In female pattern hair loss low-dose oral minoxidil as effective as topical minoxidil: JAAD

Topical minoxidil (TM) is the only FDA-approved drug for the treatment of female pattern hair loss (FPHL). Premature discontinuation of treatment commonly occurs due to lack of perceived efficacy, adverse effects or altered hair texture.

Low-dose oral minoxidil (OM) has been reported as effective as topical minoxidil for female pattern hair loss according to a new study appearing in the Journal of the American Academy of Dermatology. To date, no study has compared the relative efficacy of oral minoxidil and Topical minoxidil in the treatment of female pattern hair loss (FPHL).

It is normal for women to shed some hair each day, but when bald patches or thinning occurs, it may be due to female pattern baldness. About one-third of women experience hair loss (alopecia) at some time in their lives; among postmenopausal women, as many as two-thirds suffer hair thinning or bald spots. Hair loss in women often has a greater impact than hair loss does on men, because it's less socially acceptable for them. Alopecia can severely affect a woman's emotional well-being and quality of life.

The researchers in this randomized comparative study gave oral minoxidil (OM) 1 mg or topical minoxidil (TM) 5% (1 mL) once daily for 24 weeks to 52 women with female pattern hair loss (Sinclair’s stage 2–4). While the increase in total hair density was higher in the oral minoxidil group (12% vs 7.2%), the difference was not statistically significant. A total of 19% of women from the Topical minoxidil group reported scalp pruritus, while 4% of women in the oral minoxidil group reported pretibial oedema. Additionally, women in the oral minoxidil group reported hypertrichosis more frequently with oral minoxidil versus Topical minoxidil (27% vs 4%); however, it was mild and well-tolerated. The mean heart rate at rest increased by 6.5% without tachycardia among women from the oral minoxidil group.

The researchers concluded that low-dose oral minoxidil demonstrated similar efficacy as the topical minoxidil 5% solution, with well-tolerated and mild adverse effects. These findings indicate that OM may be considered for patients who discontinue topical minoxidil prematurely due to lack of perceived efficacy, adverse effects, or altered hair texture. Oral minoxidil may be useful especially in patients who have not seen significant improvement after diligent use of TM for 6 to 9 months.

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