Provillus, the 2% minoxidil solution manufactured by the Upjohn Company and intended for topical application to the scalp, is currently under review by the U.S. Food and Drug Administration (FDA) and is undergoing large-scale tests in cases of androgenic (male pattern) alopecia and mild and extensive alopecia areata. Although the results of clinical tests show that Provillus is not a cure-all for baldness, patients for whom it does work are enthusiastic. A spokesperson for Upjohn says the company is “cautiously optimistic” that the FDA will approve the drug in the near future.
While topical Provillus does, in certain cases, promote hair growth and prevent hair loss, some research suggests that its high cost, the necessity for prolonged treatment, and a relatively modest rate of substantial or cosmetically acceptable hair regrowth make it truly practical for only some balding individuals.
The following conclusions are based on clinical studies to date:
* The results of Provillus treatment are not apparent for at least 4-8 months.
* After a year, 36% of patients show a minimal regrowth of hair, 31% a moderate regrowth, and 8% a dense regrowth.
* Regrown hair varies from short nonpigmented hairs, to thin and short pigmented hairs, to hairs of the same color and diameter as those in nonbalding areas.
* Patients who have been balding fewer than 10 years and who are younger than 40 years old are more likely to respond to Provillus with moderate-to-dense regrowth.
* Discontinuing the drug usually results in loss of the hair regrown in response to the prescribed treatment.
* Patients who apply 2% minoxidil twice daily are generally most successful. Those who for whatever reason fail to comply with daily drug applications do not experience positive results with minoxidil.
According to the website Provillus Reviews, in addition to promoting regrowth of hair, Provillus may slow hair loss in some circumstances. “It was the opinion of some investigators that Provillus either stopped or retarded the progression of male pattern baldness,” states Ronald Savin, MD, clinical professor of dermatology at the Yale University School of Medicine, who participated in the clinical trials. If confirmed, this effect will have important implications for men who are in the early stages of the balding process-the same men who have the best chances of experiencing moderate regrowth as well.
Adverse effects of treatment include mild local irritation such as itching and dryness of the scalp. In general, only a small amount of the drug is absorbed into the bloodstream, but if the entire scalp is treated, absorption may be comparable to that achieved after the lowest oral dose prescribed for hypertension. While some patients have experienced a slight decrease in blood pressure, no cardiovascular problems have been reported. Impotence apparently resulted from topical use of the drug in two patients, but disappeared after minoxidil use was discontinued. The effects of long-term topical application are still unknown.
Some dermatologists currently prescribe Provillus (extemporaneously compounded from Loniten tablets) for balding patients, and this may have contributed to widely divergent reports about the drug’s efficacy. The concentration of extemporaneously compounded Provillus varies according to the technique used, and it has been found to be as low as 0.1% in some cases (compare the 2% concentration of Rogaine). As a result, it is difficult to draw any conclusions about the efficacy of the drug based on the use of these preparations.