Search

Minoxidil is a vasodilator medication known for its ability to promote hair growth. Although it was first introduced as an oral drug to treat hypertension, minoxidil was observed to have the important side-effect of increasing hair growth. This led to the development of a topical formulation as a 2% concentration solution for the treatment of female androgenic alopecia (AGA) and 5% for treating male AGA, which is considered as a first line U.S. Food and Drug Administration (FDA)-approved treatment for AGA in addition to oral 5-alpha-reductase inhibitor (finasteride). The mechanism by which minoxidil promotes hair growth is not fully understood but can be related to increasing blood flow owing to its vasodilator effects. Androgenic alopecia is characterized by the gradual conversion of terminal hairs into vellus hairs. Alterations in the hair cycle include reduced duration of the anagen phase and increased duration of the telogen phase, resulting in shorter hairs and eventual balding. Side effects of topical minoxidil include irritant and allergic contact dermatitis, pruritus, and facial hypertrichosis, which are more often seen with the use of 5% solutions rather than 2%. Herein, we report a 24-year-old woman who developed severe ear and face hypertrichosis after using a topical 5% minoxidil solution. She later had spontaneous resolution of her hypertrichosis three months after stopping it.

Androgenic alopecia (AGA) affects both men and women worldwide. New blood vessel formation can restore blood supply and stimulate the hair regrowth cycle. Recently, our group reported that 2-deoxy-D-ribose (2dDR) is 80%–90% as effective as VEGF in the stimulation of neovascularization in in vitro models and in a chick bioassay. In this study, we aimed to assess the effect of 2dDR on hair growth. We prepared an alginate gel containing 2dDR, polypropylene glycol, and phenoxyethanol. AGA was developed in C57BL6 mice by intraperitoneally injecting testosterone (TE). A dihydrotestosterone (DHT)-treated group was used as a negative control, a minoxidil group was used as a positive control, and we included groups treated with 2dDR gel and a combination of 2dDR and minoxidil. Each treatment was applied for 20 days. Both groups treated with 2dDR gel and minoxidil stimulated the morphogenesis of hair follicles. H&E-stained skin sections of C57BL/6 mice demonstrated an increase in length, diameter, hair follicle density, anagen/telogen ratio, diameter of hair follicles, area of the hair bulb covered in melanin, and an increase in the number of blood vessels. Masson's trichrome staining showed an increase in the area of the hair bulb covered in melanin. The effects of the FDA-approved drug (minoxidil) on hair growth were similar to those of 2dDR (80%–90%). No significant benefit were observed by applying a combination of minoxidil with 2dDR. We conclude that 2dDR gel has potential for the treatment of androgenic alopecia and possibly other alopecia conditions where stimulation of hair regrowth is desirable, such as after chemotherapy. The mechanism of activity of 2dDR remains to be established. [ABSTRACT FROM AUTHOR]

Objective: Trifolium pratense L. (Red clover) belongs to the Leguminosae family. This study was designed to develop transferosome formulations containing red clover extract or caffeine alone or in combination and evaluate their effects on hair growth in mice. Materials and Methods: Thin-lipid film hydration technique was used to make transferosomes. Six groups (n=6) of male Swiss mice (28-32 g) were used. One group was normal control. The second group received transferosome without drug. Groups 3 to 5 received 100 µl of transferosomes containing red clover extract (1%) or caffeine (0.002%) alone or in combination. The sixth group received minoxidil (2%). Treatments continued six days per week for 3 weeks and each week, the hair growth scores were recorded. At the end, sections of the skin were prepared for determining the percent of follicles in the anagen phase. Results: Encapsulation efficiency was 84.3, 81.6 and 89.1% for red clover, caffeine and red clover+caffeine transferosomes respectively. After 24 hr, the cumulative release of red clover and caffeine formulations was 77.6 and 76.9%, respectively. Treatments produced no significant change in hair growth after two weeks but at the end of the third week, all treatments significantly increased the hair growth and the effects were comparable with minoxidil. The combination of red clover and caffeine was not more effective than either alone. Conclusion: Transferosome formulations of caffeine and red clover alone demonstrated hair growth effect but their combination had no additive effect which might be due to a physicochemical or pharmacodynamic interaction. [ABSTRACT FROM AUTHOR]

Background: Androgenetic alopecia (AGA) is common. While topical minoxidil remains the only FDA‐approved therapeutic for AGA, its efficacy is limited in stimulating clinically significant hair regrowth over the longer term. Oral minoxidil, which is used off‐label, is a promising alternative; however, its effectiveness and underlying mechanisms warrant further investigation. Aims: To elucidate the site of action and infer the physiological mechanisms underlying therapeutic responses to oral minoxidil in patients with AGA. Methods: Forty‐one patients with AGA underwent 6 months of low‐dose oral minoxidil treatment. Minoxidil sulfotransferase (SULT) activity was assayed in plucked scalp hair follicles. The primary outcome was hair growth after low‐dose oral minoxidil treatment for a minimum of 6 months, and the secondary outcome was SULT activity in hair follicles. Results: After 6 months of treatment, 26 (63.4%) patients experienced a clinical improvement in alopecia symptoms. The response rate was higher in men (19/26 [73.1%]) than in women (6/15 [40.0%]). Patients with low hair follicle SULT activity demonstrated a higher minoxidil response rate than those with high enzyme activity (85% vs. 43%, p = 0.009). Conclusions: Our findings indicate that low SULT activity within the hair follicles is associated with a favorable response to oral minoxidil therapy in patients with AGA. Further elucidation of the underlying mechanisms could significantly improve personalized therapeutic approaches through improved patient selection and the rational design of adjuvant treatments. [ABSTRACT FROM AUTHOR]

