Topical Minoxidil In Treatment Research Articles

Effect of Microneedle on Hair Regrowth in Patients with Androgenetic Alopecia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract Objective Our objective was to assess the effectiveness and safety of microneedle by comparing microneedle plus 5% topical minoxidil treatment and microneedle alone to 5% topical minoxidil. Methods We searched databases such as Embase, PubMed, Cochrane library, VIP Database for Chinese Technical Periodicals, Wanfang, and China National Knowledge Infrastructure in relation to literature. The control group received 5% topical minoxidil solution, whereas the treatment group received either microneedle coupled with minoxidil or microneedle alone. The increase in hair count and hair diameter was the main evaluation criterion for assessing hair regrowth. Data were pooled with Stata 15 software. Results Eight studies with 472 participants were included. Compared with 5% topical minoxidil therapy, microneedle plus minoxidil treatment showed a significant increase in hair count (standard mean difference [SMD] :15.82, 95% confidence interval [CI]: 12.34, 19.31, p < 0.05), but no increase in hair diameter (SMD: −0.21, 95% CI: −2.94, 2.52, p = 0.879 > 0.05). The results of subgroup analysis suggested that microneedle plus minoxidil treatment showed a significant increase in hair count whether the depth of microneedle was less than 1 mm (SMD:1.16, 95% CI: 0.86, 1.42, p < 0.05) or more than 1 mm (SMD:0.52, 95% CI: 0.23, 0.82, p < 0.05). In terms of treatment period subgroup, microneedle combined with minoxidil therapy significantly increased hair count and hair diameter than single 5% topical minoxidil, whether in 12-week period (SMD: 1.08, 95% CI: 0.76, 1.39, p < 0.05) or 21 to 24 weeks period (SMD: 0.64: 95%, CI: 0.35, 0.92, p < 0.05). Conclusion According to this study, the effect of microneedle treatment alone on androgenetic alopecia (AGA) may be limited. However, microneedle plus 5% topical minoxidil treatment had better hair regrowth in hair count and can be considered as an additional therapy option for AGA. Combined with subgroup analysis results, 12-week period and less than 1 mm depth of microneedle penetration were recommended.

Scalp vascularization as a marker of topical minoxidil treatment efficacy in patients with androgenetic alopecia.

IntroductionAndrogenetic alopecia is the most common type of non-cicatricial hair loss both in male and female patients. The pathomechanism of the disease involves chronic and progressive miniaturization of hair follicles, which leads to the conversion of terminal hair to vellus hair. Minoxidil is a first-line drug in the treatment of female pattern hair loss (FPHL).AimThe study is aimed at verifying whether the degree of scalp vascularization has an impact on the efficacy of topical 5% minoxidil treatment.Material and methodsThe study involved a group of 76 patients diagnosed with FPHL, who underwent a scalp biopsy for a histological examination of their scalp vascularization. The patients were divided into two groups, with rich and poor scalp vasculature. In all patients, topical treatment with 5% minoxidil was applied for a minimum of 6 months, followed by video-trichoscopic assessment.ResultsA significant increase in the total count was observed 6 months into the treatment as compared with baseline, and a decrease in the number of single hair per follicle. It was observed that the number of single hair units had gone down in 50.67% of patients. The study also demonstrated an increase in the total hair count in 57.33% of patients as well as no drops in the total count in 68% of patients, following 6 months of treatment.ConclusionsPatients responded equally well to the applied topical minoxidil treatment, irrespectively of the number of blood vessels in the scalp.

The Effect of topical Minoxidil in Treatment of androgenetic Alopecia

The Effect of topical Minoxidil in Treatment of androgenetic Alopecia

Efficacy and safety of a new 10% topical minoxidil versus 5% topical minoxidil and placebo in the treatment of male androgenetic alopecia: a trichoscopic evaluation

