Oral Minoxidil Use in Androgenetic Alopecia and Telogen Effluvium Brittany Feaster MHS and Amy J McMichael MD BACKGROUND While current studies have supported the use of oral minoxidil as a novel adjunctive therapy for patients with nonscarring forms of alopecia there continues to be limited ID: 1014792
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1. Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NCOral Minoxidil Use in Androgenetic Alopecia and Telogen EffluviumBrittany Feaster, MHS and Amy J. McMichael, MDBACKGROUNDWhile current studies have supported the use of oral minoxidil as a novel, adjunctive therapy for patients with non-scarring forms of alopecia, there continues to be limited data on the usage, efficacy, and safety of oral minoxidil in these conditions. OBJECTIVEThis study aimed to assess oral minoxidil use in the treatment of male and female androgenetic alopecia (female pattern hair loss/male pattern hair loss) and telogen effluvium focusing particularly on women. METHODSA retrospective analysis was conducted in 100 adult patients treated for androgenetic alopecia and/or telogen effluvium with oral minoxidil (dose range, 0.625mg-2.5mg) once daily for ≥ 52 weeks. Patients using additional therapies were included. Efficacy was evaluated based on provider assessment of clinical response and clinical photographic evaluation at pre and post treatment using a 3 point scale (worsening, stabilization, and improvement). Safety was evaluated according to patient reported adverse effects. RESULTSPatient EpidemiologyTable 1. Clinical Response and Adverse EffectsTable 2.Four patients discontinued oral minoxidil use at ≤ 52 weeks due to patient reported adverse effects of edema, hypertrichosis, migraines, hair shedding, and weight gain. Clinical PhotosFigure 1. Vertex Scalp Figure 2. Temporal ScalpPre and Post treatment with once daily oral minoxidil use for ≥ 52 weeks.CONCLUSION51% of patients demonstrated clinical improvement and 41% demonstrated stabilization. Adverse effects were reported in eight patients which were mild in nature. These results suggest oral minoxidil at a dose range of 0.625mg to 2.5mg once daily is a safe and effective treatment in androgenetic alopecia and telogen effluvium. REFERENCESAlmohanna HM, Perper M, Tosti A. Safety concerns when using novel medications to treat alopecia. Expert Opin Drug Saf. 2018;17(11):1115-1128.Beach RA. Case series of oral minoxidil for androgenetic and traction alopecia: Tolerability & the five C's of oral therapy. Dermatol Ther. 2018;31(6):e12707.Fieldler-Weiss, Virginia C., et al. "Evaluation of oral minoxidil in the treatment of alopecia areata." Archives of dermatology 123.11 (1987): 1488-1490. Kanti V, Messenger A, Dobos G, et al. Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men - short version. J Eur Acad Dermatol Venereol. 2018;32(1):11-22.Perera E, Sinclair R. Treatment of chronic telogen effluvium with oral minoxidil: A retrospective study. F1000Res. 2017;6:1650.Saoraya Lueangarun RP, Therdpong Tempark, Nopadon Noppakun, . Efficacy and safety of oral minoxidil 5 mg daily during 24-week treatment in male androgenetic alopecia. Journal of the American Academy of Dermatology. 2015;72(5):AB113.Sinclair R. Treatment of monilethrix with oral minoxidil. JAAD Case Rep. 2016;2(3):212-215.Sinclair RD. Female pattern hair loss: a pilot study investigating combination therapy with low-dose oral minoxidil and spironolactone. Int J Dermatol. 2018;57(1):104-109.Varothai S, Bergfeld WF. Androgenetic alopecia: an evidence-based treatment update. Am J Clin Dermatol. 2014;15(3):217-230.Yang X, Thai KE. Treatment of permanent chemotherapy-induced alopecia with low dose oral minoxidil. Australas J Dermatol. 2016;57(4):e130-e132.CONFLICTS OF INTERESTS/DISCLOSURESThe authors Brittany Feaster and Amy J. McMichael have no conflicts of interests to disclose. Male (n)Female (n)Total (n)No. of Patients2575100Mean Age3857.552.6Race/EthnicityAsian-22Black -1414White214263Other11Unknown 31720DiagnosisAndrogenetic alopecia2575100Telogen effluvium -2424Comorbidities Alopcia areata-11CCCA-1010Lichen planopilaris-77Seborrheic dermatitis 63339Traction alopecia-33Diabetes Mellitus-55Hypertension22527Hypothyroidism 11617Male (n)Female (n)Total (n)Clinical Response Worsening268Stabilization83341Improvement 153651Adverse effectsEdema-22Hypertrichosis-55Palpitations-11Scalp dysesthesia-11Weight Gain11Concomitant TherapiesDutasteride7714Finasteride173855Flutamide-44Spironolactone-2323Topical minoxidil42731MaleFemaleTotalAverage duration of oral minoxidil use (months)23.425.324.8