Low-dose Oral Minoxidil Research Articles

Survey of Dermatology Practitioners' Opinions and Prescribing Habits of Oral Minoxidil for the Treatment of Androgenetic Alopecia.

Utilization of low-dose oral minoxidil has increased in recent years in association with several clinical studies that have shown its efficacy in treating androgenetic alopecia (AGA).  Objective: To assess dermatology providers' attitudes and recommendation behaviors of oral minoxidil for the treatment of AGA. An online survey gauging the professional opinions, prescribing behaviors, and use of oral minoxidil was sent using the Orlando Dermatology Aesthetic and Clinical Conference email listserv which included multiple levels of dermatology practitioners including MD/DOs, NPs, and PAs across the United States. Overall, the survey was sent to 2200 providers, and 201 (9.1%) responses were collected. 81% (n=139) of respondents supported the use of oral minoxidil for AGA. Support varied significantly (P=.03) by providers' number of years in practice with those in practice for greater than 30 years with the least amount of support. 92% of respondents (130, n=141) reported feeling comfortable prescribing oral minoxidil, and 83% (116, n=140) found oral minoxidil to be better than its topical formulation. 78% (108, n=139) felt their patients were satisfied with their results, and 89% (124, n=140) felt oral minoxidil was well tolerated by their patients. This study found that most prescribers use oral minoxidil as a treatment for AGA and find it to be an effective and tolerable option for patients. Support for oral minoxidil was significantly impacted by providers' years in practice. J Drugs Dermatol. 2024;23(3): doi:10.36849/JDD.7519.

Role of oral minoxidil in the treatment of androgenetic alopecia

Patterned hair loss is the most common cause of alopecia, typically presenting with progressive thinning, miniaturization, and loss of hair at classical topography depending on the sex of the patient. In the 1970s, Minoxidil was used to treat severe refractory hypertension due to its vasodilator properties. It became popular after its coincidental finding on the promotion of hair growth and stimulation of new hair production. In 1988, the Food and Drug Administration approved topical minoxidil (TM) 2% for the treatment of male androgenetic alopecia and in 1992, for female pattern hair loss. It is also used as an off-label treatment for other hair loss conditions such as telogen effluvium and alopecia areata. However, there are frequent reports of TM-induced contact dermatitis and its reversible effect, which has reduced compliance in the patients and resulted in a poor outcome. Hence, they have studied using low-dose oral minoxidil (LDOM), which showed good efficacy and safety profile in the treatment of patterned hair loss along with avoidance of high-risk adverse cardiac effects that resulted due to doses used for hypertension. The added advantages of LDOM over topical formulation are good compliance, cost savings, effective in people with low hair follicle sulfotransferase activity, and the possibility of cotherapy with other topical or oral medications.

Minoxidil oral en alopecias no androgénicas

For several years minoxidil has been used in medicine and trichology. Its mechanism of action remains unclear, it prolongs anagen, modulates angiogenesis and increases hair shaft thickness. New research suggests an antiandrogenic and immunomodulatory role. Low-dose oral minoxidil has proven to be an alternative for alopecia. The optimal dose for this purpose has not been established, it is probably different for children, women and men. Androgenic alopecia has been the most widely studied condition, there are other pathologies such as telogen effluvium, traction alopecia, alopecia areata, chemotherapy-induced alopecia, loose anagen hair syndrome, monilethrix, and scarring alopecia (fibrosing frontal alopecia and lichen planus pilaris). This literature review aims to expose the mechanism of action, pharmacokinetics, safety and efficacy of oral minoxidil in different types of non-androgenic alopecia.

Artíulo traducido] Seguridad de minoxidil oral a dosis bajas en pacientes con hipertensión o arritmias: estudio multicéntrico de 264 pacientes

Background and objectiveSystemic adverse effects (AE) are a major concern of low-dose oral minoxidil (LDOM) treatment, especially in patients with arterial hypertension or arrhythmia. The objective of this study was to evaluate the safety of LDOM in patients with hypertension or arrhythmia. Patients and methodsRetrospective multicenter study of patients with hypertension or arrhythmia treated with LDOM for any type of alopecia. ResultsA total of 254 patients with hypertension [176 women (69.3%) and 78 men (30.7%)] with a mean age of 56.9 years (range 19–82) were included. From them, the dose of LDOM was titrated in 128 patients, allowing the analysis of 382 doses. Patients were receiving a mean of 1.45 (range 0–5) antihypertensive drugs. Systemic AE were detected in 26 cases (6.8%) and included lightheadedness (3.1%), fluid retention (2.6%), general malaise (0.8%), tachycardia (0.8%) and headache (0.5%), leading to LDOM discontinuation in 6 cases (1.5%). Prior treatment with doxazosin (P<0.001), or with three or more antihypertensive drugs (P=0.012) was associated with a higher risk of discontinuation of LDOM. ConclusionsLDOM treatment showed a favorable safety profile in patients with hypertension or arrhythmia, similar to general population.