Introduction Androgenetic alopecia is a stressful condition for males. Minoxidil 2% and 5% have been FDA approved for treatment of this condition. In literature, all studies have compared minoxidil 5% with 2%. Although other concentrations (2% to 12.5%) are available nowadays, we believe our study is the first to compare 10% versus 5% topical minoxidil in treatment of AGA. Objective To compare the efficacy and safety of 5% topical minoxidil with 10% topical minoxidil and placebo in AGA treatment. Materials and methods 36-weeks, double-blinded, placebo-controlled, randomized trial. A total of 90 men with AGA. First group have applied 5% minoxidil solution, second group applied 10% minoxidil solution; or third placebo group. Efficacy was evaluated clinically and trichoscopically. Results After 36 weeks of therapy; 5% topical minoxidil (0.47 ± 0.26) (0.59 ± 0.64) was significantly superior to 10% topical minoxidil (0.05 ± 0.13) (0.45 ± 0.74) and placebo (0.01 ± 0.05) (–0.03 ± 0.08) in terms of change from baseline in total vertex and frontal hair mean count respectively. Pull test change to negative in minoxidil 5%: (37%) patients after 6 month treatment, Minoxidil 10% group (37.5%) patients changed and in placebo group all patients after 6 month were the same (0%) change. No reported sexual dysfunction in all three groups. Conclusion Five percent of topical minoxidil was moderately superior to 10% topical minoxidil and placebo in increasing hair regrowth opposite to the expected, the irritation was marked for 10% topical minoxidil. Psychosocial stress after 10% usage were worsen by the shedding, irritation compared to their high expectation in comparison to 5% usage.

A Randomized Controlled, Single-Observer Blinded Study to Determine the Efficacy of Topical Minoxidil plus Microneedling versus Topical Minoxidil Alone in the Treatment of Androgenetic Alopecia.

Background:Androgenetic alopecia (AGA) is the most common form of hair loss in adults, which is generally progressive in the absence of treatment. As a head full of healthy hair adds to the cosmetic appeal of the individual, the consequences of AGA are predominantly psychological. Currently, topical minoxidil is the first-line treatment for AGA. Many adjuvant treatment modalities have been used synergistically with minoxidil. Microneedling is one among such adjuvant treatments, which works by various mechanisms to stimulate the dermal papillary cells that play a key role in hair growth.Aim:To compare the efficacy of microneedling along with topical minoxidil and topical minoxidil alone in the treatment of AGA in men.Materials and Methods:Sixty-eight men with Norwood–Hamilton grade III and IV AGA were recruited for the study. After randomization, one group was treated with weekly microneedling and twice daily application of 5% minoxidil solution and the other group was treated with twice daily application of 5% minoxidil solution alone. Global photographs were taken at baseline (pretreatment) and at end of the study duration. Trichoscopic images were taken from a targeted fixed area before treatment (baseline) and at end of the therapy from where hair count was also carried out. The two primary efficacy parameters were assessed: increase in the hair count from that of the baseline and patient self-assessment of hair growth at the end of the study.Results:The mean increase in hair count in the targeted area of one square inch at the end of the treatment was significantly greater for the combination treatment group (12.52/inch2) compared to that for the minoxidil alone group (1.89/inch2). Four patients in the “microneedling plus topical minoxidil” group reported a 50% improvement versus none in the “minoxidil alone” group.Conclusion:Our study showed that the combination of microneedling and topical minoxidil treatment was superior compared to topical minoxidil alone with regard to increase in the hair count and patient satisfaction, although the response achieved was not cosmetically significant.

Management of androgenetic alopecia: a comparative clinical study between plasma rich in growth factors and topical minoxidil

Androgenetic alopecia (AGA) is a common hair disorder. Finasteride and minoxidil have been approved by the Food and Drug Administration (FDA) for the treatment of AGA. However, some side effects have been related to the intake of these drugs. Recently, plasma rich in growth factors has emerged as a safe alternative for the management of pattern hair loss. The purposes of the present study are to evaluate and compare the efficacy and safety of plasma rich in growth factors (PRGFs) versus topical minoxidil treatment in AGA-affected patients. Following a retrospective case control design, 379 patients treated with either PRGF or minoxidil were included in this study. Diagnostic trichograms at baseline and 4 months after treatment were performed with the aim of analyzing the anagen/telogen hair change improvement. PRGF-treated patients showed higher anagen hair increase improvement compared to minoxidil-treated ones (6.9 ± 0.4 and 4.6 ± 0.5 %, respectively) (p < 0.05). Telogen hair decrease improvement was also higher in PRGF group (5.7 ± 0.3 and 2.6 ± 0.5 %, respectively) (p < 0.05). Global photographs showed an overall volume and quality hair improvement for both treatments. No adverse effects were reported. This retrospective study shows that PRGF is a safe and effective treatment for AGA and evidences that PRGF exerts improved anagen/telogen results than topical minoxidil. Level of evidence: Level IV, therapeutic study.

