Oral minoxidil treatment for hair loss: A review of efficacy and safety

doi:10.1016/j.jaad.2020.06.1009

Journal of the American Academy of Dermatology

Volume 84, Issue 3, March 2021, Pages 737-746

https://doi.org/10.1016/j.jaad.2020.06.1009 Get rights and content

Background

Although topical minoxidil is an effective treatment option for hair loss, many patients are poorly compliant because of the necessity to apply the medication twice a day, undesirable hair texture, and scalp irritation.

Objective

In recent years, oral minoxidil at low dose has been proposed as a safe alternative. This study reviewed articles in which oral minoxidil was used to treat hair loss to determine its efficacy and safety as an alternative to topical minoxidil.

Methods

PubMed searches were performed to identify articles discussing oral minoxidil as the primary form of treatment for hair loss published up to April 2020.

Results

A total of 17 studies with 634 patients were found discussing the use of oral minoxidil as the primary treatment modality for hair loss. Androgenetic alopecia was the most studied condition, but other conditions included telogen effluvium, lichen planopilaris, loose anagen hair syndrome, monilethrix, alopecia areata, and permanent chemotherapy-induced alopecia.

Limitations

Larger randomized studies comparing the efficacy/safety of different doses with standardized objective measurements will be needed to clarify the best treatment protocol.

Conclusion

Oral minoxidil was found to be an effective and well-tolerated treatment alternative for healthy patients having difficulty with topical formulations.

Section snippets

Methods

Key word searches of PubMed were performed to identify all articles discussing OM treatment of hair loss until April 2020. Search terms included “oral minoxidil,” “hair loss,” “systemic minoxidil,” and “alopecia.” No language or time restrictions were used. Articles found were read and reviewed; they were judged appropriate for inclusion if they described treatment of hair loss primarily with OM. The references of these articles were reviewed to identify additional resources.

Efficacy

A total of 17 studies with 634 patients were found discussing the use of OM as the primary treatment modality for hair loss (Table I). AGA was the most studied condition. In general, OM was found to be an effective treatment for AGA. In the largest study, Rodrigues-Barata et al²⁰ determined a mean dose of 1 mg of OM in 148 women to be an effective form of treatment for female pattern hair loss (FPHL). Response to therapy was more significant in patients with more advanced stages of FPHL.

Discussion

Introduced in the 1970s, OM was originally intended for the treatment of severe refractory hypertension. Hypertrichosis was quickly noted as a frequent side effect, and a topical option was created to provide the hair growth benefits of minoxidil while circumventing the unwanted, and occasionally severe, adverse effects of OM. However, the topical preparation is not without limitations, because patient compliance is frequently low.

This review found that OM has promising results as an effective

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Hair loss disorder (alopecia) affects numerous people around the world. The low effectiveness and numerous side effects of common treatments have prompted researchers to investigate alternative and effective solutions. Hair follicle (HF) bioengineering is the knowledge of using hair-inductive (trichogenic) cells. Most bioengineering-based approaches focus on regenerating folliculogenesis through manipulation of regulators of physical/molecular properties in the HF niche. Despite the high potential of cell therapy, no cell product has been produced for effective treatment in the field of hair regeneration. This problem shows the challenges in the functionality of cultured human hair cells. To achieve this goal, research and development of new and practical approaches, technologies and biomaterials are needed. Based on recent advances in the field, this review evaluates emerging HF bioengineering strategies and the future prospects for the field of tissue engineering and successful HF regeneration.
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: Funding sources: None.

: Disclosure: Dr Tosti has served as a consultant or advisor for DS Laboratories, Monat Global, Almirall, Thirty Madison, Lilly, Leo Pharmaceuticals, Bristol Myers Squibb, and Procter & Gamble. Author Randolph has no conflicts of interest to delcare.

: IRB approval status: Not applicable.

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ReviewOral minoxidil treatment for hair loss: A review of efficacy and safety

Background

Objective

Methods

Results

Limitations

Conclusion

Section snippets

Methods

Efficacy

Discussion

J Invest Dermatol

J Am Acad Dermatol

J Am Acad Dermatol

J Invest Dermatol

Clin Dermatol

J Am Acad Dermatol

J Am Acad Dermatol

Am J Cardiol

J Am Acad Dermatol

J Am Acad Dermatol

J Am Acad Dermatol

J Am Acad Dermatol

JAAD Case Rep

Mechanism of action of minoxidil sulfate-induced vasodilation: a role for increased K+ permeability

J Pharmacol Exp Ther

Reversal of baldness in patient receiving minoxidil for hypertension

N Engl J Med

Dose-response study of topical minoxidil in male pattern alopecia

J Am Acad Dermatol

Long-term treatment with minoxidil in patients with severe renal failure

J Cardiovasc Pharmacol

Novel enzymatic assay predicts minoxidil response in the treatment of androgenetic alopecia

Dermatol Ther

Review
Oral minoxidil treatment for hair loss: A review of efficacy and safety