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Who can use Dr Fox Hair Growth Spray

• Adults (aged 18+).
• Assigned male at birth.
• Affected by male 'pattern' hair loss.
• Read the warning and cautions before using.

How to use Dr Fox Hair Growth Spray

• Wash and dry your scalp.
• Apply 12 pumps of product (equivalent to 2ml) to the scalp daily (suggest at night time).
• Allow the product to dry before applying any hair styling product.
• Product does NOT need rubbing in - this will risk absorption by the skin of your hands.
• Wash your hands thoroughly after applying.

Most beneficial stages of hair loss to use the Hair Growth Spray

When the spray is started early enough in the hair loss process and is used continually, hair thinning/excess hair loss can be prevented. The treatment works best at the mild-to moderate stages of hair loss: stages 2-5 of the Hamilton-Norwood scale (see illustration below).

When can I expect to see results?

Hair on the scalp grows at approximately 1cm per month. Thicker, longer, hair with greater scalp coverage, may be seen as early as 3 months with daily use. Excess hair loss has usually stopped after 6 months of daily use and changes are more obvious, with maximum benefit by 1-2 years.

In the unlikely event your hair loss continues beyond 12 months treatment, with no notable increase in hair thickness or coverage, you are likely to be a non-responder and it is unlikely you will benefit from continuing treatment.

Once improved hair coverage has been achieved, continued treatment is required to maintain the benefits. If treatment is stopped, pre-treatment appearance will likely return within 3 to 6 months.

How Dr Fox Hair Growth Spray works

In the average adult male approximately 10% of the male sex hormone testosterone is converted to the more potent hormone Dihydrotestosterone (DHT). DHT is responsible for adult male characteristics including male hair thinning and hair loss. DHT affects hair follicles in a way that prevents hairs from reaching their full growth potential.

For more information see Dihydrotestosterone (Society for Endocrinology).

The active ingredients in the Dr Fox Hair Growth Spray work to reverse hair thinning and hair loss using a combination of the following treatments:

Finasteride

Finasteride reduces the conversion of testosterone to DHT, therefore less DHT reaches hair follicles and hair is allowed to reach its full growth potential.

For more information see Common questions about finasteride (NHS).

Finasteride can be taken in tablet form (orally), but more recently treatments applied directly to the scalp (topical) have had promising results in clinical trials.

A significant benefit of topical compared with oral treatment, is the reduced risk of side effects (e.g. sexual dysfunction). Topical finasteride is not yet licensed to treat male pattern hair growth, but is a safe and effective alternative to oral treatment and is available on private prescription.

Minoxidil

Minoxidil relaxes small blood vessels where it is applied to the scalp, increasing blood flow to hair follicles. Blood carries essential oxygen and nutrients which stimulate new hair growth, encouraging thicker, longer, more visible hair. Minoxidil has been proven to stimulate hair regrowth, likely by enhancing cell multiplication.

Topical minoxidil is already licensed to treat male pattern hair loss (e.g. as Regaine).

Tretinoin

Tretinoin is a vitamin-A derivative that promotes hair growth indirectly by increasing minoxidil uptake. Minoxidil spray alone is best used twice daily, but combined with tretinoin allows minoxidil to be used once daily with equivalent results in clinical trials.

DO NOT use Dr Fox Hair Growth Spray if you:

• Were assigned female at birth - to date finasteride does not have an adequate safety profile for use by patients where there is ANY risk of pregnancy, as finasteride may affect development of the baby's genitals.
• Are less than 18 years of age.
• Have an allergy or hypersensitivity to finasteride, minoxidil, or tretinoin.
• Are susceptible to severe scalp infections or psoriasis.
• May have hair loss due to a cause other than hereditary 'pattern' hair loss, e.g. chemotherapy, total alopecia (hair loss over the entire body). If you are unsure you should consult your GP.

Cautions for use of Dr Fox Hair Growth Spray

• Keep away from children and animals. If swallowed, minoxidil can lead to heart toxicity.
• Pregnant women and women with childbearing potential should avoid handling as finasteride may affect development of a baby's genitals.
• Avoid exposure to UV light (sunlight) as tretinoin can make the skin more likely to burn.
• Do not use more than the recommended dose - treatment will not be more effective and the risk of side effects will increase.
• If treatment is stopped the beneficial effects will likely reverse within 6 months.

Do not apply the spray if:

• Your skin is broken, infected, shaved, sunburned, or inflamed, e.g. scalp eczema.
• You are having medical treatment for another condition which can cause photosensitivity (skin is more sensitive to the sun).
• Using scalp dressings or bandages.

