Topical Minoxidil Solution Research Articles

Trichogenic effect of topical ketoconazole versus minoxidil 2% in female pattern hair loss: a clinical and trichoscopic evaluation

BackgroundFemale pattern hair loss (FPHL) is a common non-scaring alopecia. Topical minoxidil is the only approved treatment for FPHL; however, it has frequent side effects. Ketoconazole is an antifungal with anti-androgenic properties.MethodsThe aim of this work was to evaluate the safety and possible trichogenic effects of ketoconazole in FPHL. Patients were randomly assigned into Group A with 20 patients who received 2% topical minoxidil solution and Group B involving 20 patients who were treated by 2% topical ketoconazole preparation. All patients were treated for 6 months and evaluated clinically plus via trichoscopy. Side effects were recorded, and patients’ satisfaction was measured.ResultsRegarding hair growth, a significant difference was detected between baseline and at 4th and 6th months in Group A. While in Group B, the improvement was delayed until the 6th month. Only 10% of Group B reported side effects. Patients’ satisfaction did not differ between the two groups.ConclusionsTopical ketoconazole mediates a trichogenic effect in FPHL with few side effects. However, ketoconazole showed a delayed improvement versus minoxidil at similar concentrations. Further studies should evaluate the efficacy of higher concentrations of ketoconazole solutions for FPHL which is a promising therapy.Trial registrationIRB approval status: reviewed and approved by IRB of Faculty of Medicine, Zagazig University; approval no. #3642

Persistent radiation-induced alopecia in patients with central nervous system tumors and head and neck sarcomas.

e23072 Background: Persistent radiation-induced alopecia (pRIA), or incomplete hair regrowth 6 months following radiotherapy (RT) completion, poses a significant quality of life burden, but its clinical characteristics and management outcomes are not well understood. Methods: Retrospective database query of patients with primary central nervous system tumors or head and neck sarcomas evaluated at an oncodermatology clinic and diagnosed with pRIA between 1/1/11 and 9/19/18. Clinical data and standardized clinical photographs were analyzed. Alopecia was graded according to the CTCAE v5. Results: Sixty-two patients with pRIA were identified (mean [SD] age, 33 [19]; 75% female; 18 < 21 years at pRIA diagnosis). The most common diagnoses were medulloblastoma (20, 32%) and glioblastoma multiforme (17, 27%). Mean duration between RT and pRIA diagnosis was 3.1 years (95% CI, 2.3-4.2). Additional cancer therapies included surgery (57, 92%), cytotoxic chemotherapy (35, 57%), and combination cytotoxic + targeted therapy (24, 39%). Cancer type, age, number of chemotherapy agents, and duration between RT and pRIA diagnosis were significantly associated with alopecia type: mixed pattern (localized and diffuse) alopecia was predominant in younger patients with medulloblastoma exposed to greater number of agents (p < .005). Alopecia grade 2 ( > 50% hair loss) was predominant in patients that received concurrent chemotherapy and RT (p = .046). Among 22 patients treated with 5% minoxidil topical solution, a response was noted in 16 (73%) (Table). One patient receiving hair transplantation and one receiving scalp reconstruction had complete resolution of pRIA. Conclusions: Concurrent chemotherapy with RT may be a risk factor for grade 2 pRIA. Topical minoxidil may provide some benefit in pRIA; however, prospective trials are needed to assess efficacy. Procedural interventions should be considered as a viable therapeutic option in a subset of patients. [Table: see text]

Comparative Study between Mesotherapy and Topical 5% Minoxidil by Dermoscopic Evaluation for Androgenic Alopecia in Male: A Randomized Controlled Trial.

