your body can make more collagen, but it

can't make more elastin. So once you are an adult, you are not going to have any more elastin. And one of the biggest causes of skin aging is the loss of elasticity due to the loss of the protein elastin. So getting back to minoxidil, the article we are talking about before mentions two studies that looked at minoxidil's effects on the synthesis of collagen.

One study was done on cultured human fibroblasts, which are the cells that produce collagen, as I already said. And this study found that minoxidil inhibited an enzyme involved in collagen production named lysyl hydroxylase. In the other study, minoxidil was found to suppress collagen synthesis in rat dermal papilla cells. However, both these studies were done in just tissue cultures, and they used higher

concentrations of minoxidil than what is used topically on the scalp. So the results of these studies can't be directly applied to human hair growth.

concentrations of minoxidil than you'd get in the blood even when taking oral minoxidil so it's not clear how clinically relevant these studies are in human beings nevertheless the authors of these in vitro studies felt that minoxidil might be a useful

therapeutic agent to treat or to prevent the formation of keloid scars which are large ugly scars some people get after traumatic injury whether this effect on collagen is a real effect in humans isn't clear but conceivably it might be beneficial in preventing the kind of

scar that occurs in later stages of androgenic alopecia since fibrosis is after all the endgame of androgenic alopecia since hair follicles eventually get replaced by scar tissue and balding men so if anything minoxidil's inhibition of

collagen is a good thing since it may prevent fibrosis in the scalp sadly the hair loss forums which are nothing but repositories of bro science and misinformation latched onto these studies and decided to jump to the conclusion that minoxidil was going to

make you lose all your collagen in your skin and you end up with baggy skin or baggy eyes or dark skin under your eyes just based on a few in vitro studies which aren't even the slightest bit applicable to how minoxidil is used in human beings so it's not enough for hair loss forums to try to scare people away from finasteride they have to also scare people away from minoxidil as well so it's funny how online communities that are about helping people fight hair loss try to

make you lose all your collagen in your skin and you end up with baggy skin or baggy eyes or dark skin under your eyes just based on a few in vitro studies which aren't even the slightest bit applicable to how minoxidil is you

get people to avoid the only two FDA-approved treatments which are actually clinically proven to work in the treatment of androgenic alopecia. But despite anecdotal cases like the ones you see posted on these hair loss forums, the actual clinical studies that were

done on topical minoxidil do not mention any problems with wrinkles or sagging skin. And keep in mind, we're talking about an actual FDA-approved drug here. In fact, in this review of minoxidil published in 2019, the only side effects

seen with topical minoxidil were dermatitis and hypertrichosis, which means growing too much hair. There were no systemic side effects seen, and that is probably because even though topical minoxidil has a high concentration of the active ingredient, less than one

percent of topical minoxidil is absorbed systemically, and this happens over the rate of several hours as opposed to it all being released immediately as would be the case if the drug were taken orally. On the other hand, oral minoxidil, which has become a fad nowadays, is

associated with a slew of side effects including potentially life-threatening side effects. I think it is worth quoting directly from the study. In fact, quote, 'Serious adverse effects including sodium and fluid retention and cardiovascular effects including ischemic heart disease, pericardial effusion, and pulmonary

hypertension had been reported with systemically administered minoxidil. Sodium and fluid retention caused a rise in body weight and in severe cases congestive heart failure occurred. This is due to the redistribution of blood flow from the outer to the inner cortex of the kidney.'

as well as plasma renin activity. Ischemic heart disease was reported, which might have been due to higher oxygen demand as heart rate and cardiac output increased. Pericardial fusion, which is fluid around the heart caused by minoxidil, occurs around five percent of patients with

unknown mechanism. Pulmonary hypertension due to increased pulmonary artery pressure and high cardiac output from minoxidil has also been described. Other adverse effects include hypertrichosis, occasional pulsating headache, itchy eyes, skin rashes such as bolus eruptions and

polymenorrhea. And our opinion, the benefits of oral medication are not sufficient to justify exposure to the risk of potential side effects, unquote. So, as you can see, contrary to popular belief, it's not just me that is against the routine use of oral minoxidil for hair loss.