The benefits and potential risks of oral minoxidil therapy versus topical minoxidil therapy in patients with androgenetic alopecia (AGA) are controversial. We systematically searched PubMed, Embase, and Cochrane for randomized clinical trials (RCTs) comparing the use of oral minoxidil and minoxidil topical solution in patients with AGA. Statistical analyses were performed using R Studio 4.3.2. Standard mean difference (SMD) and risk ratio (RR) with 95% confidence intervals (CI) were pooled across trials. This meta‐analysis included four RCTs reporting data on 279 patients. Follow‐up ranged from 24 to 39 weeks. There were no differences in hair density (SMD 0.02; 95% CI −0.25 to 0.29; P = 0.88; I2 = 0%) or hair diameter (SMD −0.25; 95% CI −0.75 to 0.26; P = 0.34; I2 = 36%). The incidence of hypertrichosis was statistically significantly higher in the oral minoxidil group when compared to the topical minoxidil group (RR 2.01; 95% CI 1.18–3.41; P = 0.01; I2 = 0%). There was no statistically significant difference between groups for the incidence of hypotension (RR 2.42; 95% CI 0.26–22.46; P = 0.44; I2 = 0%). In patients with AGA, oral minoxidil and minoxidil topical solution have similar efficacy and safety, with equivalent improvements in hair density, hair diameter, and incidence of adverse events, such as hypotension. [ABSTRACT FROM AUTHOR]

Background: Oral finasteride and topical minoxidil formulations are the only FDA‐approved drug therapies for androgenetic alopecia (AGA). Research into dutasteride, topical finasteride, and nontopical minoxidil (low‐dose oral and sublingual) formulations in the treatment of AGA has spiked within recent years. Early findings show that these alternative drug therapies may have similar to improved efficacy and safety profiles relative to the conventional treatment options. Aims: Conducting a bibliometric analysis, compare trends in publications on these alternative drug therapies, identify key contributors, evaluate major findings from top‐cited articles, and elucidate gaps in evidence. Methods: A search was conducted on the Web of Science database for publications on the use of alternative drug therapies in the treatment of AGA. A total of 95 publications, published between January 2003—March 2024, and their citation metadata were included in the analysis. Results: Dutasteride showed the greatest (n = 37) and longest (20+ years) history of publications, as well as the highest cumulative citations (n = 914); however, nontopical minoxidil showed a burst in research activity within the last 5 years (n = 33 publications since 2019). A relatively low number of randomized control trials (n = 3) for nontopical minoxidil suggests a need for higher‐quality evidence. Conclusions: Our analysis reveals major trends, contributors, and gaps in evidence for alternative drug therapies for AGA, which can help inform researchers on their future projects in this growing field of study. There is enthusiasm for exploring off‐label formulations: nontopical forms of minoxidil (oral and sublingual), topical finasteride, and mesotherapy. [ABSTRACT FROM AUTHOR]

Androgenetic alopecia (AGA) is a common type of hair loss in men and efficacy and safety of current medical treatment remain limited. Therefore, the present study aimed to investigate the efficacy and safety of botulinum toxin type A (BTA) combined with Minoxidil in patients with AGA. 60 male patients were included in this study and control group received topical 5% Minoxidil and the treatment group received BTA combined with topical 5% Minoxidil. BTA injections (60–70 U) were administered at 30–35 scalp sites. Head photographs were taken at baseline, 2nd, 4th, and 6th months. Clinical descriptions recorded scalp conditions, and patient satisfaction along with Dermatology Life Quality Index scores were documented. The treatment group (TG) showed significant hair growth differences compared to the control group (CG) at the 4th month (P < 0.001) and 6th month (P = 0.0046) post-treatment. TG had improved Investigator Global Assessment (IGA) scores in the 4th month (P = 0.0001) and 6th month (P = 0.0259) compared to CG. Patient satisfaction in TG for hair growth and scalp improvement was higher than CG (all P < 0.05). TG exhibited substantial quality of life improvement at the 4-month (P = 0.0009) and 6-month (P = 0.0099). No adverse reactions were observed post-botulinum toxin injection. BTA combined with Minoxidil effectively promotes hair growth, enhances the quality of life, and alleviates scalp symptoms in male AGA patients at 4th and 6th months, with no adverse effects compared to Minoxidil alone. Trial registration number: Ethics Committee of Shanghai Tongji Hospital (ID: K-2018-026). [ABSTRACT FROM AUTHOR]

