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This article discusses the potential exacerbation of alcohol hangover symptoms in patients who take oral minoxidil, a vasodilator commonly used to treat hair loss. The authors have observed that some patients experience worsened hangover symptoms, such as headaches and nausea, after taking oral minoxidil. While the exact mechanism is not fully understood, it is believed that the interaction between alcohol and minoxidil may contribute to these effects. The authors recommend that patients avoid taking oral minoxidil on days when they anticipate heavy alcohol consumption. Further research is needed to better understand this interaction and develop strategies to mitigate these symptoms. [Extracted from the article]

The article discusses the impact of media coverage on the prescribing habits of physicians regarding low-dose oral minoxidil (LDOM) for hair loss. The article highlights that media outlets can influence prescribing habits, and physicians should be aware of media trends to guide patient education. The use of oral minoxidil for hair loss is an off-label use, as it was originally approved for treating high blood pressure. The article also presents survey data and prescribing statistics that demonstrate an increase in LDOM prescriptions following media coverage. Safety studies have shown that LDOM may be a safe and effective treatment for hair loss. [Extracted from the article]

Platelet-rich plasma (PRP) is an adjunctive treatment in androgenetic alopecia (AGA). Its role as a monotherapy, when compared to FDA-approved therapies in moderate grades of androgenetic alopecia is not established. We sought to study the efficacy and safety of standardized non-activated PRP preparation against topical minoxidil in AGA. Men aged 20–50 with Grade III and IV (Modified Hamilton-Norwood) AGA were randomized to receive 5% Minoxidil (×6 months) or PRP injections (monthly ×3). The primary endpoints were global photographic assessment at week 24, change in target area hair counts, density, and anagen hair at week 12. Other outcomes were subjects' satisfaction and adverse events. In total, 64 participants were randomized. At week 24, 56% responded to Minoxidil arm and 38% to PRP (p = 0.124). There was a significant increase in target area hair count and density at week 12 within the groups. The difference between the groups was not statistically significant. Adverse events occurred in 53% and 37% of the PRP and minoxidil groups, respectively. Patient satisfaction was better with Minoxidil. PRP is effective in the treatment of moderate grades of androgenetic alopecia in men, although perhaps not different from minoxidil. Side effects occur more frequently with PRP. [ABSTRACT FROM AUTHOR]

We aim to evaluate the clinical efficacy and safety of using laser and light combined with topical minoxidil for alopecia areata. We searched PubMed, Embase, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (CBM), VIP database, and Wanfang Data from their inception to September 18, 2022. The risk of bias of the included RCTs was assessed by the Cochrane Collaboration tool. RevMan 5.3 software and Stata 14.0 software were used to perform the statistical analysis. The GRADE system assessed the quality of evidence. Ten studies were enrolled finally. The results of the meta-analysis showed that compared with topical minoxidil alone, the 308-nm excimer laser/light or He-Ne laser combined with topical minoxidil could reduce the SALT (Severity of Alopecia Tool) score (MD= −5.88, 95% CI [−9.79, −1.98], P=0.003). Whether fractional CO2 laser (RR=1.29, 95% CI [1.14, 1.46], P<0.0001), 308-nm excimer laser/light (RR=1.32, 95% CI [1.12, 1.55], P=0.001), He-Ne laser (RR=1.69, 95% CI [1.07, 2.69], P=0.03), or NB-UVB (RR=1.35, 95% CI [1.07,1.70], P=0.01) combined with topical minoxidil may improve the treatment response rate, comparing with topical minoxidil only. The recurrence rate of laser and light combined with topical minoxidil was lower than that of the minoxidil alone group (RR=0.54, 95% CI [0.31, 0.93], P=0.03) when follow-up time was 1 year. In addition, the incidence of adverse events including irritant contact dermatitis, erythema, desquamation, pain, and pruritus was no significant difference between the two groups (RR=1.50, 95% CI [0.95, 2.36], P=0.08). The level of evidence for outcomes was classified as very low to moderate. Based on the available evidence, laser and light combined with topical minoxidil therapy may be effective and safe for alopecia areata. However, more high-quality trials are required for comprehensive analysis and further verification. [ABSTRACT FROM AUTHOR]

Atraric acid (AA) is a phenolic compound isolated from Stereocaulon japonicum that has demonstrated anti-androgen properties and was used to design an alternative formulation for the treatment of alopecia. This new topical formulation was designed using a solvent mixture system composed of ethanol as a volatile vehicle, oleic acid as a permeation enhancer, and water for skin hydration. The ideal topical AA formulation (AA–TF#15) exhibited an 8.77-fold higher human skin flux and a 570% increase in dermal drug deposition, compared to 1% (w/w) AA in ethanol. In addition, compared to other formulations, AA–TF#15 (1% [w/w] AA) activated keratinocytes and human dermal papilla cell proliferation at a concentration of 50 µM AA, which is equivalent to 50 µM minoxidil. Moreover, AA–TF#15 treatment produced a significant increase in hair regrowth by 58.0% and 41.9% compared to the 1% (w/w) minoxidil and oral finasteride (1 mg/kg)-treated mice. In addition, AA–TF#15 showed a higher expression level of aldehyde dehydrogenase 1, β-catenin, cyclin D1, and pyruvate kinase M2 proteins in the skin of AA–TF#15-treated mice compared to that of those treated with minoxidil and oral finasteride. These findings suggest AA–TF#15 is an effective formulation for the treatment of scalp androgenic alopecia. [ABSTRACT FROM AUTHOR]

