Dear Doctor,
You routinely advise people to stay clear of Scalp Med, Follicare, Spectral DNC and other similar products. Your reason is that all of the aforementioned products contain minoxidil and if they work, at all, it is simply due to the minoxidil contained in them. Your conclusion: Just buy plain minoxidil!
Well, I would agree that many products have probably a zero chance of working. Fabao, for example, contains nothing more that Chinese herbs and is formulated based on folklore and an ancient meta-physical concept of disease. I seriously doubt it does anything. On the other hand, products like Follicare and Spectral DNC take a known active ingredient (minoxidil) and try to improve on it. These products take many promising ingredients that have been shown to grown hair, to some degree, in certain studies, like Adenosine, Amenexil, free-form fatty acids, caffeine, etc. They also add other things like either DMSO (in Follicare) or nanosomes (in Spectral DNC) to increase absorption. Clearly, the makers are going all out to “turbo charge” ordinary minoxidil.
Although none of these ingredients are effective enough to be used as a stand-alone treatment, nor are any of them proven, they all, at some point, showed some degree of promise or effect. Dr. Peter Proctor, in a Q & A session on one of the forums, said that “any ingredient that has ever been claimed to grow hair, probably does to some degree — in some people.” With logic like that, these companies take the “best of the best” of the unprovens and add them to a proven ingredient (minoxidil.) With few exceptions, I think most of these companies have good intentions to make the most effective product they can with what is currently available to them. I think very few are outright, deliberate scams.
It seems clear and logical to me that when these extra ingredients are added to a proven minoxidil base, there is bound to be some beneficial, synergistic effect.
The Million Dollar Question: Putting aside cost and value, which I don’t think should be a factor in choosing treatment, do you really believe that one of these products is not likely to be more effective than plain minoxidil?
Could the opposite be true — manipulating the basic minoxidil may make it less effective? Where is the science here? I don’t believe everything I read and when someone or some company is self-promoting the product or process and then makes claims of benefits, what proof is there really? I need to see actual proof before I can even remotely consider giving something a thumbs up. And as you suggested, most of these products seem like they’re just combinations of every herbal that is rumored to have hair benefits, along with a proven treatment like minoxidil. So then when the minoxidil ultimately helps, they can say “See, our product works!” — but in reality, it’s just a more expensive version of generic minoxidil with added vitamins that may or may not be of any use to the hair growth process.
Good intentions or not, it is a buyer beware process and these companies are ultimately just out for your money (makes sense being a business). Cost might not be a factor for you, but I don’t think many people would agree with that notion, especially in this poor economy.
I always worry when a single case is put forth as a typical example of a problem. I do not doubt this young man could’ve seen some side effects, but I would think that this is a very rare example if it is true. I do doubt the long term impotence reported, however. Propecia has a half life of 4-5 hours, which means it is out of the blood stream in a day. Tissue fixation of the drug may last for up to a week, but by then, all of the effects of the drug should be gone. Unfortunately, the report gives us little insights into objective evidence for the ED that doctors would explore, such as nocturnal penile tumescence studies, to substantiate if the problem is real or psychological.