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

Abstract

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.

Safety of low‐dose oral minoxidil treatment for hair loss. A systematic review and pooled‐analysis of individual patient data

“…Nine studies [4][5][6]8,[12][13][14][15][16] used OM in monotherapy in 140 patients (31.7%), whereas five studies 7,[9][10][11]17 used OM in monotherapy or as an additional treatment in 302 patients (68.3%). Doses of oral minoxidil ranged between 0.25 and 5 mg.…”

“…Three of them reported no variation of mean BP, whereas three studies reported a slight reduction in systolic BP and diastolic BP. 6,7,12 Three studies reported postural hypotension or dizziness in a total of five patients (1.1%). 7,8,12 Interestingly, this AE occurred only in women and with low doses of OM, namely 0.25 mg (three patients),…”

<p>Optimal Management of Frontal Fibrosing Alopecia: A Practical Guide</p>

“…Recent studies have investigated the efficacy of low-dose oral minoxidil (0. effluvium, and monilethrix, with promising results shown including increased hair thickness in LPP. [65][66][67][68] Although no studies have been published to date on the efficacy of oral minoxidil for FFA, it is nevertheless a potential consideration for adjunctive therapy, particularly if the FFA is unmasking androgenetic alopecia. Future studies are needed to investigate the efficacy of oral minoxidil specifically for patients with FFA.…”

Topical and oral minoxidil for hair disorders in pediatric patients: What do we know so far?

“…3,4 In dermatology, topical minoxidil (TMX) has been used off-label for several types of alopecia, including telogen effluvium, alopecia areata (AA), eyebrow hypotrichosis, hair shaft disorders, chemotherapy-induced alopecia (CIA), traction alopecia (TA), and scarring alopecias. 5,6 TMX is not FDA-approved in patients under 18 years old and there are no guidelines for its pediatric use. 7 Many studies have been conducted linking TMX and hair regrowth in adults.…”