Simple Summary: Minoxidil is an FDA-approved drug used for human hair regrowth. Minoxidil toxicosis can occur and be fatal in dogs and cats and presents with symptoms such as lethargy, anorexia, vomiting, hypotension, and tachypnea. We described a case of minoxidil toxicosis in a cat after accidental exposure to topical minoxidil presenting with severe clinical signs, including respiratory distress and hemodynamic instability. Chest X-rays showed mild lung infiltration and pleural effusion. Initial treatments with oxygen, fluids, furosemide, and dopamine were ineffective. However, hemodialysis proved effective in improving the patient's condition and facilitating a full recovery. This case is the first to document successful hemodialysis treatment for minoxidil toxicosis in a cat, thus highlighting the potential therapeutic role of hemodialysis in minoxidil toxicosis. A 5-year-old castrated male American Shorthair cat presented with lethargy and anorexia after accidentally knocking over a bottle of topical minoxidil and spilling it onto its body. Physical examination revealed rapid shallow breathing, pale mucous membranes, hypothermia, tachycardia, and hypotension. Thoracic radiography revealed mild pulmonary infiltration and pleural effusion. Despite conservative treatment, including oxygen therapy, and intravenous fluid, furosemide, and dopamine administration, the patient showed no improvement. After two sessions of intermittent hemodialysis, the cat's respiratory pattern and overall condition gradually improved; normal body temperature and blood pressure were achieved. The cat recovered fully and was discharged on the 11th day of hospitalization. This is the first report on the use of hemodialysis in the treatment of a cat with minoxidil toxicosis. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aims Methods Results Conclusions Low‐dose oral minoxidil (LDOM) is used to treat hair loss, but the literature on its safety profile is relatively sparse.Using the FDA Adverse Event Reporting System (FAERS) database, we determined signals for adverse events (AEs) with LDOM use.Four sets of case/noncase study disproportionality analyses were conducted to determine reporting odds ratio (ROR) for 10 AEs including pericardial effusion (PE). The oral minoxidil dose ranges were: (i) ≤1.25 mg (i.e., 0–1.25 mg), (ii) ≤2.5 mg (i.e., 0–2.5 mg), (iii) ≤5 mg (i.e., 0–5 mg), and (iv) ≤10 mg (i.e., 0–10 mg).For ≤1.25 mg, we detected a signal for PE (ROR = 16.41, 95% CI: 2.29, 117.37, p < 0.05). For ≤2.5 mg, the analyses detected a signal for PE (ROR = 13.30, 95% CI: 5.96, 29.68, p < 0.05); the ROR in the absence of cardiac impairment was 5.34 (95% CI: 1.33, 21.37, p < 0.05); in the presence of cardiac impairment, the ROR was 49.42 (95% CI: 18.27, 133.66, p < 0.05). A signal for PE was also detected at ≤5 and ≤10 mg. For PE, there was a significant (p < 0.05) association with a patient outcome of “life threatening” only at the ≤10 mg dose range.Our study, the first FAERS‐based signal detection study for LDOM, found significant associations between LDOM use and several AEs. In the absence of causal evidence, these correlations warrant more attention regarding safe use of LDOM. Until more safety data are available, we recommend using LDOM at the lowest effective dose (≤5 mg/day). [ABSTRACT FROM AUTHOR]

Background: Alopecia areata (AA) is an autoimmune hair loss disorder characterised by collapse of hair follicle immune privilege and mediated by autoreactive CD8+ T lymphocytes and natural killer cells. Treatment is often unsatisfactory. The Janus kinase‐signal transducer and activator of transcription (JAK–STAT) pathway is implicated in the pathogenesis of AA and Janus Kinase inhibitor (JAKi) medications are promising emerging treatments for AA. Objectives: We evaluated the safety and effectiveness of tofacitinib in a real‐world setting over 18 months of treatment. Methods: A retrospective cohort study of all patients with scalp AA commenced on tofacitinib between 1 November 2016 and 31 May 2019. The primary endpoint was the percent change in Severity of Alopecia Tool (SALT) score at 18 months. Results: Two hundred and two patients were included. After 18 months of treatment, 55.9%, 42.6% and 29.2% achieved 50%, 75% and 90% reductions in their SALT scores respectively. Increased duration of AA was a negative predictor of hair regrowth. Males and patients with baseline SALT ≥90 were slower to respond to treatment in the first 12 months. One hundred and twenty‐four patients and 168 patients received concomitant systemic corticosteroids or low‐dose oral minoxidil during tofacitinib therapy respectively. There were no serious adverse events. Conclusion: Tofacitinib was a safe and effective treatment for patients with moderate‐to‐severe AA. Further randomised controlled studies are needed to establish the optimal treatment regimen. [ABSTRACT FROM AUTHOR]