Acute Localized Exanthematous Pustulosis (ALEP) is a rare skin reaction characterized by the sudden onset of multiple, small, sterile, non-follicular pustules in an erythematous and edematous base succeeding systemic drug administration. ALEP is considered a subtype of Acute Generalized Exanthematous Pustulosis (AGEP), although the exact pathogenic mechanism of the disease remains poorly defined. Numerous drugs have been implicated in the pathogenesis of ALEP, while contact mechanisms have also been reported. Herein, we describe the first case of ALEP attributed to minoxidil in a female patient with androgenetic alopecia. The positivity of patch tests and the topical application of minoxidil proposes a contact-induced hypersensitivity reaction. Identifying new agents—including minoxidil—which serve as inducers of drug-specific T-cell-mediated responses in the clinical spectrum of ALEP, adds further value in understanding the complex, yet unknown, pathophysiological mechanisms of this rare drug hypersensitivity reaction. [ABSTRACT FROM AUTHOR]

The present study assessed the effect of retention on ex vivo skin and in vivo scalp penetration of radiolabeled minoxidil formulations (5% w/v). Minoxidil was radiolabeled with technetium (99mTc) with an efficiency of 99.1% using 0.2% stannous chloride as reducing agent at pH 6 and incubation temperature of 40 °C. Three different 99mTc-minoxidil formulations were prepared using aqueous ethanolic solution as vehicle. Formulation A contains 99mTc-minoxidil dissolved in vehicle, formulation B contains 10% propylene glycol (PG) and formulation C contains 10% hydroxypropyl cellulose (HPC), in addition. Results showed that addition of HPC resulted in enhanced viscosity (400 mPa.s) and significantly higher ex vivo retention (p < 0.05) and permeation (0.75±0.12%, 8 h). PG does not improve the permeation and the results (0.44±0.05%, 8 h) were not significantly different from vehicle alone (0.40±0.05%, 8 h). The results of the in vivo human scalp studies corroborated with the ex vivo results and addition of hydroxypropyl cellulose (HPH) showed significantly higher (p < 0.05) scalp retention. Post 8 h application, scalp penetration in group treated with formulation C was nearly 2.8-fold and 2.2-fold higher than those treated with formulation A and B, respectively. Further, absence of minoxidil in systemic circulation during study duration indicates safety. In conclusion, our results showed that increasing contact time of minoxidil with scalp by modifying viscosity results in reduced frequency of application and improved efficacy. [ABSTRACT FROM AUTHOR]

Male androgenetic alopecia is a common condition and represents a major concern for patients who experience this condition. While there are different treatments to stop hair loss and improve hair density, the 5-alpha reductase inhibitors have demonstrated to be effective in improving androgenetic alopecia in men and can maintain a positive response for many years. Oral finasteride 1 mg is a US FDA-approved option, but dutasteride 0.5 mg has been proven to induce better responses, especially in the frontal area. Both have been shown to be safe in clinical trials but there is widespread concern about sexual adverse effects among patients. The use of topical finasteride has increased during the last few years as a useful option to avoid systemic therapy. The efficacy of topical finasteride 0.25% daily has been demonstrated in clinical trials, with a less marked decrease in serum dihydrotestosterone levels than with oral intake. Mesotherapy with dutasteride has also become more widespread recently, although evidence of its effectiveness is limited to retrospective studies in real clinical practice. The use of oral minoxidil in androgenetic alopecia has not been approved by the FDA, however several clinical studies have shown that it is an effective treatment option. The initial dose recommended to treat male hair loss is 2.5 mg daily, although the dose is frequently increased to 5 mg daily. The main adverse effect of oral minoxidil is hypertrichosis, followed by dizziness or lower limb edema, which are much less common. Platelet-rich plasma is a non-pharmacological option to treat male androgenetic alopecia, with some clinical trials demonstrating an improvement in hair count after several months. Among the published studies, the main limitation to compare its efficacy is the heterogeneity of the procedure. The most frequent regimens propose treatment every 4 weeks for 3 months initially to assess the individual response. Another treatment alternative is the use of light devices with wavelengths of between 630 and 660 nm, known as low-level laser therapy. These devices can be used at home every day for 15–30 min. Their efficacy has been shown in a limited number of clinical trials; however, there is a lack of evidence about the efficacy of these devices compared with other medical options or as a complementary therapy in hair loss. The pipeline of potential new treatments for male androgenetic alopecia is strong. Pyrilutamide and GT20029 are being studied as topical antagonists of the androgen receptor, while cetirizine is another topical option with some initial promising results. Furthermore, according to isolated studies with heterogeneous treatment schemes, the use of botulinum toxin in the scalp might improve androgenetic alopecia, and lastly, scalp threading might increase the total hair count as growth factors are released during implantation. [ABSTRACT FROM AUTHOR]

