Efficacy Of Topical Minoxidil Research Articles

The Use of Trichoscopy to Assess the Efficacy of Topical Minoxidil 2% Solution in Patients with Female Pattern Hair Loss

The Use of Trichoscopy to Assess the Efficacy of Topical Minoxidil 2% Solution in Patients with Female Pattern Hair Loss

The efficacy of topical minoxidil 2% versus topical botanically derived inhibitors of 5 alpha reductase in treatment of female pattern hair loss by trichoscopy

Background Female pattern hair loss (FPHL) is a distressing common problem. Minoxidil is the only FDA approved medical treatment for FPHL. However, the off-label botanically derived 5-alpha reductase inhibitors (5αRIs) are commonly used despite insufficient studies. Objective To determine the effectiveness of topical botanically 5αRIs in treating FPHL, by comparing its results with topical minoxidil 2%. Patients and methods This study included 40 females with FPHL. Group 1 received topical minoxidil 2% and group 2 received topical botanically 5αRIs. Patients were clinically assessed via Savin scale; to compare between weeks 0 and 36. Change in hair diameter and count in the target site were trichoscopically assessed at weeks 0, 16, and 36. Side effects of both drugs were recorded. Results Minoxidil was effective in all disease stages, while 5αRIs were effective in early disease onset and moderate cases. Both drugs produced a significant rise in hair count and diameter, however; minoxidil had the superiority regarding the mean increase of hair diameter. Side effects of minoxidil were more troublesome. Conclusion Minoxidil is recommended as a first line of therapy for patients with FPHL who want a treatment with affordable price and could tolerate its side effects. Furthermore, it is advised to shift to topical botanical 5αRIs as a second line therapy, in cases that were nontolerant to minoxidil due to its fewer side effects. Likewise, the use of trichoscopy for therapeutic follow up is strongly recommended.

Low-dose daily aspirin reduces topical minoxidil efficacy in androgenetic alopecia patients.

Topical minoxidil is the only US FDA approved OTC drug for the treatment of androgenetic alopecia (AGA). Minoxidil is a pro-drug converted into its active form, minoxidil sulfate, by the sulfotransferase enzymes in the outer root sheath of hair follicles. Previously, we demonstrated that sulfotransferase activity in hair follicles predicts response to topical minoxidil in the treatment of AGA. In the human liver, sulfotransferase activity is significantly inhibited by salicylic acid. Low-dose OTC aspirin (75-81 mg), a derivative of salicylic acid, is used by millions of people daily for the prevention of coronary heart disease and cancer. It is not known whether oral aspirin inhibits sulfotransferase activity in hair follicles, potentially affecting minoxidil response in AGA patients. In the present study, we determined the follicular sulfotransferase enzymatic activity following 14 days of oral aspirin administration. In our cohort of 24 subjects, 50% were initially predicted to be responders to minoxidil. However, following 14 days of aspirin administration, only 27% of the subjects were predicted to respond to topical minoxidil. To the best of our knowledge, this is the first study to report the effect of low-dose daily aspirin use on the efficacy of topical minoxidil.

Alopecia and the Aging Male

Alopecia and the Aging Male

Safety and efficacy of topical minoxidil in the management of androgenetic alopecia

Of 149 subjects with androgenetic alopecia, 102 completed 1 year of a double-blind, randomized study comparing 2% minoxidil and 3% minoxidil solutions for safety and efficacy. One third of the subjects used a vehicle placebo for the first 4 months and then switched to 3% minoxidil. At 12 months the 2% minoxidil group switched to a 3% solution. During months 5 to 12 a steady increase in terminal hair counts occurred to an equal degree within the 2% and 3% minoxidil groups and the 3% treatment group switched from placebo. Total hair counts at 12 months increased from a baseline mean of 63.5 to 180.6 in the 2% treatment group, from 61.0 to 179.9 in the 3% group, and from 65.0 to 191.1 in the placebo to 3% crossover group. Although all 102 subjects completing 12 months of the study thought that visible hair growth had resulted, 89 were considered by the investigators to have visible growth. Dense hair growth, defined as hair long enough to cut or comb, was present in 48 subjects by their own evaluation and in 33 subjects by investigator evaluation. There were no serious side effects. Two instances of allergic contact dermatitis and four of pruritus were attributed to use of the drug. Two individuals complained of impotence, which disappeared within a few days of discontinuation of topical minoxidil. This effect has not been reported during the use of minoxidil in its oral form (Loniten) for the treatment of hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

