Low-dose oral minoxidil (Rogaine) is well-tolerated and as effective as topical minoxidil in treating androgenetic alopecia, offering a new option for patients who cannot tolerate topical treatments, a study in Brazil has revealed. This was shown in a randomized trial conducted.
Among the 68 participants, the mean change from baseline to week 24 in the frontal region between groups was 3.1 hairs per cm2 (95% CI -18.2 to 21.5, P=0.27) per cm2; 2.6 bottles (95% CI-2). Paulo Müller Ramos, MD, of São Paulo State University, and coauthors reported total hair density of 10.3 to 15.8, P=0.32).
Mean changes from baseline to week 24 at the top of the head were 23.4 hairs per cm2 (95% CI -0.3 to 43.0, P=0.09) and 5.5 hairs per cm2 (95% CI -12.5 to 23.5, P=0.09). total hair density was 0.32), they write in JAMA Dermatology.
The rate of increase in terminal hair density was 27.1% (P=0.005) higher in the parietal region and 13.1% (P=0.15) higher in the frontal scalp region in the oral minoxidil group.
According to the consensus of three dermatologists blinded to the treatment, 60% of the oral minoxidil group and 48% of the topical minoxidil group showed clinical improvement in the forehead, with no significant difference between the two groups. (P=0.24). More patients in the oral minoxidil group had clinical improvement in the parietal area than patients in the topical minoxidil group (70% vs. 46%, P=0.04).
Oral finasteride (Propecia) and topical minoxidil are the only two FDA-approved treatments for male pattern baldness, which is known to negatively impact self-esteem and quality of life. The authors noted that the respective negative effects on sexual function and hair and scalp health have led to increased interest in low-dose oral minoxidil (0.25-5 mg per day) as an alternative therapy.
“We observed that both oral and topical minoxidil formulations were effective and generally well tolerated by patients,” said Shoshana Marmon, M.D., of New York Medical College at Valhalla. Shoshana Marmon, M.D., told MedPage Today. “Additionally, minoxidil is also attractive to patients who are hesitant to use finasteride due to the risk of sexual side effects.”
In a single-center study conducted in Brazil from January to December 2021, 90 participants with mild to moderate male pattern baldness were treated with oral minoxidil 5 mg twice daily plus topical placebo solution or topical minoxidil. Patients were randomized 1:1 to receive 1 mL of 5%. and oral placebo for 24 weeks. Of these patients, 68 completed the study. The mean age was 36.6 years, and both groups were similar in terms of demographics and symptom severity.
The most common side effect was hirsutism, reported by 49% of the oral group and 25% of the topical group. There were no significant changes in heart rate and blood pressure.
Dropout rates were similar in the oral and topical groups, 27% and 22%, respectively, including 2% and 7% due to side effects. Except for individual side effects such as insomnia, persistent scalp eczema, and severe hair loss in the topical group, most of them were related to interruptions in attendance due to the COVID-19 pandemic.
Transient hair loss – reported to occur during the first 2 months of treatment due to premature release of telogen hairs (early telopsis) – was 9% in the oral minoxidil group and 16% in the topical minoxidil group. affected. “It is important to inform patients about the temporary and self-limiting nature of this disease to prevent premature discontinuation of treatment,” Ramos and team noted.
Marmon said that despite limitations acknowledged by the authors, including a small sample size and a relatively high proportion of patients lost to follow-up, “the results of this study are valuable to clinicians. There is,” he said.
Kate Kneisel is a freelance medical journalist based in Belleville, Ontario.
disclosure
This study was supported by the Brazilian Dermatological Society Support Fund.
Mr. Ramos reported no conflicts of interest. The co-authors reported a grant from the Brazilian Dermatological Society Support Fund during the conduct of the study.
primary source
JAMA Dermatology
Source reference: Penha MA et al. “Oral minoxidil versus topical minoxidil for male androgenic alopecia: a randomized clinical trial” JAMA Dermatol 2024; DOI: 10.1001/jamadermatol.2024.0284.