Minoxidil, finasteride, dutasteride, and clobetasol propionate might be present as adulteration agents in cosmetic products such as hair serums. In this study, minoxidil, finasteride, dutasteride, and clobetasol propionate in commercial hair serum samples are determined by an LC-HRMS method. The relative standard deviations (R.S.D.) were below 1.5% for the compounds. The correlation coefficient was determined in the range of 0.997-0.999 for each component in the calibration range. The recoveries of the method are determined as 97.5, 105.5, 104.2, and 100.8, respectively. These active pharmaceutical ingredients were not declared by the manufacturer, however, pose risk to public health due to their potential toxicological properties. The manufacturers and government authorities must be aware and give importance to inform the users to prevent the possible risks. [ABSTRACT FROM AUTHOR]

Oleanolic acid (OA) is a pentacyclic triterpenoid with favourable physiological activity. It is widely distributed in more than 200 species of plants. OA has garnered significant interest because of its potential biological activities, such as antioxidant, bacteriostatic, and hair growth-promoting effects. To study the effect of OA on hair growth and related mechanisms, we investigated hair growth in mice with testosterone-induced androgenetic alopecia (AGA) that were treated with three different concentrations of OA. The antioxidant, bacteriostatic, and cytotoxic effects of OA were evaluated. We found that mice with testosterone-induced AGA treated with 1% or 0.5% OA showed significantly enhanced hair growth and increased vascular endothelial growth factor/glyceraldehyde-3-phosphate dehydrogenase ratio and levels of fibroblast growth factor receptor and insulin-like growth factor 1. Using an immunofluorescence staining assay, we demonstrated that β-catenin, a key Wnt signalling transducer, was highly expressed in the OA-treated groups. These results suggest that OA may promote hair growth by stimulating hair matrix cell proliferation via the Wnt/β-catenin pathway and lowering the levels of tumour necrosis factor-alpha, and transforming growth factor-beta 1, dihydrotestosterone, and 5a-reductase. [ABSTRACT FROM AUTHOR]

Objective: To determine the causative gene mutation in a family with monilethrix and observe the therapeutic effect of 5% topical minoxidil. Method: Clinical data from a family with monilethrix were collected. Peripheral blood samples were taken from the proband, the parents, and 100 unrelated healthy controls. Genomic DNA was extracted. The genetic variation sites were screened with exome sequencing and verified by Sanger sequencing. The proband was treated with 5% topical minoxidil (1 mL twice daily). Hair quality was examined by dermoscopy before and after treatment. Results: The proband and her father have the heterozygous missense variant c.1204G > A (p.E402K) in exon 7 of the KRT86 gene. However, the mutation was not found in the mother and healthy controls. The proband was treated with 5% topical minoxidil. Hair density and hair shaft quality improved significantly after 6 months of treatment. No adverse events occurred during treatment. Conclusion: This study shows that p.E402K is a mutation "hot spot" in patients with autosomal dominant monilethrix in China. Treatment with 5% topical minoxidil, is safe and effective. [ABSTRACT FROM AUTHOR]

Background: Valproic acid (VPA), is often used as an anticonvulsant drug that activates the Wnt/ß-catenin signaling pathway and blocks GSK3b, a glycogen synthase kinase, and though connected with increasing hair growth and induction of anagen. Currently, only FDA-approved two percent topical minoxidil is available therapy to treat female pattern baldness. Objective: This randomized controlled clinical trial study aimed to evaluate the effectiveness of topical VPA and 5% topical minoxidil for treating Female pattern hair loss (FPHL). Patients and Methods: This study included 81 patients with FPHL who were allocated into three groups randomly (27 treated with topical sodium valproate-loaded nano spanlastics formulation, 27 treated with minoxidil® 5% lotion, and 27 treated with saline bottled containers using transdermal delivery using a derma roller for 6 months. The included patients were chosen randomly from the Outpatient Clinic of Dermatology, Andrology & STDs Department, Mansoura University Hospitals. All patients were subjected to history taking, and general dermatological and scalp examination. Results: In comparison to the control group, the mean change in the total number of hairs was substantially larger in the VPA and minoxidil groups (P = 0.047). Although the majority of adverse events in both groups were moderate and self-limiting, the variations in prevalence rates across the groups were comparable (P = 0.72). Conclusion: Topical VPA and 5% minoxidil increased the total hair count of our patients; therefore, topical VPA is a potential therapy option for FPHL. [ABSTRACT FROM AUTHOR]

We report three pediatric patients with alopecia areata and high seropositive immunoglobulin G of rubella, toxoplasmosis, cytomegalovirus, and herpes simplex virus. We treated the patients with a combination of topical and intralesional injections of corticosteroids, topical minoxidil 5%, inosine pranobex, valacyclovir, and light-emitting diode therapy with excellent results. [ABSTRACT FROM AUTHOR]

