High strength Minoxidil (the active ingredient in Rogaine) formulas have become the latest rage in the last couple of months following the release of two different formulas from two of the main suppliers of custom Minoxidil formulations.  The first to be reviewed is Xandrox 12.5%, formulated and sold by Regrowth, LLC* and Dr. Richard Lee (not to be confused with Regrowth.com, which is not affiliated with Regrowth, LLC).

The latest Xandrox is a white, opaque lotion with the feel and consistency of typical hand/skin lotion.  Xandrox contains 12.5% micronized Minoxidil, which means the Minoxidil has been ground down from it's normal crystals into very fine particles which can be more easily put into higher strength formulas.  Minoxidil's hair regrowth and maintenance has been shown to be dose dependent, meaning the higher the dose of Minoxidil, the better the hair growth.  The high strength Minoxidil formula is intended for use in typically non-responsive hair growth areas, such as at the temples or in the frontal hair line, and is meant to be used sparingly as an addition to the normal 5% formula for normal hairloss areas.

Xandrox also contains 5% Azeleic Acid, which has been shown in some studies to inhibit the formation of Dihydrotestosterone (DHT), the hormone primarily responsible for hairloss.  This may help hair growth and maintain existing hairs by preventing the cause of hairloss.  Many, including Dr. Lee, have suggested that Azeleic Acid can be used as a substitute for DHT inhibitors such as Propecia, the pill by Merck for hairloss.  Regrowth.com still believes that there is not enough testing on Azeleic Acid to risk replacing Propecia or any other effective DHT inhibitor that is working for you.  Regrowth does believe that Azeleic Acid should be a helpful addition to Propecia or other inhibitors and that it should not be harmful to use.  Also, if you are choosing not to use Propecia due to potential side effects, Azeleic Acid may be an appropriate substitute but there is really no guarantee that it will be as effective.

Betamethasone Valerate (BV) is an optional ingredient of Xandrox.  Betamethasone Valerate helps reduce irritation and may help to stimulate initial hair growth.  There is some debate as to whether long term BV use can cause long term problems.  Regular dose long term BV that is absorbed systemically can cause long term health problems as well as skin problems used locally.  According to Dr. Lee, the strength of BV in Xandrox is nowhere near high enough to be absorbed systemically, so it should not cause problems.  Since some people will be concerned anyway, he is offering the formula with or without BV.

Regrowth.com's editor has been testing the formula for almost two months as well as the other high strength formula which will be reviewed shortly.  We have found the lotion to be of high quality.  We have not seen any crystalization or alteration in the formula when kept at room temperature or below.  The lotion must be kept at least at room temperature or lower.  Dr. Lee recommends refrigeration for the formula to last the longest (about 18 months).  At room temperature, the formula will begin degrading in about 4 months according to the doctor.   We placed a small sample of the formula in a dark, enclosed compartment in a car while temperatures inside and outside the car reached as high as the 90s.  The water portion of the lotion separated from the rest and made the sample useless -- you must keep this formula at room temperature or below.  It should also not be exposed to light for too long, but since the bottles are not transparent and use pumps, this should not be a problem unless you leave the cap off.

The formula also contains Benzyl Nicotinate (BN), which is chemically similar to Niacin, to enhance absorption.  The BN can caush flushing (redness in the applied areas) as well as minor tingling or irritation.  These will appear within 5-10 minutes of application.  I experienced both.  The irritation went away within a few minutes and only happened the first few times of use.  The redness did take a little longer to go away, so you should probably apply the lotion at least a half an hour prior to any social activities.

According to Dr. Lee, the lotion is water based and will be absorbed entirely into the skin.  As long as you do not use too much, the lotion will disappear as you rub it onto your skin, which takes about 15-30 seconds.   Although it is not visible on the skin, it can lighten your hair a few shades (not permanently, only while the lotion is in your hair), but this will probably not be noticable to anybody but yourself.  Using the lotion in hairy areas will leave the hair managable after drying and will leave it basically in a similar condition to your normal hair.  The lotion has a very light fragrance smell that you have to get very close to to smell.

Because I have only been using this for about a month and a half, I am not able to review any hair growth possibilities.  I am applying it to my temple areas and frontal hairline along with the other high strength formula available now.  I have many fine, unpigmented vellus hairs there.  It appears that they may be darkening somewhat and lengthening (they are almost a quarter inch now but do not have much pigmentation, so they are not even visible in photographs).   If they darken and lengthen, it can only be attributable to the high strength Minoxidil/Azeleic Acid, so maybe in the future I will have more to report on this.   The area I am applying it to has not had hair for over 10 years (since my early-mid teen years), so if it can grow hair there, it can probably grow hair in anybody.  So far I am hopeful.

Minoxidil 12.5%, Azeleic Acid, and Betamethasone Valerate are all prescription medications that require a doctors authorization for use.   Unfortunately, hairloss is not considered a primary concern for most doctors, even dermatologists, so most doctors are unaware of these formulas because they are relativiely new and it is unlikely that you will find a doctor who will prescribe the treatment.   If you are in California, you can visit Dr. Lee's clinic to obtain a prescription.   He also has an online prescription service to obtain a prescription.  Other web sites run by doctors to obtain online prescriptions for these types of medications are also available and you can probably find out which ones Dr. Lee recommends by emailing them.

We will be following up in the future with surveys and other testimonials concerning the effectiveness of Dr. Lee's as well as other high strength Minoxidil/azeleic acid formulas.  Hopefully if they are effective in stimulating hair growth in difficult areas, we can spread the word to other men suffering from hairloss.

See Also:

• Xandrox 5% Review
• Update Me About Other Product Reviews