Aim:This study aims to compare efficacy and safety between mesotherapy (intralesional injection) and 5% topical minoxidil solution in male androgenic alopecia (AGA) by dermoscopic evaluation.Methodology:In a randomized active controlled trial, we enrolled 49 clinically diagnosed males of AGA and randomly allotted them into two groups – mesotherapy (A) (25) and minoxidil (B) (24). Males in Group A were given total 8 sessions of intralesional mesosolution with microneedling procedure while Group B males were prescribed topical solution of minoxidil 5% twice daily for 4 months. Results were evaluated at baseline and then monthly for 4 months with clinical photographs, dermoscopy, trichoscan, 7-point standard assessment tool, and patient-self assessment scores.Results:Grade II was the most common presentation in our study. All dermoscopic parameters such as variation of hair shaft diameter, follicular units with single and multiple hairs, yellow dots, and perifollicular halo did not show any significant difference between the groups at all time points except at 1st month where the difference in variation of hair shaft diameter between the two group was 0.04. We observed a significant increase (P = 0.01) in the variation of hair shaft diameter between pre- and post-treatment in mesotherapy group compared to minoxidil group. The rest of parameters failed to show any significant difference within the group in mesotherapy and minoxidil.Conclusion:In our study, we observed a significant increase in the variation of hair shaft diameter between pre- and post-treatment in Group A compared to B. Other dermoscopic, trichoscan, and subjective measurement tool failed to show significant difference between two groups. Our observation suggests that there is no significant improvement of mesotherapy in male AGA over minoxidil.

A cross-sectional randomized comparative study of topical minoxidil solution with and without finasteride in male pattern androgenetic alopecia in South Indian patients

<p class="abstract"><strong>Background:</strong> Finasteride is one of the common drugs used in androgenetic alopecia. Literature speaks about sexual side effects in about 2% of the patients. To overcome this, we used topical finasteride. The objective of the study was to know the efficacy of topical minoxidil solution with and without finasteride.</p><p class="abstract"><strong>Methods:</strong> We randomized about 300 subjects, aged 18-45 years, who came for outpatient consultation for male pattern androgenetic alopecia into two groups. One group (group A) treated with 0.1% topical finasteride with 5% minoxidil solution and another group (group B) treated with 5% minoxidil solution after informed consent from both of them.<strong></strong></p><p class="abstract"><strong>Results:</strong> Analysis of the extent of bald area, hair count and number of terminal hair showed no significant difference in both the groups.</p><p><strong>Conclusions:</strong> No significant difference in the therapeutic response of topical minoxidil solution whether its plain or added with topical finasteride. So, adding topical finasteride in the minoxidil solution found to be of no value. It only adds up the cost and also creates the unnecessary fear of sexual side effects in the mind of the patients. </p>

The effectiveness of adding low-level light therapy to minoxidil 5% solution in the treatment of patients with androgenetic alopecia.

Androgenetic alopecia is the commonest type of alopecia affecting over half of men and women. Low-level light therapy is a new technique for stimulating hair growth in both genders. To overcome the shortcomings of previous epidemiological studies and a lack of controlled clinical trials on the subject, this study compared the effectiveness of adding low-level light therapy to minoxidil topical solution in the treatment of androgenetic alopecia in patients presenting to two skin clinics in Isfahan, Iran during 2014-2015. This clinical trial included 50 patients aged 17-45 presenting to Khorshid and Alzahra educational centers and skin diseases research center for androgenetic alopecia during 2014-2015. The patients were randomly divided into a control and a case group. The case group received topical minoxidil 5% solution plus low-level light therapy twice per day. The control group was given the same topical solution and a laser comb system that was turned off to act as a placebo. Changes in patients' hair density and diameter and its overall regrowth as well as their satisfaction with the treatment were assessed at months 0 (baseline), 3, 6, 9 and 12. The percentage of recovery from androgenetic alopecia and the patients' satisfaction with their treatment were significantly higher in the case group compared to the control group. The patients' mean hair density and diameter were found to be higher in the case group after the intervention compared to the control group. The study limitations included patient compliance, small sample size, patient insight due to novelty of the method and clinical judgement. As a new method of treatment, low-level light therapy can help improve the percentage of recovery from androgenetic alopecia and increase patients' satisfaction with their treatment.

The use of topical minoxidil to accelerate nail growth: a pilot study.