Differential Diagnosis of Headache and Vertigo: Topical Minoxidil Self-medication Should Be Considered

We describe a girl with headache and dizziness presumably caused by topical minoxidil (2%) treatment. Minoxidil was administered for the treatment of hair loss. Other common causes for the symptoms were excluded. Discontinuation of minoxidil led to prompt recovery over several weeks. Headache and dizziness are potential side effects of topical minoxidil treatment. Symptoms are reversed by discontinuation of treatment.

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.

Minoxidil activates β-catenin pathway in human dermal papilla cells: A possible explanation for its anagen prolongation effect

It is believed that the length of the actively growing phase of the anagen hair cycle mainly contributes to hair length. Recent studies showed that maintenance of β-catenin activity in the dermal papilla cells (DPCs) enables hair follicles to keep actively growing. Topical minoxidil treatment promotes hair growth in men with androgenetic alopecia, suggesting that minoxidil may prolong the actively growing phase of the anagen hair cycle. To investigate whether minoxidil prolongs the anagen hair cycle in mice and, if so, to investigate whether minoxidil activates β-catenin pathway in human DPCs. Dorsal skins of C57BL/6 mice were depilated to synchronize the hair cycle. After 10 days, 3% minoxidil were topically applied daily for 10 days. Sections of back skins were stained with hematoxylin and eosin. Hair follicles were graded and hair cycle score (HCS) was calculated. Cultured human DPCs were transiently transfected with the β-catenin responsive TCF reporter plasmid (pTopflash) and corresponding negative control reporter (pFopflash) to assess the activity of β-catenin signaling by minoxidil. Immunofluorescence staining and immunoblot were performed to examine the expression and localization of β-catenin in the presence or absence of minoxidil. Phosphorylation of GSK3β, PKA and PKB were also examined by immunoblot after minoxidil treatment. RT-PCR analysis and immunoblot were employed to investigate the expression of β-catenin pathway targets in DPCs, such as Axin2, Lef-1, and EP2. Modest extension of anagen phase thereby delay of catagen progression was observed by application of minoxidil in mice. Minoxidil stimulated the transcriptional activity of pTopflash but not pFopflash. Nuclear accumulation of β-catenin was also observed after minoxidil treatment. Immunoblot further showed that minoxidil treatment increases the phosphorylation of GSK3β, PKA and PKB. Moreover, minoxidil induced Axin2, Lef-1, and EP2 expression. Our results strongly suggest that minoxidil extends the anagen phase by activating β-catenin activity in the DPCs.

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.

An Open, Randomized, Comparative Study of Oral Finasteride and 5% Topical Minoxidil in Male Androgenetic Alopecia

Background and Aim: Androgenetic alopecia (AGA) is undoubtedly the most common form of hair loss in males. It is a condition which may cause cosmetic and psychosocial problems in androgen-dependent cases. In this open, randomized and comparative study we evaluated the efficacy of oral finasteride and 5% topical minoxidil treatment for 12 months in 65 male patients with mild to severe AGA. Methods: We randomly assigned 40 (61.53%) patients to receive 1 mg/day oral finasteride for 12 months, and 25 (38.47%) patients applied 5% topical minoxidil solution twice daily for 12 months. Results: There were no significant differences between the 2 groups considering age, age of onset of hair loss, family history and type of hair loss (p > 0.05). In the clinical evaluation at the endpoint of treatment, the clinical cure rates (i.e. increased intensity of hair) were 80% (32/40) for the oral finasteride group and 52% (13/25) for the 5% topical minoxidil group. Encountered side effects were all mild, and there was no need to stop the treatment. In the group given oral finasteride, side effects were noted in 7 patients: 6 patients suffered from loss of libido, and 1 patient had an increase in other body hairs; irritation of the scalp was seen in 1 patient in the group administered 5% minoxidil. These adverse events disappeared as soon as the treatment was stopped. The laboratory data on both drug groups did not show any statistically or clinically significant intragroup changes from baseline values to the endpoint (p > 0.05), except the level of serum total testosterone which was increased, and free testosterone and serum prostate-specific antigen in the finasteride group which were statistically decreased from baseline values to the endpoint (p < 0.05). Conclusion: In this comparative study of systemic finasteride and topical minoxidil, it was concluded that both drugs were effective and safe in the treatment of mild to severe AGA, although oral finasteride treatment was more effective (p < 0.05). Adverse events were not considered important either, and these side effects disappeared as soon as the treatment was stopped.

