Systemic Minoxidil Research Articles

Role of systemic minoxidil in the treatment of alopecia areata: A scoping review to direct future research

Role of systemic minoxidil in the treatment of alopecia areata: A scoping review to direct future research

Literature Review

![Figure][1]</img> John JM, Sinclair RS. Systemic minoxidil for hair disorders in pediatric patients: a safety and tolerability review. Int J Dermatol . 2022 Aug 14. Online ahead of print. In this retrospective case-series study, John and Sinclair examined the safety profile of low-dose oral

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.

Bicalutamide improves minoxidil-induced hypertrichosis in female pattern hair loss: A retrospective review of 35 patients

Bicalutamide improves minoxidil-induced hypertrichosis in female pattern hair loss: A retrospective review of 35 patients

Systemic Minoxidil Accidental Exposure in a Paediatric Population: A Case Series Study of Cutaneous and Systemic Side Effects.

Oral minoxidil is an approved treatment for high blood pressure which is also used as an off-label drug for alopecia. Knowledge about the effects of systemic minoxidil in the paediatric population is limited. A retrospective case series study of paediatric patients with history of systemic minoxidil intake due to contaminated sets of omeprazole was performed to describe side effects of high dose oral minoxidil intake in children. Twenty patients aged between 2 months and 13 years joined the study. They had received high doses of oral minoxidil (mean dose 0.90 mg/kg/day) during a mean time of 38.3 days. Hypertrichosis appeared in 65%, with a mean latency time of 24.31 days. Treatment time was associated with the appearance of hypertrichosis (p < 0.05). Most common initial zone of hypertrichosis was the face. Systemic effects developed in 15%, with no cases of severe disorders. The present study shows a novel insight into the side effects of high doses of oral minoxidil in children.

Treatment-resistant alopecia areata. Response to combination therapy with minoxidil plus anthralin

Combination therapy with 5% minoxidil plus 0.5% anthralin was used to treat 51 patients with severe treatment-resistant alopecia areata. History of a cosmetically inadequate response to one or both drugs used as a single agent was present in 50 of the 51 patients. Therapy was relatively well tolerated except by 1 patient who developed a severe irritant reaction and was dropped from the study. Mild to moderate irritant dermatitis was seen in all remaining patients. Cosmetic response was seen in 5 (11%) of 45 patients who completed the 6-month study. Cosmetic response was maintained in 4 (80%) of 5 patients who continued treatment for as long as 84 weeks. All responders had evidence of hair regrowth by week 12. The rapidity and extent of hair regrowth were greater with combination therapy than with either drug used as a single agent. Serum and 24-hour urinary minoxidil determinations showed enhanced systemic minoxidil absorption, which was probably secondary to the irritant dermatitis in some patients; however, no clinical evidence of a systemic minoxidil effect was found. These data suggest that combination therapy using drugs with probable different mechanisms of action may provide a synergistic effect in alopecia areata.

Relationship Between Contact Time of Applied Dose and Percutaneous Absorption of Minoxidil From a Topical Solution

Twenty-two healthy male volunteers completed a four-way, multiple-dose, randomized crossover study to determine the relationship between contact time of applied drug on the scalp and minoxidil absorption from a 2% topical solution. One milliliter of solution was applied twice daily over 150cm2 of bald scalp to each subject for 6 days. Unabsorbed drug was washed off the scalp after 1, 2, 4, and 11.5h of contact time in each of four treatments. Cumulative urinary excretion profiles within steady-state, 12-h dosing intervals were well described by straight lines for all treatments, indicating that systemic minoxidil elimination was rate controlled by constant, zero-order percutaneous drug absorption. The extent of minoxidil absorption, expressed as steady-state urinary excretion of unchanged minoxidil, minoxidil glucuronide, or the sum of these, increased in a disproportionate manner with increase in contact time of drug on the scalp. Relative to the amount absorbed after a contact time of 11.5h, absorption was ~50% complete by 1h and >75% complete by 4h. This suggests that minoxidil absorption from the vehicle into skin occurs rapidly relative to diffusion through skin. The rate of minoxidil absorption from vehicle into skin was characterized as nonlinear, whereas minoxidil excretion into urine was rate controlled by diffusion from one or more components of the skin which apparently serve as a reservoir, or depot, for minoxidil.