Actual scientists who have studied oral minoxidil are against it too. I've done several videos on why you should not use oral minoxidil for hair loss and I'll link them below in case you haven't seen it yet. But nevertheless, oral minoxidil

for hair loss is still one of the most contentious topics there is in any discussion of treatment for hair loss. And whenever I bring it up in one of my videos, I get lots of comments promoting against use and people getting very upset for me for not being in favor of

it. People always tend to bring up some recently published review articles that supposedly show it is safe to use. But the problem with this is that we lack large randomized controlled studies that use low-dose oral minoxidil for hair loss and actually monitor for

potentially serious side effects like developing pericardial effusion around the heart, which can kill you. As in the quote I just read, this was actually very commonly seen in early studies of oral minoxidil, occurring in five percent of cases, and this is a potentially

life-threatening complication. The only way to properly diagnose this is with echocardiograms, which means cardiac ultrasounds, and you can bet your life that the dermatologists who are prescribing oral minoxidil to hair loss patients have barely even heard of cardiac echocardiograms, let alone know how to

interpret them properly. So we need studies that do echocardiograms over time and monitor for development of fluid around the heart as well as monitor for other serious cardiovascular side effects before we can conclude that low-dose oral minoxidil is a safe treatment for hair loss. Until then, I am

going to exercise prudence, even if it means telling people things they may not want to hear. So anyways, getting back to the subject of topical minoxidil, before you get worried about minoxidil effects on collagen, let's talk about another less often discussed potential effect of

minoxidil, which may actually be an anti-aging effect. So when it comes to anti-aging, collagen tends to get most of the hype these days, as there are a lot of worthless collagen supplements on the market, and they're propped up by social

media stars as being health elixirs like bone broth and other garbage you can buy at Whole Foods. It turns out though that minoxidil has an effect on the other important protein in the skin besides collagen, and that protein is elastin. Like I said already, elastin is important

for skin elasticity and you lose elastin as you age but unlike collagen you don't produce more or less of it once you're an adult however there is some evidence that minoxidil can restore elastin though I have to admit while this is interesting it is only based on animal

evidence at this point so just like the effect of minoxidil and collagen it is difficult to know how relevant this data is but let's take a look at the data anyways this study on minoxidil and elastin was published in 2017 and it was

done on mice these were actually elderly mice which were mice at the advanced age of 2 years old minoxidil was given in the drinking water though the control group of mice just got regular water without minoxidil the mice got the minoxidil for 10 weeks total now this

turned out to be 18 milligrams per kilogram which is much higher than a human dose but that's pretty typical of animal studies and this is a reason most animal studies need to be taken with a grain of salt but let's see what the

researchers discovered well as expected since this is oral minoxidil and oral minoxidil is a blood pressure medication after all the mice on minoxidil had lower blood pressures than the mice given just plain water no surprise there the investigators looked

at elastin in the major blood vessel of the mice which is the aorta they found more elastin fibers in minoxidil mice than the control mice as seen in this figure the elastic layer was thicker with minoxidil due to more elastin

fibers. There were some changes in the types of collagen seen in the two groups of mice, but the actual amount of collagen did not change with minoxidil. Looking under the microscope, the elastic fibers looked more normal after minoxidil in these elderly mice. In this

figure, a control mouse aorta is on the left and the minoxidil mouse aorta is on the right. The elastin on the right has fewer breaks, shown by the red arrows, and more normally oriented fibers, shown by the black arrows. Minoxidil increased the

mRNA levels for the protein tropoelastin, which is the precursor that is used to create elastin in the body. It also activated the lysyl oxidase enzyme that helps form the elastin proteins. Finally, aortas after minoxidil were more

flexible and more like the aortas of young mice. The investigators concluded that quote, "Minoxidil not only induces an increase in elastin production, but also triggers the complex multi-molecular processes that are necessary for the assembly of elastic fibers." Unquote. Not

only that, but they felt that minoxidil quote, "could be seen as an anti-aging molecule." Unquote. That's right, rather than causing aging, minoxidil has some anti-aging effects, at least in rodents. Now, I'm probably the last person to

suggest that we just look at animal studies and conclude from those that we would see the same effects in humans. That would be preposterous. The fact though is that we don't have human studies showing that minoxidil has either an aging or an anti-aging effect.

in the skin we don't know what these effects on collagen and elastin have on hair loss and it's most likely they have nothing to do with minoxidil effects on hair loss at all. The fact is though, is that there is no reason to hesitate to

use topical minoxidil because of unsubstantiated reports of skin aging, especially since it may turn out that minoxidil might actually be a good anti-aging drug for the skin. The point is that finasteride and minoxidil are the two big guns we have to fight hair loss.