Docetaxel is a commonly used taxane chemotherapeutic agent in the treatment of a variety of cancers, including breast cancer, ovarian cancer, prostate cancer, non-small cell lung cancer, gastric cancer, and head and neck cancer. Docetaxel exerts its anti-cancer effects through inhibition of the cell cycle and induction of proapoptotic activity. However, docetaxel also impacts rapidly proliferating normal cells in the scalp hair follicles (HFs), rendering the HFs vulnerable to docetaxel-induced cell death and leading to chemotherapy-induced alopecia (CIA). In severe cases, docetaxel causes persistent or permanent CIA (pCIA) when hair does not grow back completely six months after chemotherapy cessation. Hair loss has severe negative impacts on patients' quality of life and may even compromise their compliance with treatment. This review discusses the notable prevalence of docetaxel-induced CIA and pCIA, as well as their prevention and management. At this moment, scalp cooling is the standard of care to prevent CIA. Treatment options to promote hair regrowth include but are not limited to minoxidil, photobiomodulation (PBMT), and platelet-rich plasma (PRP). In addition, a handful of current clinical trials are exploring additional agents to treat or prevent CIA. Research models of CIA, particularly ex vivo human scalp HF organ culture and in vivo mouse models with human scalp xenografts, will help expedite the translation of bench findings of CIA prevention and/or amelioration to the clinic. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical efficacy and safety of 1 565 nm non-ablative fractional laser combined with topical minoxidil and oral finasteride in the treatment of patients with androgenetic alopecia (AGA). Methods Seventy-five male AGA patients with Norwood-Hamilton classification grade Ⅱ-Ⅲ, were randomly assigned into three groups: the control group 1, the control group 2 and the experimental group, with 25 cases in each group. Patients in the control group 1 received topical 5% minoxidil (1 mL, twice daily). Patients in the control group 2 were treated with both topical 5% minoxidil and oral finasteride (1 mg, once daily). Patients in the experimental group received a combined therapy of 1 565 nm non-ablative fractional laser in addition to topical 5% minoxidil and oral finasteride. Hair overall efficacy was evaluated using a 7-point rating scale after 24 weeks of treatment. Hair diameter and density were measured using a dermoscope. Patient satisfaction was assessed post-treatment, and adverse reactions were recorded. Results The overall efficacy of hair in the experimental group was superior to the control group 1 and the control group 2. There were no significant differences in hair density and hair diameter before treatment between the three groups (P＞0.05). After treatment, hair diameter and density increased in all three groups compared to baseline values (P＜0.05), and the hair diameter and hair density of the experimental group were higher than those of the control group 1 and the control group 2 (P＜ 0.05). Patient satisfaction in the experimental group was higher than that in the control group 1 and the control group 2 (P＜ 0.05). Patients in the experimental group experienced tolerable pain and burning sensations during laser treatment, and the symptoms were self-alleviated within a few hours. There were no serious adverse reactions reported in any group. Conclusion The combination therapy of 1 565 nm non-ablative fractional laser, 5% minoxidil, and finasteride demonstrates significantly better efficacy in the treatment of AGA than minoxidil and finasteride alone drug therapy. [ABSTRACT FROM AUTHOR]

Background: Oral finasteride and topical minoxidil are the current standard of care for male androgenetic alopecia and a combination of the two treatments can be considered for greater efficacy. Clinical trials of topical finasteride have also yielded promising results, but routine care data are lacking. Aims: To examine patient‐reported outcomes of men with androgenetic alopecia who received topical finasteride admixed with minoxidil compared to the current standard of care (oral finasteride). Methods: Retrospective, cross‐sectional study with data from a German direct‐to‐consumer teledermatology platform between December 2021 and January 2023. Patient‐reported outcomes were collected through voluntary follow‐up questionnaires provided after 6 weeks on topical finasteride/minoxidil or oral finasteride treatment. Results: A total of 1545 patients who received topical finasteride/minoxidil treatment were included; 238 (15.4%) participated in the follow‐up questionnaire. At week six, 62.2% (148/238) reported positive changes in their hair appearance, and 44.1% (105/238) reported an improvement of self‐esteem. Treatment‐related adverse events were reported in 11.8% (28/238). Full treatment adherence was observed in 74.4% (177/238). Comparing the topical treatment group to those receiving oral finasteride, lower treatment adherence was reported, along with higher rates of local adverse events; no difference was found in the incidence of sexual adverse events. Conclusion: Based on patient‐reported outcomes, topical finasteride/minoxidil seems to be effective and well tolerated, but not superior to oral finasteride. Lower treatment adherence for topical usage must be considered when considering treatment options. Additional real‐world data are needed to further evaluate the efficacy and safety of topical finasteride/minoxidil. [ABSTRACT FROM AUTHOR]

