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

Abstract

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.

A child with generalized hypertrichosis due to secondary topical minoxidil exposure

“…2 Drugs, including phenytoin, cyclosporine, oral minoxidil, streptomycin, zidovudine, can also induce acquired generalized hypertrichosis. 1,3 In the present case, there was no accidental oral ingestion of minoxidil.…”

“…Endocrinological causes of hypertrichosis include Cushing syndrome, acromegaly (mostly in adults) and hypothyroidism, which were ruled out through blood tests and ultrasound study 2 . Drugs, including phenytoin, cyclosporine, oral minoxidil, streptomycin, zidovudine, can also induce acquired generalized hypertrichosis 1,3 . In the present case, there was no accidental oral ingestion of minoxidil.…”

Role of oral minoxidil in patterned hair loss

“…A study where 20 patients aged between 2 months and 13 years were accidentally exposed to high doses of OM (mean dose 0.90 mg/kg/day) showed that systemic side effects developed only in 15% of patients,[ 27 ] with no severe disorders, the most common side effects were diarrhea, anxiety, headache, facial edema, and severe asthenia; these manifestations appeared during treatment, and were transient, resolving within 3 days. [ 27 ] Sixty-five percent of them presented hypertrichosis, with a wide range of latency from treatment onset. Initial zone of appearance was the face, back, and limbs.…”

“…Resolution happened for 61.5% of patients within 6 months; after this time, 38.5% of the patients had persistent hypertrichosis. [ 27 ] The tachycardia, pedal edema, and postural hypotension reported in adults are rarely seen at the doses used in children. [ 24 ]…”

Caizhixuan hair tonic regulates both apoptosis and the PI3K/Akt pathway to treat androgenetic alopecia

“…At present, the effective rates of finasteride and minoxidil, which have been approved by the Food and Drug Administration (FDA) for the treatment of AGA, are 48% and 35%, respectively [4]. However, wide application of these two drugs in the clinic is limited due to the side effects caused by long-term administration, such as sexual dysfunction, facial hairiness and scalp stimulation [5][6][7]. Therefore, it is crucial to actively seek new drugs that effectively promote hair growth.…”