Linear nail growth rate is affected by various conditions, one of which is the level of blood flow. Our supposition was that topical minoxidil, which has vasodilatory properties, can increase the rate of nail growth. The aim of this study was to determine the impact of topical minoxidil on nail growth. A 5% topical minoxidil solution was applied twice daily to the fingernails of 32 participants. Two groups of 16 participants were randomly chosen. In one group, the applications were made to the right index and left ring fingernails, and, in the other, the left index and right ring fingernails. During each visit (weekly during the first month and every 2 weeks during the second month), the nail length of six fingernails (index, middle, and ring of both hands) was measured using a digital caliper. Beginning in the first week, the mean nail length of the treated nails was greater than that of nails in the untreated group with statistical significance. There were no systemic or cutaneous side effects. During the first month, the mean growth of the treated nails was 4.27 mm/month compared with 3.91 mm/month in the untreated nails (P = 0.003). These findings suggest that a 5% concentration of topical minoxidil can stimulate nail growth with increased growth beginning in the first week of application. The results may have important implications for the treatment of nail disorders; however, a comparable study involving participants with nail disorders is highly recommended.

Minoxidil Overdosage: A Case Report

Abstract A 64-year-old man ingested about 60 ml 2% of topical minoxidil solution in order tomake his hair grow faster. Twelve hours after ingestion he was brought to the University Clinic of Toxicology with severe hypotension, tachycardia, chest pain and subendocardial ischemia. ECG showed diffuse T-wave inversion and depressed ST segments. He was also oligoanuric at admission. In spite of the intensive hydration with crystalloidsolutions and intravenous dopamine administration that resulted in partial hemodynamic improvement and resolution of the ECG changes, kidneyfailure occurred. After two hymodialysis sessions, urea and creatinine levels returned to normal and rebound hypertension appeared. The patient was discharged after 12 days of hospitalization in a good condition. Topical minoxidilsolution is formulation used for treatment of androgenic alopecia. If orally ingested it leads to severe hypotension, acute coronary syndrome, compensatory tachycardia and acute kidneyfailure. Emergency therapeutic approach is a precondition for successful outcome.

Topical minoxidil solution in stimulating nail growth: A pilot study

Topical minoxidil solution in stimulating nail growth: A pilot study

Drug treatment of alopecia

Alopecia is the term used to describe hairless areas of the scalp. They can follow a specific pattern, be diffuse or circumscript. Androgenetic alopecia (AGA) follows a pattern: in men thinning of temples and vertex up to total baldness; in women thinning of the midline or parietal area. Lack of iron or cytostatic drugs cause diffuse alopecia, while in autoimmune diseases such as alopecia areata or lichen planus bizarre shapes of hairless areas are observed. For therapy, the following medications are used: topical minoxidil solution for AGA of men and women; systemic finasteride 1 mg for men with AGA; topical diphencyprone immunotherapy for alopecia areata; systemic antimycotic agents for tinea capitis; antibiotics such as clindamycin and rifampicin for folliculitis decalvans; systemic corticosteroids and isotretinoin for folliculitis et perifolliculitis capitis abscedens et suffodiens; topical corticosteroids for lichen planus and Kossard's frontal fibrosing alopecia.

Androgenetic alopecia: an evidence-based treatment update.

Androgenetic alopecia (AGA) is one of the most common chronic problems seen by dermatologists worldwide. It is characterized by progressive hair loss, especially of scalp hair, and has distinctive patterns of loss in women versus men, but in both genders the central scalp is most severely affected. It often begins around puberty and is known to effect self-esteem and the individual's quality of life. In contrast to the high prevalence of AGA, approved therapeutic options are limited. In addition to the scarce pharmacologic treatments, there are numerous nonprescription products claimed to be effective in restoring hair in androgenetic alopecia. The purpose of this paper is to review published medical and non-medical treatments for male and female AGA using the American College of Physicians evidence assessment methods. MEDLINE, EMBASE and Cochrane Library were searched for systematic reviews, randomized controlled trials, open studies, case reports and relevant studies of the treatment of male and female AGA. The relevant articles were classified according to grade and level of evidence. The medical treatments with the best level of evidence classification for efficacy and safety for male AGA are oral finasteride and topical minoxidil solution. For female AGA, topical minoxidil solution appears to be the most effective and safe treatment. The medical treatments corresponding to the next level of evidence quality are some commonly used therapeutic non-FDA-approved options including oral and topical anti-hormonal treatments. Surgical treatment of follicular unit hair transplantation is an option in cases that have failed medical treatment although there is high variation in outcomes. Some articles, especially those concerning traditional herbs claimed to promote hair regrowth, were published in non-English, local journals. An assessment of the evidence quality of current publications indicates that oral finasteride (for men only) and topical minoxidil (for men and women) are the best treatments of AGA.