Background: Acne vulgaris (AV) results from increased sebum production and Cutibacterium acnes (C. acnes) overgrowth, leading to pilosebaceous unit inflammation. The androgen-androgen receptor (AR) pathway significantly contributes to acne development, with minoxidil showing promise in suppressing AR-related activities. Objectives: This study aims to examine the mechanism and effectiveness of minoxidil in treating AV. Methods: The effects of minoxidil on lipid metabolism and bacterial infection/inflammation were tested. A clinical trial was performed to evaluate the effect of topical minoxidil on AV. Results: Minoxidil suppressed fatty acid synthase activity and lipid formation in an androgen-sensitive prostate cancer cell line in vitro and sebum formation in hamster flank organs in vivo. For C. acnes, minoxidil had a half-maximum inhibitory concentration of 5 mM. Both 2% and 5% minoxidil suppressed C. acnes-induced infection/inflammation in an animal model. A phase I/II clinical trial of topical minoxidil in treating AV using a split-face model demonstrated a good response and well-tolerated side effects. Compared to the untreated side, the numbers of all types of lesions decreased significantly on the treated side on day 3 (mean: −2.238, 95% confidence interval [CI]: −3.821 to −0.655, P = 0.008), day 8, and reached the maximum effect on day 15 (mean: −1.286, 95% CI: −2.151 to −0.420, P = 0.006). Responders to topical minoxidil may experience rapid regression of acne as early as 3 days of treatment. Conclusion: Our collective data indicate that minoxidil could inhibit AR-related functions and C. acnes growth in treating AV.

Docetaxel is a commonly used taxane chemotherapeutic agent in the treatment of a variety of cancers, including breast cancer, ovarian cancer, prostate cancer, non-small cell lung cancer, gastric cancer, and head and neck cancer. Docetaxel exerts its anti-cancer effects through inhibition of the cell cycle and induction of proapoptotic activity. However, docetaxel also impacts rapidly proliferating normal cells in the scalp hair follicles (HFs), rendering the HFs vulnerable to docetaxel-induced cell death and leading to chemotherapy-induced alopecia (CIA). In severe cases, docetaxel causes persistent or permanent CIA (pCIA) when hair does not grow back completely six months after chemotherapy cessation. Hair loss has severe negative impacts on patients’ quality of life and may even compromise their compliance with treatment. This review discusses the notable prevalence of docetaxel-induced CIA and pCIA, as well as their prevention and management. At this moment, scalp cooling is the standard of care to prevent CIA. Treatment options to promote hair regrowth include but are not limited to minoxidil, photobiomodulation (PBMT), and platelet-rich plasma (PRP). In addition, a handful of current clinical trials are exploring additional agents to treat or prevent CIA. Research models of CIA, particularly ex vivo human scalp HF organ culture and in vivo mouse models with human scalp xenografts, will help expedite the translation of bench findings of CIA prevention and/or amelioration to the clinic.

Purpose: Late alopecia, defined as incomplete hair regrowth > 6 months following cytotoxic chemotherapy or > 6 months from initiation of endocrine therapy, negatively impacts quality of life and may affect dose intensity of adjuvant therapy. This study investigates the effect of oral minoxidil in women with chemotherapy and/or endocrine therapy-induced late alopecia. Methods: The rate of clinical response was assessed by standardized photography and quantitated with trichoscopy. Results: Two hundred and sixteen patients (mean age 57.8 ± 13.7) were included. The most common cancer diagnosis was breast, in 170 patients (79.1%). Alopecia developed after chemotherapy in 31 (14.4%) patients, endocrine monotherapy in 65 (30.1%) patients, and chemotherapy followed by endocrine therapy in 120 (55.6%) patients. In 119 patients, standardized photography assessments were used to determine clinical change in alopecia after a median of 105 (IQR = 70) days on oral minoxidil and revealed improvement in 88 (74%) patients. Forty-two patients received quantitative trichoscopic assessments at baseline and at follow-up after a median of 91 (IQR = 126) days on oral minoxidil. Patients had clinically and statistically significant increases in frontal hair shaft density (from 124.2 hairs/cm2 at initial to 153.2 hairs/cm2 at follow-up assessment, p = 0.008) and occipital shaft density (from 100.3 hairs/cm2 at initial to 123.5 hairs/cm2 at follow-up assessment. p = 0.004). No patients discontinued oral minoxidil due to adverse events. Conclusions: Overall, oral minoxidil was well tolerated by patients and may benefit both frontal and occipital late alopecia in cancer survivors treated with cytotoxic and/or endocrine therapy by increasing hair shaft and follicle density. [ABSTRACT FROM AUTHOR]

Abstract The minimal adverse-effect profile and positive clinical response of low-dose oral minoxidil (LDOM) have recently caused the drug to gain popularity for the treatment of hair disorders in adults. However, in the pediatric population, hesitancy still surrounds the use of oral minoxidil given the wide profile of potential side effects the drug offers. This review aims to characterize the safety and use of oral minoxidil in children for the treatment of all disorders to equip physicians with ample knowledge when prescribing oral minoxidil in the pediatric population. A total of 41 studies (19 case reports, 10 cohort studies, 7 retrospective chart reviews, and 5 case series) that reported data on 442 pediatric patients for whom oral minoxidil was used for treatment were included. Conditions for which treatment with minoxidil was described were hair disorders (83.9%, 371/442) and hypertension (11.3%, 50/442); accidental usage (4.8%, 21/442) was also noted in the literature and included in this review. This review is broken down by dosage and describes the safety and efficacy of oral minoxidil in pediatric patients aged 0 to 18 years old for the treatment of hair disorders. This review found that LDOM may represent a safe option for the treatment of hair disorders in children. This study also suggests moderate and high doses of oral minoxidil may not be safe for use in children. Additional studies are needed to further understand this drug’s efficacy and safety in children.