Background: Androgenetic alopecia (AGA) is caused by the susceptibility of hair follicles to androgenic miniaturization, which leads to hair loss. The most common modalities for the treatment of AGA include the use of topical minoxidil and oral finasteride. Low-level laser therapy (LLLT) is a newer modality of treatment for AGA. We tried to evaluate the added benefit of LLLT in AGA compared with topical minoxidil 5% alone. Aim: The aim of this study was to compare the efficacy of LLLT combined with topical 5% minoxidil in AGA versus topical 5% minoxidil used alone. Materials and Methods: After ethics committee approval, 54 patients of AGA were randomly divided into two groups. Group A participants received LLLT therapy twice a week plus topical 5% minoxidil and Group B participants received only minoxidil 5% solution. Both the groups were followed up for 16 weeks and evaluated with gross photographs, TrichoScan analysis, and dermoscopy to look for any improvement in hair density. Results: After 16 weeks, improvement in hair density of 14.78% ± 10.93% in Group A was recorded compared to 11.43% ± 6.43% in Group B. However, while comparing both means, P value was 0.45 which was not significant. The physician global assessment and patient satisfaction score revealed no significant difference between both the groups. Conclusion: Although LLLT appears to be safe and effective in the treatment of male pattern hair loss, we did not observe any significant difference in terms of improvement in hair density between both the groups. [ABSTRACT FROM AUTHOR]

Topical minoxidil is used for treating different hair disorders. Even though it is an effective therapy, many patients show poor compliance due to the cost, side effects, and duration of treatment. Topical minoxidil is the mainstay treatment for androgenetic alopecia (AGA). Recently, low alcohol or alcohol-free topical minoxidil formulation has proven to be an alternative for patients suffering from AGA, including those with poor compliance with other therapies. Thus, the current article provides the positioning of low alcohol or alcohol-free topical minoxidil to manage AGA in Indian clinical practice. [ABSTRACT FROM AUTHOR]

Alopecia areata (AA), a polygenic and chronic autoimmune disease and there is no definitive cure. We aimed to evaluate latanoprost effects in patients with AA. In this controlled randomized double‐blind clinical trial, we enrolled patients with AA randomly assigned to six groups of 18; Group 1 received latanoprost eye drops; group 2 minoxidil 5% solution; group 3 latanoprost eye drops and minoxidil 5% solution; group 4 betamethasone and minoxidil 5% solution; group 5 betamethasone solution and latanoprost eye drops; group 6 (the control group) betamethasone solution. The alopecia severity in patients before and after treatment was assessed by severity of alopecia tool (SALT). One hundred and eight patients, 50% male (mean age: 32.6 ± 10.4) were studied. The overall SALT score decreased in all. After 2 weeks, patients receiving betamethason‐minoxidil and betamethason‐latanoprost showed more decline in their SALT than other groups. In final, there was statistically significant difference among betamethasone‐latanoprost group with minoxidil, betamethasone‐minoxidil and betamethasone groups. Regrowth was higher in latanoprost and betamethasone‐latanoprost groups than minoxidil. Topical latanoprost added to therapeutic efficacy of topical betamethason and minoxidil in treating patchy AA, suggesting it being beneficial and safe adjuvant therapy and add to efficacy of topical treatments without any adverse effects. [ABSTRACT FROM AUTHOR]

Cell membrane lipids are sometimes referred to as internal lipids and contribute to physiomechanical properties of hair, contributing to hair integrity by acting as a "glue" between protein structures via interaction between lipids and the hydrophobic domains of globular proteins within the cuticle and cortex cells (Robbins, 2009; Marsh, Whitaker, et al., 2018b). Keywords: chemical analysis; hair treatment; Lipidomics; mass spectrometry; UV light exposure EN chemical analysis hair treatment Lipidomics mass spectrometry UV light exposure 672 684 13 11/10/22 20221201 NES 221201 Profiling the lipid classes and lipids in hair was used to understand the diversity of changes to the hair lipidome when exposed to UV and visible light. The main lipid classes that differed were vitamin A fatty acid esters, sterol esters, several ceramides, mono-, di- and triglycerides, phosphatidylethanolamines (all decreased in UV-exposed hair) and bismonoacylglycerolphosphates, acylcarnitines and acylglycines (all increased in UV-exposed hair). [Extracted from the article]