Androgenetic alopecia, hirsutism and hypertrichosis

Having too much hair on the face or the body and not enough on the scalp respectively, is generally not a mirror of a life-threatening disease. However, the emotional impact of such cosmetic problems may be remarkable in the individual case. Currently rational treatment options are becoming increasingly available to correct such hair problems. This review highlights the new therapeutic achievements in the treatment of both androgenetic alopecia and hirsutism. Oral treatment of male patterned hair loss with finasteride in men is emphasized, and the use of antiandrogens in women is discussed. In addition, the mode of action and clinical results of topical minoxidil treatment find mention. The second part of the review deals with hirsutism and hypertrichosis. The diagnostic steps and investigations are briefly reviewed, and the advances in laser treatment of hirsutism and hypertrichosis are presented.

The effect of topical minoxidil treatment on hair follicular growth of neonatal hairless descendants of Mexican hairless dogs.

The effect of daily topical minoxidil treatment on hair growth was investigated in eight neonatal hairless pups. After 21 days of minoxidil treatment, hair growth occurred in the minoxidil-treated areas of each neonatal hairless pup. The numbers of hairs in the treated areas increased as compared with that in the areas treated with vehicle only. Histological findings revealed that the skin treated with minoxidil contained many hair follicles derived from epidermal ingrowths (hair germs) projecting into the dermis. These hair follicles showed various stages of neofolliculogenesis. After 31 days of treatment, terminal hair growth was observed. In the minoxidil-untreated areas, epidermal ingrowths remained undifferentiated. These results revealed that hairless dogs developed hair growth reactions following minoxidil-treatment when such treatment is applied in the early neonatal period. Neonatal hairless pups are a useful model for evaluating the effectiveness of hair growth stimulators.