Use of topical minoxidil in the treatment of male pattern baldness

This 12-month, double-blind, randomized study evaluated the safety and efficacy of topical minoxidil in the treatment of male pattern baldness. Three formulations were compared: 2% minoxidil solution, 3% minoxidil solution, and placebo. After 4 months all placebo patients crossed over to treatment with the 3% solution. Of the 96 patients randomized into the study, 79 were evaluable at month 12; 25 of these were in the 2% minoxidil group, 24 were in the 3% minoxidil group, and 29 were in the placebo-to-3% solution switchover group. At monthly intervals a hair count was obtained within a 1-inch diameter area on the scalp vertex. In addition, a gross visual estimate of the degree of new hair growth over the entire balding area was made independently by the investigator and the patient. At the end of 4 months there was significant regrowth of nonvellus (terminal and indeterminate) hairs in the patients using the 2% and 3% solutions (p = 0.0001). The mean nonvellus hair count at month 4 was 162.8 in the 2% minoxidil group, 155.4 in the 3% minoxidil group, and 107.1 in the placebo group. The mean increase in the 2% and 3% treatment groups was 58.2 and 48.8, respectively, whereas the mean increase in the placebo group was 4.0. Total hair counts at month 4 demonstrated significantly more growth of hair in the 2% minoxidil group than in the placebo group (p = 0.013), with no significant difference between the 3% minoxidil group and the other two treatment groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Androgenetic alopecia: Treatment results with topical minoxidil

A double-blind 12-month trial was conducted to evaluate the safety and efficacy of topical minoxidil in patients with androgenetic alopecia. During the first 4 months of the study, patients applied a topical solution containing either 2% minoxidil, 3% minoxidil, or placebo to their scalps twice daily. At the end of the fourth month, patients taking placebo were crossed over to treatment with 3% minoxidil solution. Of 60 patients enrolled in the study, 43 were evaluable at month 12. Hairs were counted in a 1-inch target area and classified as vellus, indeterminate, and terminal; the latter two classifications were combined as nonvellus hairs for further statistical analysis. All three groups had significant increases in total, nonvellus, and terminal hair counts between baseline and month 4 and between month 4 and month 12. At month 4 the average total hair counts increased from a baseline mean of 158.2 to 270.2 in the 2% minoxidil group, from 156.6 to 287.0 in the 3% minoxidil group, and from 162.6 to 246.9 in the placebo group. At month 12 the means were 415.6, 448.5, and 471.1 in the 2% minoxidil, 3% minoxidil, and placebo-3% minoxidil crossover subjects, respectively. The increases from month 4 to month 12 were highly significant for each group (p = 0.0001). Average increases in nonvellus hair counts between months 4 and 12 were 216, 181, and 264 in the 2% minoxidil, 3% minoxidil, and placebo-to-3% minoxidil crossover groups, respectively, all highly significant differences from zero (p = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

2% Topical Minoxidil Solution in Male-Pattern Baldness: Preliminary European Results

A 48-week, double-blind, randomized study was conducted in France, West Germany and the UK to compare the safety and efficacy of topical minoxidil 2% (Regaine; registered trade mark of the Upjohn Company) solution with placebo in the treatment of early male-pattern baldness. At week 24, the end of the placebo period, there were 225 evaluable patients, 116 in the treatment group and 109 in the placebo group. The 2% minoxidil group showed superiority to the placebo group with respect to the following parameters at week 24: (1) non-vellus hair counts (p = 0.0084); (2) changes in non-vellus hair counts compared with baseline values (p = 0.0227), and (3) investigators' evaluations of hair growth (p = 0.019). There was no significant difference between minoxidil and placebo treatment with regard to blood pressure, pulse or weight changes. No serious side effects were reported during the study. The greatest number of medical events were dermatological in nature and mainly local and mild in intensity. From week 24 to week 48 all patients received active medication and showed further hair growth. At week 48 the investigators evaluated the new hair growth as moderate or dense in 32.7% of the patients. Our conclusion confirms previous reported studies according to which topical minoxidil seems to offer a safe and efficacious treatment for early male-pattern baldness in some patients. Further studies need to be done to characterize the most likely responders.

Topical Minoxidil Lacks Efficacy in Alopecia Areata

To the Editor.— Since the original report by Weiss et al 1 there have been several enthusiastic reports on the efficacy of topical minoxidil in the treatment of alopecia areata. 2-4 This trend was continued in the follow-up study by Weiss et al 5 on their preliminary report. We have studied the effects of 3% minoxidil solution on 15 patients with alopecia totalis in a double-blind cross-over trial. The duration of alopecia ranged from 1.5 to 40 years (median, 17.7 years); all patients had previously been treated unsuccessfully with topical or injected steroids, some had had treatment with oral steroids, and others sensitization with dinitrochlorobenzene and psoralens and UV-A treatment. There were ten women and five men, and their ages ranged from 18 to 67 years (median, 39.9 years). The patients were randomly allocated to receive active treatment or placebo. The scalp was treated twice daily for 16 weeks, after