Background: The key pathophysiological changes in androgenetic alopecia (AGA) are limited to hair follicles (HFs) in frontal and vertex regions, sparing the occipital region. Objectives: To identify biological differences among HF subpopulations. Methods: Paired vertex and occipital HFs from 10 male donors with AGA were collected for RNA sequencing assay. Furthermore, HF and cell experiments were conducted on the identified key genes to reveal their roles in AGA. Results: Transcriptome profiles revealed that 506 mRNAs, 55 microRNAs and 127 long noncoding RNAs were differentially expressed in the AGA vertex HFs. Pathway analysis of mRNAs and microRNAs revealed involvement of the hypoxia‐inducible factor (HIF)‐1, Wnt/β‐catenin, and focal adhesion pathways. Differential expression of HIF‐1 prolyl hydroxylase enzymes (EGLN1, EGLN3) and Wnt/β‐catenin pathway inhibitors (SERPINF1, SFRP2) was experimentally validated. In vitro studies revealed that reduction of EGLN1, EGLN3, SERPINF1 and SFRP2 stimulated proliferation of dermal papilla cells. Ex vivo HF studies showed that downregulation of EGLN1, EGLN3 and SERPINF1 promoted HF growth, postponed HF catagen transition, and prolonged the anagen stage, suggesting that these genes may be potentially utilized as therapeutic targets for AGA. Conclusions: We characterized key transcriptome changes in male AGA HFs, and found that HIF‐1 pathway‐related genes (EGLN1, EGLN3) and Wnt pathway inhibitors (SERPINF1, SFRP2) may play important roles in AGA. What is already known about this topic?Multiple differentially expressed genes and signalling pathways have been found between hair follicles (HFs) in the balding area (frontal and vertex regions) and nonbalding area (occipital region) of individuals with androgenetic alopecia (AGA).A whole‐transcriptome atlas of the vertex and occipital region is lacking. What does this study add?We identified a number of differentially expressed genes and pathways between balding vertex and nonbalding occipital AGA HFs by using whole‐transcriptome analyses.We identified pathways not previously reported in AGA, such as the hypoxia‐inducible factor (HIF)‐1 signalling pathway.We verified that HIF‐1 pathway‐related genes (EGLN1, EGLN3) and Wnt pathway inhibitors (PEDF, SFRP2) played important roles in dermal papilla cell activity, hair growth and the hair cycle. What is the translational message?The EGLN1, EGLN3, SERPINF1 and SFRP2 genes may be potentially utilized as therapeutic targets for AGA. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy and safety of 2% minoxidil combined with microneedling in the treatment of female pattern hair loss. Methods: Forty female patients with female pattern hair loss were randomly divided into two groups with 20 patients each. The control group was treated with 2% minoxidil. The combined treatment group was treated with weekly microneedling in addition to daily minoxidil. The treatment period of both groups was 24 weeks. Results: There were no significant differences in age or duration of disease between the two groups of patients. The effective rate in the combined treatment group was 85%, which was significantly higher than that of the control group (45%). The hair counts were also higher in the combined treatment group. All of the adverse reactions observed during the treatment period were mild. No severe adverse event was observed in either group. Conclusion: Microneedling combined with minoxidil had better efficacy for female pattern hair loss during the treatment period and follow‐up. Microneedling combined with minoxidil therapy was safe and effective. [ABSTRACT FROM AUTHOR]

Androgenic alopecia, a polygenetic disorder, is characterized by well-defined hair loss that progresses gradually. The disease affects both males and females and exerts a drastic impact on a person's psychological well-being. Minoxidil (MIN) is the commonly prescribed FDA-approved agent for the treatment of disease. It is conventionally administered as a topical solution but is allied with several adverse reactions, such as erythema and dermatitis, resulting in decreased patient compliance. To overcome these side effects, researchers developed various nanocarriers of MIN. Encapsulation of MIN in various nanocarriers enhances the entry of the drug into hair follicles and results in the formation of reservoirs for controlled delivery of the drug. It also increases the therapeutic outcomes in comparison to conventional formulations. The present review discusses the composition and physicochemical properties of different nanocarrier systems of MIN. Although successful encapsulation of MIN has been observed in these nanocarriers, there is still scarce data regarding their loading in a final dosage form. This allows researchers to conduct more invivo studies and focus on their clinical applications. Highlights: • Androgenic alopecia is a polygenetic disorder with gradual loss of hair that progresses with age. • Minoxidil An FDA-approved drug for the treatment of androgenic alopecia. • Is allied with several adverse reactions, having decreased therapeutic efficacy. • Several nanocarriers including polymeric lipid-based and inorganic nanoparticles have been developed to improve their therapeutic efficacy. • Utilization of these nanocarriers results in increased retention of MIN within the hair follicles and utilizes low concentrations of solvents. • Modifications of different physicochemical properties of these carriers I.e. Particle size Zeta potential and entrapment efficiency are important to attain the above objectives. [ABSTRACT FROM AUTHOR]

Minoxidil (MXD) is the only topical over-the-counter medicine approved by the United States Food and Drug Administration for the treatment of androgenetic alopecia. For the purpose of targeting the delivery of MXD to dermal papilla in the hair follicle, MXD Pickering emulsion gels were fabricated based on the designability of deep eutectic solvent (DES) and the versatility of cellulose nanocrystal (CNC) and sodium carboxymethyl cellulose (CMC-Na). Structural studies and theoretical calculations results suggest that CNC can stabilize the interface between the MXD-DES and water, leading to the formation of Pickering emulsions. The rheological properties and stabilities of MXD Pickering emulsions were enhanced through gelation using CMC-Na, which highlights the good compatibility and effectiveness of natural polysaccharides in emulsion gels. Due to the particle size of emulsion droplets (679 nm) and the rheological properties of emulsion gel, the fabricated MXD formulations show in vivo hair regrowth promotion and hair follicle targeting capabilities. Interestingly, the MXD Pickering emulsion-based formulations exert therapeutic effects by upregulating the expression of hair growth factors. The proposed nanodrug strategy based on supramolecular strategies of CNC and CMC-Na provides an interesting avenue for androgenetic alopecia treatment. [Display omitted] • l -Menthol-based deep eutectic solvents are formed for minoxidil (MXD) formulation. • The role of cellulose nanocrystals in Pickering emulsion is revealed. • Sodium carboxymethyl cellulose is used to construct Pickering emulsion gel. • MXD Pickering emulsion of 679 nm is made for hair follicle-targeting delivery. • MXD Pickering emulsion gel effectively upregulates key factors for hair regrowth. [ABSTRACT FROM AUTHOR]