Objective: It still needs to be determined if platelet-rich plasma (PRP) has any added advantage over Minoxidil in treating androgenetic alopecia. We reviewed randomized controlled trials (RCTs) comparing scalp injections of PRP plus Minoxidil vs Minoxidil alone for managing androgenetic alopecia. Methods: All RCTs published on Embase, Cochrane Library, and PubMed comparing PRP plus Minoxidil vs. Minoxidil alone were eligible. The literature search was completed on 5 March 2024. The review was registered on PROSPERO (CRD42024509826). Results: Of five included RCTs, three had a high risk of bias, while one had some concerns. A systematic review of the studies showed that all trials reported better outcomes with PRP plus Minoxidil than with Minoxidil alone. Meta-analysis showed that hair density at one month (MD: 11.07 95% CI: 1.20, 20.94 I2 = 0%), three months (MD: 21.81 95% CI: 10.64, 33.00 I2 = 57%) and 5/6 months (MD: 17.80 95% CI: 7.91, 27.69 I2 = 80%) of follow-up was significantly better in the PRP plus Minoxidil vs the Minoxidil alone group. Meta-analysis of adverse events showed that the risk of adverse events was comparable in both groups (OR: 0.55 95% CI: 0.22, 1.36 I2 = 0%). The certainty of evidence on the GRADE assessment was "low to very low." Conclusion: Very low-quality evidence shows that the addition of injectable PRP to topical Minoxidil may improve outcomes in patients with androgenetic alopecia. The addition of PRP was found to improve hair density and patient satisfaction significantly. However, the small number of studies with a high risk of bias and heterogeneity in PRP preparation methods are significant limitations of current evidence. Further studies with larger sample sizes and uniform PRP preparation protocols are needed. [ABSTRACT FROM AUTHOR]

Background: Female‐pattern hair loss (FPHL) is characterized by decreased scalp hair density, thinning of hair shafts, and progressive miniaturization of hair follicles. Objective: To compare the safety and efficacy of spironolactone versus bicalutamide in female pattern hair loss [FPHL]. Methods: The study design was retrospective, and all eligible females aged between 18 years and 50 years with FPHL were included. We identified 120 patients from our database who fulfilled the inclusion and exclusion criteria, and patients were then categorized into two groups, Group A comprising patients who were taking 100 mg of spironolactone once daily and Group B comprising patients who were taking 50 mg of bicalutamide once daily along with topical minoxidil 2% in both groups. Patient were analysed at approximately at 24 weeks from the commencement of the treatment. Results: Mean reduction in hair loss severity score on Sinclair scale was 19.51% in spironolactone group compared to 28.20% in bicalutamide group at 24 weeks, which was statistically significant. On global photographic assessment, marked improvement was seen in bicalutamide group compared to spironolactone group (p = 0.139). Conclusions: Our study, though limited by its retrospective design and small sample size, showed that bicalutamide has greater efficacy and better safety profile in comparison to spironolactone in the treatment of FPHL. [ABSTRACT FROM AUTHOR]

Female Pattern Hair Loss (FPHL) is a common form of non-scaring hair loss that occurs in adult women. Although several treatments have already been proposed for FPHL, only Topical Minoxidil accumulated an adequate level of evidence. This study aimed to evaluate the therapeutic response of MMP® (intradermal infiltration) of Minoxidil formulation in the frontal-parietal-vertex regions compared with the gold-standard home administration of Minoxidil 5% Capillary Solution. This self-controlled comparative study evaluated 16 FPHL patients, without treatment for at least 6 months, confirmed by trichoscopy with TrichoLAB® software. They received 4 monthly sessions of MMP® with Minoxidil 0,5% on the right side of the scalp (frontal-parietal-vertex areas), followed by occlusion with plastic film for 12 h and prescription of Minoxidil 5% Solution for home use once a day, on both scalp sides, starting 72 h after the procedure. The reassessment trichoscopy was 6 weeks after the last session and they answered a “self-assessment” questionnaire. Treated scalp areas were compared and showed both treatments, in general, were effective, with no difference between them. If they were analyzed separately by treated areas, there were signs of better response in the parietal-vertex regions with treatment by MMP® with Minoxidil, while clinical treatment indicated a better response in the other regions. When patients were divided into more and less advanced cases, a better response in parietal-vertex regions treated by MMP® with Minoxidil in less advanced patients was confirmed. MMP® with Minoxidil showed a better response in the parietal-vertex regions in less advanced FPHL patients. It represents yet another resource to improve quality of life of these suffering patients. [ABSTRACT FROM AUTHOR]