Low-dose oral minoxidil for androgenetic alopecia is not associated with clinically significant blood-pressure changes: A retrospective study

Low-dose oral minoxidil for androgenetic alopecia is not associated with clinically significant blood-pressure changes: A retrospective study

Low dose oral minoxidil and the conundrum of cardiovascular complications.

In recent months, the general public has become more cognizant of the potential of oral minoxidil to promote hair growth; this was promulgated, in part, by an article published in the New York Times entitled, "An Old Medicine Grows New Hair for Pennies a Day, Doctors Say." Minoxidil was added to the pharmacologic armamentarium as an antihypertensive nearly 60 years ago and was found to trigger hypertrichosis in many patients, but its use dropped sharply as cardiologists observed a number of adverse cardiovascular events including ischemic heart disease, left ventricular hypertrophy, pleural effusions, and pericardial effusions. Studies in the realm of dermatology have explored the utility and safety of low dose oral minoxidil (LDOM) for management of alopecia. This article highlights potential clinical conundrums posed by these rare but severe cardiovascular complications and the importance of collaboration between cardiologists and dermatologists when employing this agent in patients with cardiorenal or cardiovascular risk factors.

42482 Low dose oral minoxidil as monotherapy in patients with hair loss

42482 Low dose oral minoxidil as monotherapy in patients with hair loss

Safety of Low-Dose Oral Minoxidil in Patients With Hypertension and Arrhythmia: A Multicenter Study of 264 Patients

Background and objectiveSystemic adverse effects (AE) are a major concern of low-dose oral minoxidil (LDOM) treatment, especially in patients with arterial hypertension or arrhythmia. The objective of this study was to evaluate the safety of LDOM in patients with hypertension or arrhythmia. Patients and methodsRetrospective multicenter study of patients with hypertension or arrhythmia treated with LDOM for any type of alopecia. ResultsA total of 254 patients with hypertension [176 women (69.3%) and 78 men (30.7%)] with a mean age of 56.9 years (range 19–82) were included. From them, the dose of LDOM was titrated in 128 patients, allowing the analysis of 382 doses. Patients were receiving a mean of 1.45 (range 0–5) antihypertensive drugs. Systemic AE were detected in 26 cases (6.8%) and included lightheadedness (3.1%), fluid retention (2.6%), general malaise (0.8%), tachycardia (0.8%) and headache (0.5%), leading to LDOM discontinuation in 6 cases (1.5%). Prior treatment with doxazosin (P<0.001), or with three or more antihypertensive drugs (P=0.012) was associated with a higher risk of discontinuation of LDOM. ConclusionsLDOM treatment showed a favorable safety profile in patients with hypertension or arrhythmia, similar to general population.

JAAD Game Changer: Safety of low-dose oral minoxidil for hair loss: A multicenter study of 1404 patients

JAAD Game Changer: Safety of low-dose oral minoxidil for hair loss: A multicenter study of 1404 patients

Safety and tolerability of low dose oral minoxidil monotherapy in female pattern hair loss: A retrospective review with longitudinal ambulatory blood pressure monitoring

Safety and tolerability of low dose oral minoxidil monotherapy in female pattern hair loss: A retrospective review with longitudinal ambulatory blood pressure monitoring

Low-dose Oral Minoxidil in the Treatment of Alopecia: Evidence and Experience-based Consensus Statement of Indian Experts.

Alopecia is a highly prevalent condition worldwide including in India. There are different types of alopecia with differing etiology, presentation, and hence treatment. Androgenetic alopecia represents the most common form of hair loss affecting male as well as female population termed as male and female pattern hair loss, respectively. Several treatment options are available for the treatment of alopecia with often unsatisfactory results resulting in psychological distress among such patients. Topical minoxidil is known to be effective in the treatment of alopecia. However, oral minoxidil is not currently approved for the treatment of alopecia. This expert consensus is prepared to provide guidance to the clinicians regarding the use of oral minoxidil in the treatment of alopecia. Extensive literature review was performed to prepare the draft consensus which was then revised based on the suggestions and comments from the experts. The final draft was circulated to the experts for review and approval. This consensus document provides overview of evidence related to oral minoxidil and consensus from the experts for its use in the treatment of minoxidil.