[Display omitted] • Temperature-responsive detachable microneedles with robust adhesion and mechanical strength were developed. • The microneedle system facilitated transdermal drug release, reduced drug dose, and provided robust manipulation. • The microneedle system exhibited remarkable hair regrowth promotion effect and accelerated vascularization. Androgenetic alopecia (AGA) is one of the most customary inducement of hair loss, and topical minoxidil (MXD) has been widely used to treat AGA, but the drug delivery rate is seriously limited by the poor solubility of MXD and traditional inefficient transdermal delivery methods. Microneedles (MNs) can directly puncture the skin for administration with improved drug delivery rate and weaker side effects. However, the common solid MN is easy to fall off, especially in hairy areas, which reduces the duration of drug action. To ensure robust attachment and prolong the drug efficacy, we designed minoxidil nanoparticle-loaded hyaluronic acid (HA) microneedles and integrated with a switchable temperature-responsive adhesion ring, which polished the solubility of MXD and made the MNs retained in the body for a longer time and improved clinical operability. In AGA model, the MXD NP-loaded MN system could promote the hair follicles transformation from telogen phase to anagen phase. Compared with the application of the traditional minoxidil solution, our MN system can achieve therapeutic effect with a lower dose and frequency, which reduced side effects and advanced user compliance. Therefore, this transdermal delivery system can possibly offer a promising strategy for treating alopecia and other dermatoses. [ABSTRACT FROM AUTHOR]

Background: Minoxidil was introduced into the market as a hypotensive agent, however, aftermarketing, the hypertrichosis side effect was reported by almost all users. This adverse effect encourages the repositioning or repurposing the use of minoxidil as a topical preparation for the treatment of hair loss. Objective: topical minoxidil is contemplated as an effective treatment to reduce hair loss and promote regrowth in conditions like androgenetic alopecia. However, the unerring mode of action of minoxidil remains obscure. In this review, the molecular pharmacology of minoxidil, the response of hair follicles to treatment, and the side effects of the topically applied minoxidil were reviewed. The innovation in the formulation of topical preparation toward enhancing delivery was highlighted focusing on the use of nanoemulsion and nanocarrier systems such as nanoparticles and liposomes that enriched the topical delivery.

Kartika Ruchiatan, Erda Avriyanti, Reti Hindritiani, Diah Puspitosari, Oki Suwarsa, Hendra Gunawan Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Bandung, West Java, IndonesiaCorrespondence: Kartika RuchiatanDepartment of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Pasteur 38, Bandung, West Java, 40161, Indonesia, Tel +62222032426 ext. 3449; +62811247932, Email kartika.ruchiatan@unpad.ac.idAbstract: Alopecia areata (AA) is an autoimmune disease-specific to specific organs mediated by T lymphocytes with hair follicles as targets. Severe AA could be in the form of alopecia universalis (AU). AU therapy is relatively difficult and challenging with varying outcomes. Herein, we reported a case of AU in a 19-year-old man with alopecia in the hairy scalp area, eyebrows, eyelashes, moustache, beard, and axillary hair since 2.5 years ago. The patient’s severity of alopecia tool (SALT) score was 100%. The patient was given a combination therapy of 15 mg methotrexate per week and 16 mg methylprednisolone per day orally and topical treatment with minoxidil 5%. Observations after nine months of treatment showed an improvement in the decrease in SALT scores to 41%. However, striae were found after 3rd month of therapy. Systemic combination therapy of methotrexate and low-dose corticosteroids and topical minoxidil 5% in this patient gave responsive results. Performed the hematological examination, liver function levels, blood glucose levels, and cortisol during long-term use of methotrexate and corticosteroids are necessary. The combination of systemic methotrexate and corticosteroids, and topical minoxidil showed promising results in AU. Nevertheless, long-term observation is still needed to monitor the side effects of therapy.Keywords: alopecia areata, alopecia universalis, corticosteroid, methotrexate, minoxidil

There are a number of options available for the medical management of androgenetic alopecia. The key questions for practitioners are what the available medications are and what is their efficacy? What are the possible side-effects of these options? Are there differences in response according to parameters like gender? Are combinations effective? What are the newer options available and what could the future hold? This narrative review attempts to answer these questions. The main focus is on the medical treatment options which have significant evidence as of now – minoxidil, 5 alfa-reductase inhibitors, low light laser therapy, and platelet-rich plasma.

A 55-year-old man presented to our institution with abnormal chest X-ray shadows. Chest computed tomography (CT) showed left-sided interlobular septal thickening; thus, we suspected lymphangitis carcinomatosis and other disorders that show similar CT findings. Bronchoscopy and laboratory and imaging studies yielded no diagnostic findings. Pulmonary shadows during follow-up spontaneously improved then worsened. Thoracoscopic lung biopsy samples showed interstitial pneumonia and granulomas but the etiology of the pulmonary lesion could not be determined. At seven years after presentation, the patient's pulmonary shadows had gradually deteriorated, and he reported using topical minoxidil. His history of minoxidil use was linked to changes in the pulmonary shadows. The diagnostic delay was due to the patient's hesitancy to report drugs obtained online and the difficulty in obtaining such a history.

We report the case of a 71-year-old male with essential thrombosis who presented with ground-glass lung opacity with a mosaic pattern on computed tomography, which resolved spontaneously with hospitalization. This was confused with a case of hypersensitivity pneumonitis (HP), which later turned out to be a drug-induced lung disease caused by surreptitiously administered minoxidil. This case emphasizes the importance of obtaining a correct medication history to make an accurate diagnosis, and this is the first report of minoxidil causing HP-like pulmonary illness.

