Oral Minoxidil Possibly Effective for Male Androgenetic Alopecia

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Investigators observed that once-daily 5-mg oral minoxidil may effectively and safely treat male androgenetic alopecia.

Once-daily 5-mg oral minoxidil may be an effective and safe treatment option for male androgenetic alopecia, according to study results published in the Journal of the American Academy of Dermatology.

Male patients with male androgenetic alopecia who were receiving oral minoxidil monotherapy or minoxidil as an add-on therapy were included in the retrospective study (n=41; mean age, 33.3 [range, 20-55] years). For ≥6 months, patients were treated with minoxidil at a dose of either 2.5 mg/d or 5 mg/d. Dermatologists with expertise in hair disorders assessed pretreatment and post-treatment clinical images to identify changes in hair loss. A 4-point scale was used to assess these changes (worsening, stabilization, mild improvement, or marked improvement). A ≥1 grade improvement on the Norwood-Hamilton scale was considered a marked improvement.

A total of 25 patients (61%) had been previously treated with other therapies (median, 18 [range, 12 to 48] months), including oral dutasteride (n=18), mesotherapy with dutasteride (n=9), oral finasteride (n=3), topical minoxidil (n=2), and topical finasteride (n=1). The majority of patients (90.2%) experienced clinical improvement, with 26.8% of these patients demonstrating a marked improvement. Of the 4 patients who achieved stabilization, none worsened. Almost one-third of patients (29.3%) experienced mild adverse effects during treatment, including hypertrichosis (24.3%), lower limb edema (4.8%), and shedding (2.4%).

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Study limitations include the retrospective design, lack of a randomized control group, and the small sample size.

Although the study’s findings are promising, the researchers concluded that “the optimum dose [of minoxidil] needs to be delineated in future controlled studies.”

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Jimenez-Cauhe J, Saceda-Corralo D, Rodrigues-Barata R, et al. Effectiveness and safety of low-dose oral minoxidil in male androgenetic alopecia [published online May 2, 2019]. J Am Acad Dermatol. doi:10.1016/j.jaad.2019.04.054