A Pilot Study of the Efficacy in Treatment of Female Pattern Hair Loss using 5% Minoxidil Solution Combined with Oral Chelated Zinc Supplement

Abstract Background: Zinc supplement is popular trace element gave to female pattern hair loss (FPHL). But the type of patient, efficacy and side effect in detail of Zinc supplement are not well characterized. Objective: To determine efficacy and side effect of chelated Zinc in women with FPHL which using 5% minoxidil solution. Materials and methods: 18 Thai women with FPHL applied 5% topical minoxidil solution twice daily combined with 15 mg oral chelated Zinc for 24 weeks. Then measure growth of hair by global photograph, hair density and hair shaft diameter during 24 weeks of treatment. Results: All 18 female patients were attached to the study at 24-week follow up visit. The mean age was 47.5 ± 9.7 years (range, 26-61 years). Percentage of increasing in hair density and hair shaft diameter at 24-week follow-up visit after receiving 5% minoxidil solution combined with oral chelated Zinc supplement was 12.2% and 5.5%, respectively. There were statistically significant differences improvement in both hair density and hair shaft diameter (p<0.001 and p<0.001). Furthermore, The assessment of Global Photographic Review (GPR) by two dermatologists showed 11.1% of patients had moderately improved, 61.1% had minimally improved and 27.8% no change. There were no statistically significant differences between serum Zinc and Ferritin. Furthermore, no side effect of oral chelated Zinc was reported. Conclusions: Using chelated Zinc as additional trace supplements in FPHL has an efficacy to improve hair density and hair shaft diameter with no side effect.

Hair restoration approaches for early onset male androgenetic alopecia

Society places great emphasis on the presence of hair. Some degree of hair loss is accepted as a normal part of the aging process, in line with the observation that more than 50% of men will develop androgenetic alopecia by the age of 50years. However, it is possible to understand the psychosocial isolation and distress felt by men with a strong familial predisposition to androgenetic alopecia, who tend to display hair loss in their late teens or twenties. There are currently two drugs which have been licensed for the treatment of male androgenetic alopecia: oral finasteride and topical minoxidil solution which are effective to some extent. Furthermore, upon discontinuing treatment, any gain that has been achieved is quickly lost. Added to which there is an entire market of unproven over the counter products: advertised in the electronic media, local hair salons, and various departmental stores. In this review, we highlight the important advances in the management of male androgenetic alopecia with emphasis on approaches that can lead to more successful and long-term hair restoration for young adults. In particular, we discuss the evidence supporting the use of the follicular unit grafting technique in conjunction with medical treatment before and after the procedure. Moreover, some other alterations of this most popular state of the art hair restoration technique have been mentioned briefly. As a result, patients and physicians seem equally satisfied from this procedure for its naturally looking results which are cosmetically more acceptable and esthetically pleasing for longer period of time.

Quality of life in women with female pattern hair loss and the impact of topical minoxidil treatment on quality of life in these patients

Female pattern hair loss (FPHL) is the most common hair loss disorder in women and it may impact on the psychological and social activities of patients, thereby reducing their quality of life (QoL). Topical minoxidil has been shown to be effective and safe in the treatment of patients with FPHL. The aim of this study was to assess the QoL of patients with FPHL and investigate whether topical minoxidil solution treatment improves the QoL of these patients. In this study, we enrolled 125 female patients aged 16–72 years to answer visual analog scale (VAS) and dermatology life quality index (DLQI) questionnaires. Of these patients, 31 were recruited for the follow-up study after 12 months of treatment with 2% minoxidil. Each index and the change in QoL prior to and following treatment were statistically analyzed. There was identified to be a correlation between clinical severity and the values of the indices in all patients. There was a statistically significant difference between the VAS and DLQI scores prior to and following treatment with 2% minoxidil. A comparison between the good responders (n=23) and the poor responders (n=8) revealed no significant difference in the improvement of VAS and DLQI scores. The QoL of the patients was severely impaired by FPHL. The DLQI and VAS used in this study were validated as useful indices for the evaluation of QoL due to their high reliability, sensitivity and simplicity. This evaluation is recommended for the management of FPHL treatment. The results of the study demonstrated that topical minoxidil improved the QoL of the patients.

