Evaluation of Oral Minoxidil in the Treatment of Alopecia Areata

Abstract

A dose-response effect has previously been demonstrated in topical minoxidil treatment of alopecia areata. Limitations in minoxidil solubility and percutaneous absorption have impaired the development of more effective topical therapy. Oral minoxidil (5 mg every 12 hours), a dose demonstrated to be relatively well tolerated if a 2-g sodium diet is strictly followed, was given to 65 patients with severe, treatment-resistant alopecia areata in an attempt to bypass the limitations of topical treatment and increase efficacy. Although hair regrowth progressed more rapidly and was more extensive with oral than topical 5% minoxidil, cosmetic response was seen only in 18% of the patients. Neither serum nor tissue levels of minoxidil correlated with response. These findings suggest that improved preparations of topical minoxidil, when used as a single therapeutic agent, are unlikely to be cosmetically effective in the majority of patients with severe alopecia areata.

Role of low dose oral minoxidil in the treatment of hair loss: A review

“…Clinically evident improvement has been noticed in the form of hair regrowth and decreased hair shedding and has been noticed in all studies with good patient satisfaction in many of the studies. An improvement of 80% and 93% have been noticed by Fiedler-Weiss et al [24] and Wambier CG et al [44] in their respective studies when used for alopecia areata while an improvement of 92% in Telogen effluvium was noticed by Perera and Sinclair in his study on 36 subjects. [24,26] Granted that these studies have had many flaws such as small sample size and lack of control; however, the results, as well as the patient satisfaction scores, are significantly high enough to demand attention.…”

“…An improvement of 80% and 93% have been noticed by Fiedler-Weiss et al [24] and Wambier CG et al [44] in their respective studies when used for alopecia areata while an improvement of 92% in Telogen effluvium was noticed by Perera and Sinclair in his study on 36 subjects. [24,26] Granted that these studies have had many flaws such as small sample size and lack of control; however, the results, as well as the patient satisfaction scores, are significantly high enough to demand attention. Furthermore, the adverse effects noticed with doses ranging from 0.25 mg to 5 mg in these studies were very minuscule.…”

“…[23] e above conclusion supports the findings of Fiedler-Weiss et al who compared OM and TM in the treatment of alopecia areata. [24] Reasons for this are:…”

“…Study n* Dosage (mg) Findings AA Fiedler-Weiss et al [24] 65 5 mg twice daily Some form of improvement:80% Cosmetically meaningful improvement in 18% Wambier et al [44] 12 Females: 2.5 mg Males: 5 mg Combined with Oral tofacitinib 10 mg Median final percentage regrowth-93% TE Perera and Sinclair [26] 36 0.25-2.5mg Improvement-92% Reduction of mean HSS from baseline to 12 months-2.58 (range 1-6) Permanent CIA Yang and ai [27] (Case report)…”

Alopecia areata: revisão e atualização

“…Its mechanism of action has yet to be determined, but it is known that it stimulates the follicular synthesis of DNA, and has a direct action, demonstrated in vitro, on the proliferation and differentiation of the keratinocytes, and it regulates the physiology of the hair independently from influences in the regional blood flow. 74,75 Although useful, there are works that describe cosmetically acceptable results in proportions of only 20 to 45% of cases, [76][77][78][79] it has proven little effective in the severe forms. When minoxidil functions, the first results are observed starting from the twelfth week of use.…”