Practical guidelines for the management of erectile dysfunction in diabetes

Practical Diabetes InternationalVolume 12, Issue 5 p. 211-214 Review ArticleFree Access Practical guidelines for the management of erectile dysfunction in diabetes Dr. D Meeking MRCP, Corresponding Author Dr. D Meeking MRCP Research Fellow St Thomas' Hospital, London, UKResearch Fellow, Department of Medicine, St. Thomas' Hospital, London, SE1 7EH, UKSearch for more papers by this authorM Cummings MRCP, M Cummings MRCP Lecturer St Thomas' Hospital, London, UKSearch for more papers by this authorKM Shaw MD FRCP, KM Shaw MD FRCP Consultant Physician Queen Alexandral HOspital, Portsmouth, UKSearch for more papers by this authorWD Alexander FRCP, WD Alexander FRCP Consultant Physician Queen Mary's Hospital, Sidcup, UKSearch for more papers by this author Dr. D Meeking MRCP, Corresponding Author Dr. D Meeking MRCP Research Fellow St Thomas' Hospital, London, UKResearch Fellow, Department of Medicine, St. Thomas' Hospital, London, SE1 7EH, UKSearch for more papers by this authorM Cummings MRCP, M Cummings MRCP Lecturer St Thomas' Hospital, London, UKSearch for more papers by this authorKM Shaw MD FRCP, KM Shaw MD FRCP Consultant Physician Queen Alexandral HOspital, Portsmouth, UKSearch for more papers by this authorWD Alexander FRCP, WD Alexander FRCP Consultant Physician Queen Mary's Hospital, Sidcup, UKSearch for more papers by this author First published: September/October 1995 https://doi.org/10.1002/pdi.1960120506Citations: 4AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat References 1 McCulloch DK, Campbell IW, Wu FC, et al. The prevalence of diabetic impotence. Diabetologia 1980; 18: 279– 283 2 Price DE, O'Malley BP, James MA, et al. Why are impotent men not being trealed? Practical Diabetes 1991; 8: 10– 11 3 Alexander WD. The diabetes physician and an assessment and trealment programme for male erectile impotence. Diabet Med 1990; 7: 540– 3 4 Ryder REJ, Facey P, Hayward MWJ, et al. Detailed investigation of the cause of impotence in 20 diabetic men. Practical Diabetes 1991; 9: 7– 11 5 Krane RJ, Goldstein I, Saenz de Tejada I. Impotence. N Engl J Med 1989; 321: 1648– 59 6 Lehman TP, Jacobs JA. Etiology of diabetic impotence. J Urol 1983; 129: 291– 4 7 Podolsky S. Diagnosis and treatment of sexual dysfunction in the male diabetic. Med Clin North Am 1982; 66: 1389– 96 8 Cooper AJ. Advances in the assessment of organic causes of impotence. Br J Hosp Med 1986; 36: 186– 92 9 Fairburn CJ, McCulloch DK, Wu FC. The effect of diabetes on male sexual function. Baillieres Clin Endocrinol Metab 1982; 11: 749– 67 10 Schiave RC. Psychological treatment of erectile disorders in diabetic patients. Psycbiatr Clin North Am 1980; 3: 337– 9 11 Masters WH, Johnson VE. Human sexual inadequacy. London: Churchill 1970 12 Close CF, O'Leary H, Ryder REJ. Trànsdermal glyceryl trinitrate in the treatment of erectile dysfunction in diabetes. Diabet Med 1994; 11 (suppl.1) S42: 110 13 Radomski SB, Hirschorn S, Rangaswamy S. Topical minoxidil in treatment of male erectile dysfunction. J Urol 1994; 151 (5): 1225– 6 14 Reid K, Morales A, Harris C, et al. Double blind trial of Yohimbine in treatment of pscyhogenic impotence. Lancet 1987; 1: 421– 3 15 Ryder RE, Close CF, Moriarty KT, et al. Impotence in diabetes: aetiology, implications for treatment and preferred vacuum device. Diabet Med 1992; 9 (10): 893– 8 16 Price DF. Managing impotence in diabetes. BMJ 1993; 307: 275– 6 17 Wiles PG. Successful non-invasive management of erectile impotence in diabetic men. BMJ 1988; 296: 161– 2 18 Alexander WD. The treatment of choice for erectile impotence. Diabetes 1991; 40 (suppl): 533A 19 Gerstenberg TC, Metz P, Otteson B, Fahrenkrug J. Intravenous self-injection with vasoactive intestinal polypeptide and phentolamine in the management of erectile failure. J Urol 1992; 147: 1277– 9 20 McLaren RH, Barrett DM. Patient and partner satisfaction with the AMS 700 penile prosthesis. J Urol 1992; 147: 62 21 Montorsi F, Guazzoni G, Bergamashi F, Rigatti P. Patient partner satisfaction with semi-rigid penile prosthesis. A five year follow-up study. J Urol 1993; 150 (6): 1819 22 Pryor JP. Surgical procedures to correct erectile dysfunction. In: A Gregoire, J Pryor, eds. Impotence. An integrated approach to clinical practice. Edinburgh: Churchill Livingstone 1993 Citing Literature Volume12, Issue5September/October 1995Pages 211-214 ReferencesRelatedInformation

The Therapeutic Use of Topical Minoxidil

Topical minoxidil is a trichogenic agent that stimulates the hair follicle via the vasoactive metabolite minoxidil sulfate without any evidence of antiandrogen activity or an effect on the immune system. Less than 5% of the applied dose is absorbed. The therapeutic effect on hair regrowth is demonstrated for androgenetic alopecia in males and females, by a computer-assisted image analysis counting technique of nonvellus hairs from a photographic print. Patients with severe alopecia areata respond poorly to topical minoxidil treatment. The most common adverse reactions are limited to irritant and allergic contact dermatitis on the scalp. The use of retinoic acid with topical minoxidil has been disappointing relative to the increase in systemic exposure. The value of topical minoxidil as an adjunct for the hair transplant procedure and its effect on hair loss from chemotherapy are being evaluated.