BackgroundAndrogenetic alopecia (AGA) affects almost half the population, and several treatments intending to regenerate a normal scalp hair phenotype are used. This is the first study comparing treatment efficacy response and resistance using standardized continuous outcomes.ObjectiveTo systematically compare the relative efficacy of treatments used for terminal hair (TH) regrowth in women and men with AGA.MethodsA systematic literature review was conducted (from inception to August 11, 2021) to identify randomized, Placebo-controlled trials with ≥ 20 patients and reporting changes in TH density after 24 weeks. Efficacy was analyzed by sex at 12 and 24 weeks using Bayesian network meta-analysis (B-NMA) and compared to frequentist and continuous outcomes profiles.ResultsThe search identified 2,314 unique articles. Ninety-eight were included for full-text review, and 17 articles met the inclusion criteria for data extraction and analyses. Eligible treatments included ALRV5XR, Dutasteride 0.5 mg/day, Finasteride 1 mg/day, low-level laser comb treatment (LLLT), Minoxidil 2% and 5%, Nutrafol, and Viviscal. At 24 weeks, the B-NMA regrowth efficacy in TH/cm2 and significance (**) in women were ALRV5XR: 30.09**, LLLT: 16.62**, Minoxidil 2%: 12.13**, Minoxidil 5%: 10.82**, and Nutrafol: 7.32**, and in men; ALRV5XR: 21.03**, LLLT: 18.75**, Dutasteride: 18.37**, Viviscal: 13.23, Minoxidil 5%: 13.13**, Finasteride: 12.38, and Minoxidil 2%: 10.54. Two distinct TH regrowth response profiles were found; Continuous: ALRV5XR regrowth rates were linear in men and accelerated in women; Resistant: after 12 weeks, LLLT, Nutrafol, and Viviscal regrowth rates attenuated while Dutasteride and Finasteride plateaued; Minoxidil 2% and 5% lost some regrowth. There were no statistical differences for the same treatment between women and men. B-NMA provided more accurate, statistically relevant, and conservative results than the frequentist-NMA.ConclusionSome TH regrowth can be expected from most AGA treatments with less variability in women than men. Responses to drug treatments were rapid, showing strong early efficacy followed by the greatest resistance effects from flatlining to loss of regrowth after 12–16 weeks. Finasteride, Minoxidil 2% and Viviscal in men were not statistically different from Placebo. LLLT appeared more efficacious than pharmaceuticals. The natural product formulation ALRV5XR showed better efficacy in all tested parameters without signs of treatment resistance (see Graphical abstract).Systematic review registrationwww.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42021268040, identifier CRD42021268040.

Introduction. The skin biopsies of 30 patients with androgenetic alopecia before and after treatment with platelet-rich plasma in combination with 2 % minoxidil were examined by immunohistochemistry. Goal. The study looked at immunohistochemical changes in the scalp biopsies of patients with stage I-II androgenetic alopecia according to the Ludwig scale and to identify possible changes after injection of platelet-rich plasma in combination with topical 2 % minoxidil lotion. Materials and methods. Skin biopsies of 30 patients with androgenetic alopecia were examined using an immunohistochemical study before and after treatment, which lasted 3 months and included 3 sessions of PRP (once per month) and topical application of minoxidil 2 % lotion twice a day. Results. It was found that androgenetic alorecia is accompanied by inflammatory perifollicular infiltration by T-lymphocytes CD3 +, CD4 + and CD8 +, macrophages (CD68 +); imbalance of germ polypeptides VEGF, TGF-β1, EGFR; accumulation of oxidative stress enzymes eNOS and iNOS; accumulation of pathological fraction of collagen IV. Injections of platelet-rich plasma in combination with topical administration of 2 % minoxidil as a treatment for androgenetic alopecia lead to normalization of immunohistochemical parameters of the skin, which indicates the possibility of using this combination for long-term therapeutic effect. Conclusions. This study complemented the understanding of the pathogenesis of AGA and serves as a basis for improving treatment regimens for this pathology. However, additional studies are needed to further study the pathomorphology of androgenetic alopecia and to standardize the technique of using platelet-rich plasma in patients with this disease.

Introduction. Alopecia is a polyetiological disorder characterized by hair loss and reducing their number per unit area. Baldness causes psychological and social discomfort to patients, in connection with what an important task is to develop formulations that are more effective than the reference agents.Aim. Investigate the possibility of applying the original substance Y in several dosage forms for the treatment of alopecia in comparison with reference drugs: minoxidil and burdock oil.Materials and methods. The research subject was the original substance Y, for which several dosage forms were made: gel, alcohol and oil compositions. The study on the effectiveness and safety of the developed formulations was carried out on 9 groups of male C57BL/6 mice. Depilation with further assessment of the percentage of hair follicles in the growth and resting phases was tested as a pre-clinical model of alopecia. In the study of the mechanism of action of substance Y, chemiluminescent assay was performed compared with natural antioxidant quercetin in the system luminol – 2,2'-azo-bis(2-amidinopropane)dihydrochloride, in potassium-phosphate buffer medium (pH = 7.4). Statistical processing of the results was carried out using two-way ANOVA using GraphPad Prism 8.0.2, USA software at the level of statistical significance of differences p < 0.05 and p < 0.005.Results and discussion. Based on the results of histological analysis and visual changes, it was found that the effectiveness of the topical forms of substance Y decreases in the following order: gel, alcohol form, oil composition. The use of a combination of the gel base with the test substance Y resulted to the appearance of a larger number of hair follicles in the growth phase than when using the reference preparation – 2 % minoxidil solution (the differences are statistically significant). Chemiluminescent assessment of antioxidant activity showed the lack of antioxidant effect in substance Y.Conclusion. The study combines two pharmaceutical profiles: technological and pharmacological. In the course of the experiments, the prospects of the gel form of the original substance Y for topical therapy of alopecia were shown. In the near future, it is planned to study the mechanism of action of substance Y, as well as registration of patent protection for a new drug.