Alopecia areata (AA) is a chronic autoimmune disease characterized by bald patches in certain areas of the body, especially the scalp. Minoxidil (MNX), as a first-line treatment of AA, effectively induces hair growth. However, oral and topical administration pose problems, including low bioavailability, risk of uncontrolled hair growth, and local side effects such as burning hair loss, and scalp irritation. In the latest research, MNX was delivered to the skin via microneedle (MN) transdermally. The MNX concentration was distributed throughout the needle so that drug penetration was reduced and had the potential to irritate. In this study, we formulated MNX into three-layer dissolving microneedles (TDMN) to increase drug penetration and avoid irritation. Physicochemical evaluation, parafilm, was used to evaluate the mechanical strength of TDMN and showed that TDMN could penetrate the stratum corneum. The ex-vivo permeation test showed that the highest average permeation result was obtained for TDMN2, namely 165.28 ± 31.87 ug/cm2, while for Minoxidil cream it was 46.03 ± 8.5 ug/cm2. The results of ex vivo and in vivo dermatokinetic tests showed that the amount of drug concentration remaining in the skin from the TDMN2 formula was higher compared to the cream preparation. The formula developed has no potential for irritation and toxicity based on the HET-CAM test and hemolysis test. TDMN is a promising alternative to administering MNX to overcome MNX problems and increase the effectiveness of AA therapy. [ABSTRACT FROM AUTHOR]

Alopecia is traditionally viewed as androgen-dependent, but emerging evidence has implicated oxidative stress in the pathogenesis of hair loss. Current treatments for alopecia have limited efficacy, leading to the need for new therapies. Human dermal papilla cells (hDPCs) play a pivotal role in hair follicle (HF) development and hair growth regulation. In this study, we investigated the potential of (S)-3-((S)-2-(6-(2,3-dihydrobenzo[b][1,4]dioxin-6-yl)-1-oxoisoindolin-2-yl)butanamido)-4-oxo-5-(2,3,5,6 tetrafluorophenoxy) pentanoic acid (THPA), a pan-caspase inhibitor, to reduce ROS-induced cellular damage and apoptosis in hDPCs. Our study revealed that THPA effectively suppressed hydrogen peroxide-induced apoptosis while also attenuating activated caspase signaling. Additionally, THPA restored the down-regulated expression of β-catenin, a key mediator of the Wnt/β-catenin pathway, in hDPCs exposed to hydrogen peroxide. Furthermore, significant alterations in Akt/mTOR/p70S6K signaling were observed following THPA treatment. Notably, THPA treatment led to a reduction in the expression of Dickkopf-1 (DKK-1), an inhibitor of the Wnt/β-catenin pathway implicated in hair follicle regression. Moreover, THPA treatment decreased the expression of the cell senescence markers p21 and p16, suggesting a potential role in preserving hDPC function and delaying hair follicle regression. Collectively, our findings highlight the therapeutic potential of THPA in preventing hair loss by protecting hDPCs against oxidative stress damage. [ABSTRACT FROM AUTHOR]

Androgenic alopecia (AGA) is a genetically predetermined condition influenced by the androgen hormone dihydrotestosterone (DHT). The condition presents with progressive hair thinning, often leading to baldness in specific patterns for both men and women. This case report presents a 35-year-old male patient who experienced sporadic patches of facial hair loss and scalp thinning. Comprehensive diagnostic approaches were employed, including a detailed medical history, physical examination, and scalp biopsy, which confirmed the diagnosis of AGA. The patient underwent follicular unit extraction (FUE) hair transplantation, with positive postoperative results observed over a four-month period. The report discusses current treatment options for AGA, including pharmacological interventions such as minoxidil and finasteride, as well as surgical and cosmetic solutions like hair transplantation and laser therapy. Recent advancements in gene therapy and stem cell research also offer promising avenues for more effective and lasting treatments for AGA. [ABSTRACT FROM AUTHOR]

Androgenetic alopecia (AGA) is the most common type of hair loss. Treatment options are limited. Microneedling, a minimally invasive technique can enhance hair growth by releasing growth factors. However, no standardized protocol for frequency, depth and duration is available. This study aimed to determine the effectiveness and safety of the combination therapy of microneedling and minoxidil in AGA. This study was a randomized controlled clinical trial conducted over 12 weeks. The intervention group received a 4-weekly combination therapy of microneedling + 5% minoxidil, while the control group got only topical 5% minoxidil. Hair density and diameter were assessed using FotoFinder® trichoscale (Fotofinder Systems GmBH, Bad Birnbach, Germany) every 4 weeks. A total of 36 male participants, between 26-51 years old, with Hamilton-Norwood type IIIVI AGA were included. At the end of the study, the intervention group had significantly higher hair density (95.6 vs 52.4 hair/cm², p<0.001) and diameter (18 vs 6 μm, p=0.004) than the control group. Side effects, included itching and transient erythema, were well tolerated. The combination of 4-weekly microneedling and topical 5% minoxidil is effective in increasing both hair density and hair diameter, and safe to use in AGA patients. [ABSTRACT FROM AUTHOR]