Consult your GP before using if you:

• Have heart disease, treated or untreated high or low blood pressure (cautions for minoxidil 5%).
• Have a history of urinary obstruction, or difficulty passing urine, this may be caused by an enlarged prostate gland (caution for finasteride).
• Develop male breast changes - lumps, pain, enlargement or nipple discharge, as these may indicate underlying breast cancer (caution for finasteride).
• Develop male breast tissue growth (gynecomastia). This is an uncommon side effect of finasteride (usually in higher doses in tablet form) and early management increases the likelihood of complete reversal.
• Have a PSA (prostate specific antigen) blood test. Topical finasteride may alter the test results.

Possible side effects of Dr Fox Hair Growth Spray

Side effects are much less likely when using topical rather than tablet form (oral) medication as active ingredients are delivered directly to the skin with little entering into the bloodstream.

Most common side effects

Temporary increase in hair loss over the first 2-6 weeks of treatment is NORMAL and to be expected. This is likely due to hairs moving from the Resting phase to the Growth phase of the hair growth cycle.

Skin irritation (itching, dryness, redness) at the application site is most likely due to the alcohol base, but may be due to minoxidil or tretinoin. Irritation usually settles with continued use - regular washing and moisturising is also beneficial. If you develop bothersome skin redness, rash, or other irritation, stop treatment. If irritation is severe or does not improve after stopping treatment, you should seek advice from a pharmacist or your GP.

Uncommon side effects

• Feeling dizzy or faint when first starting treatment. This is likely due to the blood pressure-lowering action of minoxidil and usually subsides after short-term use. Applying treatment before bed can minimise these symptoms.
• A small amount of weight gain and or swollen feet may occur due to minoxidil causing blood vessels to dilate.
• Male breast tissue growth (gynecomastia). This is an uncommon side effect of finasteride (usually in higher doses in tablet form).
• Nausea.
• A change in mood.
• Unwanted hair growth in areas treated accidentally. Reversible over 3-6 months once product ceases to have contact with the area of skin.

Stop treatment and seek advice from your GP if you experience:

• Bothersome dizziness or feeling faint which persists after stopping treatment.
• More rapid weight gain, or weight gain associated with breathlessness.
• Persistent, bothersome nausea.
• Low mood, depression or feeling depressed (feelings of sadness and unworthiness).

Rare side effects

Please stop treatment and seek advice from your GP urgently if you experience:

• Chest pain and or palpitations (an uncomfortable awareness of your heart beating in your chest).
• Severe depression/suicidal thoughts.
• An allergic reaction: swelling of the lips, face, tongue, or throat; breathing difficulties or difficulty swallowing.

Possible sexual side effects

Sexual side effects are much less likely when using topical rather than tablet (oral) treatment. The following are therefore possible but unlikely:

• Reduced male fertility - advise stop treatment 3 months prior to planned conception.
• Reduced libido and erectile dysfunction.

Frequency unknown

If you develop any of the following symptoms and are concerned, discuss with your doctor or pharmacist.

• Eye irritation.
• Vomiting.
• Pain in the testicles.
• Anxiety.

Reporting side effects

Worrying or unwanted side effects should be reported via the MHRA Yellow Card scheme, also available via their app which can be downloaded from Apple App Store or Google Play Store.

Please keep your regular GP informed. You can also contact Dr Fox doctors if you need medical advice about the product.

Alternative hair loss treatments

Oral finasteride 1mg tablets and minoxidil only topical applications are also available from Dr Fox. These should not be used at the same time as the Dr Fox Hair Growth Spray.

Microneedling, hair transplants, platelet-rich plasma injections, and low level laser therapy are other alternative hair loss treatments.

Further information

• DermNet: Male pattern hair loss
• British Association of Dermatologists: Male pattern hair loss
• Alopecia UK: Androgenetic Alopecia

The hair growth cycle

Hair growth is a continuous process which can be explained via 4 cycling phases:

1. Anagen (growth) - a single shaft of hair grows from a hair follicle for 2-8 years. Hair length depends upon the length of this phase (unless the hair is cut).
2. Catagen (regression) - over 1-2 weeks, the supporting hair follicle regresess and detaches from the hair. The hair however remains in place, secured by a small white bulb of keratin.
3. Telogen (resting) - the old hair rests for 2-3 months. while the old hair is resting, a new hair develops at the base of the hair follicle (the start of anagen for the new hair).
4. Exogen/Anogen restart (shedding) - as the new hair grows, it pushes the old hair out. On the diagram above, exogen occurs between anagen restart and anagen.

For individuals not experiencing hair loss, it is normal to shed over 100 scalp hairs per day!

• If the anagen/growth phase moves into the catagen/regression phase prematurely, excess hair shedding and thinning occurs. This is characteristic of male pattern hair loss.
• If the percentage of hair follicles remaining in the telogen/resting phase is increased, hair loss decreases.

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