In recent months, the general public has become more cognizant of the potential of oral minoxidil to promote hair growth; this was promulgated, in part, by an article published in the New York Times entitled, “An Old Medicine Grows New Hair for Pennies a Day, Doctors Say.” Minoxidil was added to the pharmacologic armamentarium as an antihypertensive nearly 60 years ago and was found to trigger hypertrichosis in many patients, but its use dropped sharply as cardiologists observed a number of adverse cardiovascular events including ischemic heart disease, left ventricular hypertrophy, pleural effusions, and pericardial effusions. Studies in the realm of dermatology have explored the utility and safety of low dose oral minoxidil (LDOM) for management of alopecia. This article highlights potential clinical conundrums posed by these rare but severe cardiovascular complications and the importance of collaboration between cardiologists and dermatologists when employing this agent in patients with cardiorenal or cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

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Minoxidil is a drug with a hypotensive effect. It was introduced in the 1970s in the treatment of hypertension. This drug is characterized by a multifaceted mechanism of action - including a vasodilatory effect, probably through the activation of the ATP-sensitive potassium channels in vascular smooth muscle cells. Hypertrichosis was observed in patients treated with minoxidil, which prompted research into the possibility of applying this drug to diseases associated with alopecia. The first attempts were unsuccessful due to side effects associated with its hypotensive effect. Introduction of local treatment, and in recent years also methods of oral treatment with low doses of minoxidil, has allowed it to achieve a good therapeutic effect without a significant risk of side effects. In dermatology, the effect of minoxidil associated with stimulation of the onset and prolongation of the anagen phase is used. Minoxidil is available in the form of 2% and 5% solutions, 5% foam and in the form of compound drug for either topical or oral treatment. Side effects are present in 15-20% of patients and in most cases, they do not lead to discontinuation of the treatment. The most common side effects of topical preparations include itching, erythema, and scaling, while in the oral form, hypertrichosis of the facial skin, dizziness, and swelling of the lower limbs are most often observed. [ABSTRACT FROM AUTHOR]

Recent studies have shown that low-dose oral minoxidil (OM) can be a safe and effective treatment of numerous hair disorders including male-patterned hair loss (MPHL) and female-patterned hair loss (FPHL). There are several practical advantages of OM over its topical formulation: enhanced cosmesis, cost-savings, and the possibility of co-therapy with other topical formulations or topicals used for camouflage. This treatment may be particularly helpful for patients who are unable to tolerate topical minoxidil or other systemic treatments. Doses ranging from 0.25 to 1.25 mg daily are usually used for FPHL and doses ranging from 2.5 to 5 mg/day for MPHL. The low side-effect profile of low-dose OM allows for long-term adherence to the medication and favorable clinical response, resulting in stabilization and improvement of hair loss. More studies are needed to test the efficacy of OM in other types of alopecia as well as additional comparative studies assessing OM to other commonly used medications. [ABSTRACT FROM AUTHOR]

Androgenetic alopecia (AGA) is the most common cause of hair loss, often challenging to treat. While oral finasteride (1 mg/d) is an FDA-approved treatment for male AGA, oral minoxidil and oral dutasteride are not approved yet. However, clinicians have been increasingly using these two drugs off-label for hair loss. Recently, Japan and South Korea have approved oral dutasteride (0.5 mg/d) for male AGA. A probable efficacy ranking, in decreasing order, is – dutasteride 0.5 mg/d, finasteride 5 mg/d, minoxidil 5 mg/d, finasteride 1 mg/d, followed by minoxidil 0.25 mg/d. Oral minoxidil predominantly causes hypertrichosis and cardiovascular system (CVS) symptoms/signs in a dose-dependent manner, whereas oral finasteride and dutasteride are associated with sexual dysfunction and neuropsychiatric side effects. The average plasma half-lives of minoxidil, finasteride, and dutasteride are ∼4 h, ∼4.5 h, and ∼5 weeks, respectively. Minoxidil acts through multiple pathways to promote hair growth. It has been shown as a vasodilator, an anti-inflammatory agent, a Wnt/β-catenin signaling inducer, and an antiandrogen. Finasteride inhibits 5α-reductase (5AR) type II isoenzyme, while dutasteride inhibits both type I and type II. Thus, dutasteride suppresses DHT levels more than finasteride in the serum and scalp. [ABSTRACT FROM AUTHOR]