Evaluation of oral minoxidil in the treatment of alopecia areata

Fiedler-Weiss, Virginia C.

doi:10.1001/archderm.123.11.1488

Cited by 18 publications

(14 citation statements)

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“…Patients showed much more extensive regrowth with oral vs topical minoxidil 5% [4], After 6 months of treatment with oral minoxidil, there were only 6 nonresponders in the group of 34 patients. Data from all 34 patients treated with oral minoxidil were analyzed together because of the small num ber of biopsies.…”

Section: Resultsmentioning

confidence: 88%

“…12 h [4], Scalp bi opsies were performed as previously outlined after 6 months of treatment. Twenty-eight patients were responders; 6 were nonresponders.…”

Section: Patientsmentioning

confidence: 99%

“…We have recently demonstrated some increase in efficacy with low-dose oral minoxidil therapy [4], Histologically AA is characterized by miniaturized follicles showing varying degrees of degeneration [5] and by a dense perifollicular infiltration of T lymphocytes (helper-inducer, suppressor-cytotoxic and activated), Langerhans cells and monocytes [6][7][8][9][10], T lymphocytes appear to be the predominant cell type in the perifollicular infiltrates and, by implication, may be of pathogenic significance in the hair loss process.…”

Section: Introductionmentioning

confidence: 99%

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Immunohistochemical Characterization of the Cellular Infiltrate in Severe Alopecia areata before and after Minoxidil Treatment

Fiedler

Buys²

1987

Dermatology

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The mechanism of minoxidil-induced hair regrowth in alopecia areata (AA) is unknown. In vitro studies suggest that pharmacologic tissue levels of minoxidil may have both epithelial and T cell effects. Response in 36 of 47 patients with severe AA to topical minoxidil 5% b.i.d. was characterized by a return toward normal of hair follicle diameter, depth and structure, and an apparent shift in T cell populations from the skin into the peripheral blood. Nonresponders showed none of these changes. Biopsies from 34 patients subsequently treated with oral minoxidil 5 mg q. 12 h showed no further changes in perifollicular total T, helper-inducer T or suppressor-cytotoxic T cell counts; they did, however, demonstrate significant decreases in perifollicular Langerhans cell and activated T cell counts, and nearly significant decreases in perifollicular monocyte counts. It is possible that minoxidil may be altering a presumed follicular chemoattractive stimulus to a variety of cell types. Decreases in activated T cell counts suggest the possibility of direct immunomodulatory effects of minoxidil on T cells which might contribute to a hair regrowth response in AA.

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Section: Resultsmentioning

confidence: 88%

“…12 h [4], Scalp bi opsies were performed as previously outlined after 6 months of treatment. Twenty-eight patients were responders; 6 were nonresponders.…”

Section: Patientsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Immunohistochemical Characterization of the Cellular Infiltrate in Severe Alopecia areata before and after Minoxidil Treatment

Fiedler

Buys²

1987

Dermatology

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“…Records between Jan 2012 and Oct 2015 were extracted. Inclusion criteria included female patients with a hair shedding score (HSS) 12 of 4–6 without visible mid frontal scalp hair loss (Sinclair stage 1) 17 and no hair follicle miniaturization on scalp biopsy. Patients were excluded if they were using other treatments for hair loss whilst taking oral minoxidil.…”

Section: Methodsmentioning

confidence: 99%

Treatment of chronic telogen effluvium with oral minoxidil: A retrospective study

Perera

Sinclair

2017

F1000Res

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Background: Chronic telogen effluvium (CTE) may be primary or secondary to various causes, including drug reaction, nutritional deficiency and female pattern hair loss (FPHL). Oral minoxidil stimulates hair growth, and topical minoxidil is used in the treatment of FPHL and male androgenetic alopecia. minoxidil has not been used to treat CTE. This study aimed to assess the treatment of CTE with once daily oral minoxidil. Methods: Women with a diagnosis of CTE based on >6 month history of increased telogen hair shedding, no visible mid frontal scalp hair loss (Sinclair stage 1) and no hair follicle miniaturization on scalp biopsy were treated with once daily oral minoxidil. Hair shedding scores (HSS) at baseline, 6 and 12 months were analysed using the Wilcoxon rank sum test for pair-wise comparisons. Results: Thirty-six women were treated with oral minoxidil (range, 0.25-2.5 mg) daily for 6 months. Mean age was 46.9 years (range 20-83), HSS at baseline was 5.64, and duration of diagnosis was 6.55 years (range 1-27). There was a reduction in mean HSS scores from baseline to 6 months of 1.7 (p<0.001) and baseline to 12 months of 2.58 (p<0.001). Five women who described trichodynia at baseline, noted improvement or resolution within 3 months. Mean change in blood pressure was minus 0.5 mmHg systolic and plus 2.1 mmHg diastolic. Two patients developed transient postural dizziness that resolved with continued treatment. One patient developed ankle oedema. Thirteen women developed facial hypertrichosis. For 6 patients this was mild and did not require treatment; 4 had waxing of their upper lip or forehead; 3 had laser hair removal. No patients developed any haematological abnormality. All 36 women completed 12 months of treatment. Conclusions: Once daily oral minoxidil appears to reduce hair shedding in CTE. Placebo controlled studies are recommended to further assess this response.

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“…A concentration of 2-5% minoxidil is used twice daily as a topical application to the affected area with good results in patient with mild to moderate AA. The authors use oral minoxidil at a dose of 5 mg daily and find this to be a useful adjunct treatment for more extensive AA [19]. Minoxidil can maintain affected hairs…”

Section: Minoxidilmentioning

confidence: 99%

Limited Effectiveness of Platelet-Rich-Plasma Treatment on Chronic Severe Alopecia Areata

Sinclair¹

2014

Hair Therap Transplantat

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Alopecia Areata (AA) is a common non-scarring alopecia that usually presents as well circumscribed patches of sudden hair loss that affects 0.1-0.2% of the population. The aetiology is thought to be both genetic and autoimmune in nature. 139 single nucleotide polymorphisms have been identified in 8 regions of the genome and are found to be associated with T cells or the hair follicle. Furthermore, patients with AA have been found to have an increased frequency of hair follicle-specific auto-antibodies. The diagnosis of AA is usually made on clinical grounds, and further investigations are not usually indicated. Intralesional corticosteroids remain the treatment of choice. Systemic steroids are also highly effective; however side effects make them less desirable to both patients and physicians. Other treatment options available include anthralin, minoxidil, topical immunotherapy and these treatments will be discussed further in depth in this chapter. The morbidity of AA is largely psychological; therefore the successful treatment of AA should include focusing on the improvement of the psychological impact of this condition.

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Evaluation of oral minoxidil in the treatment of alopecia areata

Cited by 18 publications

References 0 publications

Immunohistochemical Characterization of the Cellular Infiltrate in Severe Alopecia areata before and after Minoxidil Treatment

Immunohistochemical Characterization of the Cellular Infiltrate in Severe Alopecia areata before and after Minoxidil Treatment

Treatment of chronic telogen effluvium with oral minoxidil: A retrospective study

Limited Effectiveness of Platelet-Rich-Plasma Treatment on Chronic Severe Alopecia Areata

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