Review of oral minoxidil as treatment of hair disorders: in search of the perfect dose

Abstract

Topical minoxidil has been used for many years as treatment for different hair disorders. Even though it is an effective therapy, many patients show poor compliance due to the cosmesis, cost and side‐effects. During the last few years, low‐dose oral minoxidil has proven to be an alternative for patients with alopecia. We performed a literature search including all the articles that used oral minoxidil as a primary treatment in various hair diseases in order to evaluate the efficacy and safety of low‐dose oral minoxidil as an alternative to topical minoxidil. Androgenetic alopecia was the most common studied condition, but others included telogen effluvium, tractional alopecia, postchemotherapy‐induced alopecia, monilethrix, loose anagen hair syndrome, alopecia areata and scarring alopecias (frontal fibrosing alopecia and lichen planopilaris). Larger randomized comparative studies including standardized objective measurements should be done in order to clarify the best treatment protocol, including dosage and treatment duration. Oral minoxidil has proven to be a successful and well‐tolerated alternative for patients with hair loss, including those with poor adherence to other therapies. Different dosing regimens have been utilized in scarring and non‐scarring alopecia, varying from 0.25 to 5 mg daily. Higher doses have not been studied in men or women. Available literature suggests women require lower doses, from 0.25 to 2.5 mg daily, while men require higher doses for maximal efficacy, from 1.25 to 5 mg a day.

Low‐dose oral minoxidil increases hair density and thickness in androgenetic alopecia: a retrospective analysis of 60 patients

“…Editor, Beta-blockers (BB) are known to induce or aggravate psoriasis. [1][2][3][4][5] However, previous epidemiological studies have reported conflicting results. 6,7 Considering the correlation between psoriasis and hypertension, it is important to determine whether BB can influence psoriasis development while selecting antihypertensive agents for patients at high risk of psoriasis.…”

“…Patients were prescribed 0.625-5.0 mg daily of LDOM concurrently with other treatments, similar to dosages previously reported in the literature (Table 1). 5 Analyses were performed using one-sided one-sample t-tests and two-sample test of proportions run on Stata/IC (StataCorp LLC, College Station, TX, USA).A statistically significant increase of 13.9 hairs/cm 2 (D9.1% increase, P < 0.01) was found on the CP. A nonsignificant increase of 10.4 hairs/cm 2 was found on the…”

“…Patients were prescribed 0.625-5.0 mg daily of LDOM concurrently with other treatments, similar to dosages previously reported in the literature (Table 1). 5 Analyses were performed using one-sided one-sample t-tests and two-sample test of proportions run on Stata/IC (StataCorp LLC, College Station, TX, USA).…”

Pharmacological Management of Pattern Hair Loss

“…The proponents of OM have rationalized its use in this form to overcome the disadvantages of topical applications, namely, scalp irritation, daily twice application, unpredictable outcomes, etc. 41 42 Different dosing regimens have been utilized in scarring and nonscarring alopecia, varying from 0.25 to 5 mg daily with women requiring lower doses than men. 42 However, the studies have shown that efficacy of 1mg OM is similar to 5% topical minoxidil.…”

“… 41 42 Different dosing regimens have been utilized in scarring and nonscarring alopecia, varying from 0.25 to 5 mg daily with women requiring lower doses than men. 42 However, the studies have shown that efficacy of 1mg OM is similar to 5% topical minoxidil. The adverse effects are seen in fair number of patients (20%) using OM, of which hypertrichosis is the most frequent (significant enough to mandate laser hair reduction).…”