Results of a National Survey on Over-The-Counter Medicines, Part 1: Pharmacist Opinion on Current Scheduling Status

> OTC medicines make up an important part of the community pharmacy world. As with most aspects of practice, however, hurdles exist that prevent an optimal level of care. To gauge pharmacist agreement on the scheduling status of various OTC medicines. Pharmacists across Canada were surveyed by mail. Of the 5037 surveys mailed, 2403 were returned, with 2305 being usable for analysis (response rate of 49.4%). Across 25 agents, pharmacists tended to support existing control for pharmacies (such as Nix crème rinse and minoxidil topical solution) and returning control to pharmacies for unscheduled agents (such as ranitidine 75 mg tablets and nicotine patches). Pharmacists generally favour tighter control of OTC agents, especially those that are unscheduled. This hopefully reflects pharmacist desire to ensure their proper selection and use.

A randomized, single-blind trial of 5% minoxidil foam once daily versus 2% minoxidil solution twice daily in the treatment of androgenetic alopecia in women

Although twice-daily application of propylene glycol-containing 2% minoxidil topical solution (MTS) stimulates new hair growth, higher concentrations of minoxidil in a once-daily, propylene glycol-free formulation may improve efficacy and reduce unpleasant side effects. We sought to compare the efficacy, safety, and acceptability and to show noninferiority of once-daily 5% minoxidil topical foam (MTF) with twice-daily 2% MTS in women with androgenetic alopecia. A total of 113 women with androgenetic alopecia were randomized to 24 weeks of treatment with 5% MTF or 2% MTS. The primary efficacy parameter was change from baseline in nonvellus target area hair count at week 24. Secondary end points included change in nonvellus target area hair width, overall efficacy by global photographic review as assessed by treatment-blinded evaluators and the subject herself, adverse events, and participants' assessment of product aesthetics. After 24 weeks, women randomized to 5% MTF once daily showed noninferior target area hair count and target area hair width and experienced greater, but nonsignificant, improvements in target area hair count, target area hair width, and overall efficacy by global photographic review than those randomized to 2% MTS used twice daily. 5% MTF was significantly superior to 2% MTS in participants' agreement with "the treatment does not interfere with styling my hair" (P= .002). Women randomized to 5% MTF experienced significantly lower rates of local intolerance (P= .046) especially in pruritus and dandruff compared with 2% MTS. Because of differences in the formulations tested, study participants were not blinded to treatment. Once-daily 5% MTF is noninferior and as effective for stimulating hair growth as twice-daily 2% MTS in women with androgenetic alopecia and is associated with several aesthetic and practical advantages.

The Cost Effectiveness of Topical Minoxidil Therapy in Management of Baldness

“Use it or loss it (Rogaine),” is an advertisement as a cure for baldness. Rogaine is a commercial name for Minoxidil. Minoxidil is a vasodilator used orally for treatment of severe to malignant hypertension. Minoxidil therapy also causes hypertrichosis (increase of body hair). This drug is used topically to treat baldness.Minoxidil is not effective in halting the receding hairline on the frontal scalp. Its antibald effect is limited to the vertex of the head. It takes several months (2–4) to regrow hair by twice‐a‐day application. Continuous use of Minoxidil topical solution is needed to maintain hair regrowth. Stopping Minoxidil application causes loss of newly regrown hair in 3 to 4 months.Purpose of this case study will answer several questions. Is Minoxidil effective against baldness? Is it a permanent, cost‐effective remedy for baldness? What age group will get the maximum benefit from Minoxidil therapy? What types of baldness are amenable to Minoxidil therapy? Is it effective in female baldness? Is Rogaine free from remarkable adverse effects? What are the causes of baldness? Is there any permanent remedy for baldness?