The stumptailed macaque as a model for androgenetic alopecia: Effects of topical minoxidil analyzed by use of the folliculogram

The use of the stumptailed macaque, which possesses hereditary balding characteristics similar in many respects to that of androgenetic alopecia in humans, enables us to obtain a morphometric assessment of the rate of cyclic change of the hair follicle. The analysis of folliculograms results in data that can determine the rate of cyclic progression (resting to regrowing phase, and regrowing to late anagen phase) and the overall change in follicular size. Topical minoxidil apparently activates the resting follicles in the bald scalp and stimulates their cyclic progression. It also increases DNA synthesis, resulting in relative enlargement of the growing anagen follicles. All minoxidil-treated animals had hair regrowth, although in varying degrees of restoration to the prebald condition and after varying durations of treatment. In general, the response was greater in the younger, early-bald stumptailed macaques compared with the older, advancedbald animals. The degree of response varied from regrowth of thicker, darker hairs over the entire bald area, with folliculograms showing corresponding large proportions of late anagen follicles, to the arresting of the balding process, with folliculograms showing maintenance of moderate populations of anagen follicles. Cessation of topical minoxidil treatment resulted in a renewal of the balding process, with folliculograms demonstrating increases in the proportion of resting follicles. This withdrawal from treatment apparently had no effect on hair regrowth during subsequent reapplications of minoxidil. Such treatment resulted in regrowth similar to that in the first treatment phase. Continuous treatment of topical minoxidil for 4 years has not resulted in systemic or local side effects in these animals.

Evaluation of Oral Minoxidil in the Treatment of Alopecia Areata

A dose-response effect has previously been demonstrated in topical minoxidil treatment of alopecia areata. Limitations in minoxidil solubility and percutaneous absorption have impaired the development of more effective topical therapy. Oral minoxidil (5 mg every 12 hours), a dose demonstrated to be relatively well tolerated if a 2-g sodium diet is strictly followed, was given to 65 patients with severe, treatment-resistant alopecia areata in an attempt to bypass the limitations of topical treatment and increase efficacy. Although hair regrowth progressed more rapidly and was more extensive with oral than topical 5% minoxidil, cosmetic response was seen only in 18% of the patients. Neither serum nor tissue levels of minoxidil correlated with response. These findings suggest that improved preparations of topical minoxidil, when used as a single therapeutic agent, are unlikely to be cosmetically effective in the majority of patients with severe alopecia areata.

Dose-response study of topical minoxidil in male pattern baldness

Eighty-nine healthy men with male pattern baldness completed a 6-month double-blind, placebo-controlled study of 0.01%, 0.1%, 1%, and 2% topical minoxidil. Subjects on 2% topical minoxidil had a statistically significant increase in mean total target area hair count over baseline compared to the placebo, 0.01%, and 0.1% topical minoxidil groups (p = 0.04). Changes from baseline were more impressive with the 2% topical minoxidil group but not significantly different from the 1% topical minoxidil group in all parameters of objective response to treatment. The investigator, however, rated more subjects as having at least a moderate cosmetic response to treatment in the 2% versus 1% topical minoxidil treatment group. These results indicate that 1% topical minoxidil is the lowest effective concentration of topical minoxidil for male pattern baldness of those tested. Because of the more impressive changes in hair counts and the cosmetic preference for the 2% versus 1% topical minoxidil, 2% topical minoxidil may be the standard preferred treatment for male pattern baldness.

Topical Minoxidil Dose-Response Effect in Alopecia Areata

Topical 5% minoxidil solution was used to treat 47 patients with severe alopecia areata. Forty patients (85%) had terminal hair regrowth after 48 to 60 weeks of treatment. In the majority of patients, hair regrowth was not cosmetically acceptable. Data were compared with those from a previous study with topical 1% minoxidil solution. Both the percentage of responders and the quality of their hair regrowth were significantly greater with 5% than with 1% topical minoxidil solution. One patient developed an allergic contact dermatitis to minoxidil, but no systemic side effects were detected. The results strongly suggest a dose-response effect for topical minoxidil treatment of alopecia areata and the importance of exploring modifications in dosing and delivery systems to enhance therapeutic efficacy.