In fact, they are the only two FDA clinically proven weapons we can use to save our hair, and even though finasteride by itself is good enough for most people, there are some people whose hair loss is aggressive enough that adding minoxidil may be a requirement.

Also, I think it is pretty funny how people would avoid minoxidil because of fears about aging, yet they're okay with going bald because let's face it, nobody looks younger when they lose their hair. Now there are people who are going to continue to claim that minoxidil causes

skin aging no matter what I say, but like I mentioned, in all the clinical studies done on minoxidil which involved thousands of people, skin aging was never reported as a side effect. People can have bad skin for many different reasons such as sun exposure, smoking, or just

poor genetics. It's easy to blame poor skin on minoxidil, but the research simply does not back up these anecdotal claims any more than someone claiming finasteride made their anus numb on the Propecia Help forums. Now people have sometimes accused me of being totally

against anecdotal evidence under any circumstance so let me make things perfectly clear I don't mind it when anecdotes are used to raise questions but you can't just leave it at that It is necessary to take the next step which is to do quality research like

randomized control trials to see whether or not an anecdote is true However usually this isn't done because the anecdotes are too bizarre or too unbelievable and instead anecdotes are weaponized against science and are blown out of proportion by people who have an

agenda even if that agenda is just to get people to believe their sob story about minoxidil making their face ugly when they were already ugly to begin with The fact of the matter is that minoxidil is an outstanding treatment It isn't considered as effective of a

long-term treatment for treating androgenic alopecia as finasteride since minoxidil doesn't target the root cause of androgenic alopecia but it is still the best growth stimulant on the market we have and as I've shown these baseless

claims being made about the drug causing skin aging are not grounded in any strong scientific evidence and even the basic scientific data shows that minoxidil might be more likely to be a skin anti-aging drug due to its effects on restoring elastin which is the one

skin protein that normally can't be restored after you lose it but more human research would need to be done to prove that claim and I hope it happens because if a substance can be proven to restore elastin then that could be a far more effective anti-aging remedy than

Mommy bloggers drinking soup stock on Instagram. Unfortunately, people in the hair loss forums want to jump to conclusions before the research is done. They'll take bits and pieces of different studies and then stitch them together until they have some kind of theory that explains everything. And this

is sadly what happens when people with no scientific background decide they know better than actual researchers and then try to establish their own hypotheses about androgenic alopecia. That is how we end up with ridiculous theories like scalp tension,

blood flow, sulforaphane, as well as dental malocclusion. And you know that's fine, but my goal in this channel is not to try to present an alternative hypothesis, but rather I just want to look at the science and try to put it

into perspective. I do this so my viewers can understand not just the studies that have been done on different topics, but also how strong the studies actually are and how relevant they are to everyday people using drugs like finasteride and minoxidil. So the bottom line here is

obvious: don't throw out your minoxidil if you don't want to use minoxidil. You probably don't have to, since a 5-AR inhibiting drug like finasteride or dutasteride will usually be good enough for most people. But minoxidil is not

going to give you wrinkles, and very likely the only actual effect you're going to get from using minoxidil is hair growth. And that would be worth it even if minoxidil did cause skin aging. Hair is far more important for looks than skin. I mean, just look at David

bowie at the age of 70 and see how much his hair helped his looks. If he were bald, he'd look way worse, even if his skin did look younger. Out of respect for him and his memory, I'm not going to photoshop an example of him as a bald

man for comparison to how he looks at the age of 70 in this photo, but it's extremely obvious in this photo just how much having hair helps a man's appearance. Keep in mind he is 70 years old here. I know this is anecdotal, but if

slap-head apologists can name-drop people like Jason Statham, The Rock, and Bruce Willis every time someone talks about hair loss, then it is only fair I can counter with my own anecdotes. Bottom line though is that while skin health is important, hair is more important and

even if you don't agree, there is no good evidence minoxidil causes skin aging anyways and the current evidence actually suggests it may even be good for skin health. So please stick with the science, tunes, and ignore the broccoli you hear online. Keep fighting the good

fight, stay on the path, and I'll see you next time, my fellow hair loss witchers. Take care.

Does Minoxidil cause skin aging?

Does Minoxidil cause skin aging?