The Cost Effectiveness Of Topical Minoxidil Therapy In Management Of Baldness

“Use it or loss it (Rogaine),” is an advertisement as a cure for baldness. Rogaine is a commercial name for Minoxidil. Minoxidil is a vasodilator used orally for treatment of severe to malignant hypertension. Minoxidil therapy also causes hypertrichosis (increase of body hair). This drug is used topically to treat baldness. Minoxidil is not effective in halting the receding hairline on the frontal scalp. Its antibald effect is limited to the vertex of the head. It takes several months (2-4) to regrow hair by twice-aday application. Continuous use of Minoxidil topical solution is needed to maintain hair regrowth. Stopping Minoxidil application causes loss of newly regrown hair in 3 to 4 months. Purpose of this case study will answer several questions. Is Minoxidil effective against baldness? Is it a permanent, cost-effective remedy for baldness? What age group will get the maximum benefit from Minoxidil therapy? What types of baldness are amenable to Minoxidil therapy? Is it effective in female baldness? Is Rogaine free from remarkable adverse effects? What are the causes of baldness? Is there any permanent remedy for baldness?

Finasteride Treatment of Hair Loss in Women

To review available evidence on the safety and efficacy of finasteride in the treatment of alopecia in women. A literature search was conducted through PubMed (1948-March 2010) and MEDLINE (1950-March 2010) using the search terms finasteride and alopecia. References cited in relevant publications were reviewed. All data sources identified were reviewed for inclusion. Reports of finasteride treatment of female alopecia were included in the review. This included prospective and retrospective trials, case series, and case reports. Studies in men were not included. Few pharmacologic options exist for women with alopecia who do not achieve satisfactory responses to topical minoxidil solution. Treatment successes with finasteride in women with female pattern hair loss, although an off-label indication, have been primarily described in uncontrolled studies and anecdotal reports. In 2 controlled clinical studies, finasteride showed no benefit over placebo or no treatment in female pattern hair loss. A finasteride regimen of 1 mg orally daily, as indicated in male pattern hair loss, may be recommended for those who fail or cannot tolerate minoxidil therapy. A 12-month trial is needed to assess stabilization of hair loss, and hair regrowth may take 2 years or longer. Although data are sparse, menopausal status, circulating androgen concentrations, and concomitant symptoms of hyperandrogenism do not appear to predict response to finasteride. Overall, finasteride is well tolerated; however, women of childbearing potential must adhere to reliable contraception while receiving finasteride, and treatment is contraindicated in pregnancy, due to known teratogenicity. Although objective evidence of efficacy is limited, finasteride may be considered for treatment of female pattern hair loss in patients who fail topical minoxidil treatment.

A multicenter, randomized, placebo-controlled, double-blind clinical trial of a novel formulation of 5% minoxidil topical foam versus placebo in the treatment of androgenetic alopecia in men

An alternative to currently marketed topical minoxidil solutions is desirable. To assess the efficacy and safety of a new 5% minoxidil topical formulation in a propylene glycol-free foam vehicle in men with androgenetic alopecia (AGA). This was a 16-week, double-blind, placebo-controlled trial of 5% minoxidil topical foam (MTF) in 352 men, 18 to 49 years old. At week 16, 143 subjects continued on an open-label phase to collect 52 weeks of safety information on 5% MTF. At week 16 compared with baseline, there was a statistically significant increase in (1) hair counts in the 5% MTF group versus placebo (P < .0001) and (2) subjective assessment of improved hair loss condition (P < .0001) in the 5% MTF group versus placebo. The 5% MTF was well tolerated over a 52-week period. There was no collection of efficacy data beyond 16 weeks. We believe that 5% MTF is a safe and effective treatment for men with AGA.

Is topical minoxidil solution effective on androgenetic alopecia in routine daily practice?

Objectives: Minoxidil solution stimulates hair growth in androgenetic alopecia. In order to maintain any beneficial effect, applications must continue indefinitely. The purpose of this study was to evaluate the ratio of patients who were satisfied with the drug and continued to use it versus those who were displeased and did not continue their treatment, and the reasons for the discontinuation. Methods: A total of 1495 men aged 20–40 years who suffered from androgenetic hair loss were selected among patients who were referred to two private dermatologists. They were subjected to treatment with 5% topical minoxidil solution. These patients were treated with no difference from the routine office patients. Factors such as the duration of treatment, adverse effects, the patient's satisfaction and the causes of treatment cessation were also closely studied. Results: Almost all the patients gradually avoided continuing the treatment. Only in a few patients was the cessation of medication due to adverse effects. The causes of discontinuation in the majority of patients were the low effect of medication and an aversion to this topical treatment method. Conclusions: The insignificant cosmetic effect of minoxidil solution caused discontinuity of treatment among almost all patients.