Low-dose oral minoxidil improves hair density in traction alopecia

Low-dose oral minoxidil improves hair density in traction alopecia

Trichorrhexis nodosa improving with oral minoxidil: a case report.

Trichorrhexis nodosa is a condition of hair fragility. We present the case of a patient diagnosed with trichorrhexis nodosa that improved with a novel treatment; low-dose oral minoxidil.

Efficacy of low-dose oral minoxidil in the management of anticancer therapy-induced alopecia in patients with breast cancer: A retrospective cohort study

Efficacy of low-dose oral minoxidil in the management of anticancer therapy-induced alopecia in patients with breast cancer: A retrospective cohort study

Systemic minoxidil for hair disorders in pediatric patients: a safety and tolerability review.

Topical minoxidil has been used for many years to treat adult alopecia, and there is growing evidence supporting the off-label use of low-dose oral minoxidil (LDOM). However, there is little data on its use in pediatrics, and there are no recommended treatment guidelines. Adverse events are of particular concern in this population. We retrospectively reviewed the medical records of 63 patients aged between 0 and 12 years from a specialist hair clinic who were treated with LDOM or sublingual minoxidil (SM) to evaluate its safety and tolerability. LDOM and SM were generally well-tolerated, with mild hypertrichosis being the most commonly reported adverse event. Further large-scale studies are warranted to determine the efficacy and optimum dosage of systemic minoxidil for alopecia in the pediatric population.

Safety and tolerability of low-dose oral minoxidil in adolescents: A retrospective review

To the Editor: Low-dose oral minoxidil (LDOM) has been used “off-label” to treat hair loss in adult male and female patients.1,2 However, data on its use in the adolescent population are limited, and there are no pediatric guidelines for prescribing LDOM.3 The objective of our study was to evaluate the safety and tolerability of low-dose systemic minoxidil in the adolescent population.

There Is a Positive Dose-Dependent Association between Low-Dose Oral Minoxidil and Its Efficacy for Androgenetic Alopecia: Findings from a Systematic Review with Meta-Regression Analyses

Background: Recently, low-dose oral minoxidil (LDOM) has entered the landscape of therapies for androgenetic alopecia (AGA). We determined whether using LDOM is associated with improving AGA in a dose-dependent manner; secondarily, we examined whether a dose-dependent association also exists for safety. Methods: Systematic searches were conducted in PubMed and Scopus to identify studies that would be eligible for our quantitative analyses; the logistics of our analyses was determined by the data we gathered. Results: Six studies were eligible for quantitative analyses; we conducted meta-regressions. We found that, for persons with AGA, increasing the dosage of LDOM by 1 mg/day was – after six months – significantly associated with an expected sex-adjusted increase in hair diameter (mean difference = 1.4 μm, p = 0.01), total hair density (mean difference = 47.1 hairs/cm², p = 0.007), terminal hair density (mean difference = 9.1 hairs/cm², p = 0.001), risk of hypertrichosis (mean difference = 17.9%, p = 0.006), and cardiovascular adverse events (mean difference = 4.8%, p = 0.004). Conclusions: Our study produced new evidence as our work is the first to show a positive dose-dependent association between the use of LDOM and change in hair diameter, hair density, risk of hypertrichosis, and cardiovascular adverse events for persons with AGA. Future randomized trials could produce causal evidence that would corroborate these dose-dependent associations.

Prospective cardiovascular evaluation with 24-hour Holter and 24-hour ambulatory blood pressure monitoring in men using 5-mg oral minoxidil for androgenetic alopecia

To the Editor: Low-dose oral minoxidil (LDOM; 0.25-5 mg/d) is an effective treatment for androgenetic alopecia.1,2 However, even at low doses, minoxidil has been associated with electrocardiogram alterations (premature ventricular contractions and T-wave inversion) and palpitations.3,4

Research Highlights

ABSTRACT This series of research highlights discusses recent studies on potassium monitoring of young healthy women treated for acne with spironolactone, adverse effects of low-dose oral minoxidil, and issues in transgender dermatology.

Low-dose oral minoxidil for treatment of androgenetic alopecia and telogen effluvium in a pediatric population: A descriptive study

Low-dose oral minoxidil for treatment of androgenetic alopecia and telogen effluvium in a pediatric population: A descriptive study