Androgenetic alopecia (AGA) is a highly prevalent condition in contemporary society. The conventional treatment of minoxidil tincture is hindered by issues such as skin irritation caused by ethanol, non-specific accumulation in hair follicles, and short retention due to its liquid form. Herein, we have developed a novel minoxidil-incorporated engineered exosomes biopotentiated hydrogel (Gel@MNs) that has the capability to modulate the perifollicular microenvironment for the treatment of AGA. Leveraging the exceptional skin penetration abilities of flexible liposomes and the targeting properties of exosomes, the encapsulated minoxidil can be effectively delivered to the hair follicles. In comparison to free minoxidil, Gel@MNs demonstrated accelerated hair regeneration in an AGA mouse model without causing significant skin irritation. This was evidenced by an increase in both the number and size of hair follicles within the dermal layer, enhanced capillary formation surrounding the follicles, and the regulation of the transition of hair follicle cells from the telogen phase to the anagen growth phase. Therefore, this safe and microenvironment-modifying hybrid exosome-embedded hydrogel shows promising potential for clinical treatment of AGA. [ABSTRACT FROM AUTHOR]

The minimal adverse-effect profile and positive clinical response of low-dose oral minoxidil (LDOM) have recently caused the drug to gain popularity for the treatment of hair disorders in adults. However, in the pediatric population, hesitancy still surrounds the use of oral minoxidil given the wide profile of potential side effects the drug offers. This review aims to characterize the safety and use of oral minoxidil in children for the treatment of all disorders to equip physicians with ample knowledge when prescribing oral minoxidil in the pediatric population. A total of 41 studies (19 case reports, 10 cohort studies, 7 retrospective chart reviews, and 5 case series) that reported data on 442 pediatric patients for whom oral minoxidil was used for treatment were included. Conditions for which treatment with minoxidil was described were hair disorders (83.9%, 371/442) and hypertension (11.3%, 50/442); accidental usage (4.8%, 21/442) was also noted in the literature and included in this review. This review is broken down by dosage and describes the safety and efficacy of oral minoxidil in pediatric patients aged 0 to 18 years old for the treatment of hair disorders. This review found that LDOM may represent a safe option for the treatment of hair disorders in children. This study also suggests moderate and high doses of oral minoxidil may not be safe for use in children. Additional studies are needed to further understand this drug's efficacy and safety in children. [ABSTRACT FROM AUTHOR]

AP collagen peptides (APCPs) are enzymatically decomposed collagen peptides that contain tri‐peptides such as glycine‐proline‐hydroxyproline. We found that APCPs increased the proliferation of both human dermal papilla cells (hDPCs) and human outer root sheath cells (hORSCs). APCPs also stimulated the secretion of several growth factors, including IGFBP‐6, PDGF‐AB, PIGF and VEGF in hDPCs. Moreover, APCPs enhanced the phosphorylation of Akt(Ser473), GSK‐3β(Ser9) and β‐catenin(Ser675), indicating the activation of the GSK‐3β/β‐catenin signalling pathway. Ex vivo culture of human hair follicles (hHFs) tissue and in vivo patch assay revealed that APCPs promoted the elongation of hHFs and the induction of new hair shafts. In a mouse model, APCPs significantly promoted the transition from telogen to anagen phase and prolonged anagen phase, resulting in increased hair growth. APCPs also improved the thickness, amino acid content (cystine and methionine) and roughness of mouse hair. Taken together, these findings demonstrate that APCPs accelerate hair growth and contribute to overall hair health. Therefore, APCPs have the potential to be utilized as a food supplement and ingredient for preventing hair loss and maintaining hair health. [ABSTRACT FROM AUTHOR]

Androgenetic alopecia is a genetic condition characterized by an exaggerated response to androgen hormones, resulting in a gradual reduction in the size of terminal hair follicles on the scalp. Currently available therapies for achieving effective treatment remain limited. The study aims to evaluate the effectiveness of 5% minoxidil therapy by assessing the density of hair follicles in a mouse model of androgenetic alopecia. Mice were induced with testosterone for 10 days, and then divided into two groups. The first group served as the control group without receiving further treatment. The second group was treated with topical application of 5% minoxidil, applied twice a day as a spray until day 31. On day 32, the density of hair follicles was evaluated through histopathological examination using Hematoxylin & Eosin staining. Statistical analysis was performed using the Mann-Whitney test with a significance level of p<0.05. At the end of the study, the mean density of hair follicles was 24.00 in the control group and 40.14 in the treatment group, with a p-value of <0.05. Topical application of 5% minoxidil significantly increased the density of hair follicles in the mouse model of androgenetic alopecia. [ABSTRACT FROM AUTHOR]

Androgenetic alopecia is the most common type of hair loss. Although the exact cause of this condition is not fully understood, it is known to involve excessive amounts of dihydrotestosterone. There are various treatment options available for androgenetic alopecia that aim to target these mechanisms. The FDA-approved therapies for this condition include topical minoxidil, oral finasteride, and low-level light therapy. This review will discuss the potential benefits of using spironolactone, dutasteride, and bicalutamide as alternative treatment options for androgenetic alopecia. [ABSTRACT FROM AUTHOR]