Journal of the American Academy of Dermatology

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Understanding breast cancer as a global health concern

Br J Radiol

Risk prediction models for cardiotoxicity of chemotherapy among patients with breast cancer

JAMA Netw Open

The emergence of supportive oncodermatology: the study of dermatologic adverse events to cancer therapies

J Am Acad Dermatol

Female pattern hair loss: a pilot study investigating combination therapy with low-dose oral minoxidil and spironolactone

Int J Dermatol

Safety of low-dose oral minoxidil for hair loss: a multicenter study of 1404 patients

Tolerability and effectiveness of low-dose oral minoxidil for alopecia in patients with breast cancer: A retrospective cohort study.

Tolerability and effectiveness of low-dose oral minoxidil for alopecia in patients with breast cancer: A retrospective cohort study

JAMA Dermatology

<jats:sec id="ab-dcs240009-4"><jats:title>Importance</jats:title><jats:p>The results of small studies suggest that off-label use of low-dose oral minoxidil (LDOM) may be safe and effective for patients with hair loss, but larger trials and standardized guidelines are lacking.</jats:p></jats:sec><jats:sec id="ab-dcs240009-5"><jats:title>Objective</jats:title><jats:p>To create an expert consensus statement for LDOM prescribing for patients with hair loss.</jats:p></jats:sec><jats:sec id="ab-dcs240009-6"><jats:title>Evidence Review</jats:title><jats:p>The current literature on the pharmacological properties, adverse effect profile, and use of LDOM for patients with hair loss was reviewed. Topics of interest were identified, and a modified Delphi consensus process was created. A total of 43 hair loss specialist dermatologists from 12 countries participated in a modified Delphi process. Consensus was reached if at least 70% agreed or strongly agreed on a 5-point Likert scale.</jats:p></jats:sec><jats:sec id="ab-dcs240009-7"><jats:title>Findings</jats:title><jats:p>Over 4 survey rounds, 180 items in the first round, 121 items in the second round, 16 items in the third round, and 11 items in the fourth round were considered and revised. A total of 76 items achieved consensus including diagnoses for which LDOM may provide direct or supportive benefit, indications for LDOM compared to topical minoxidil, dosing for adults (18 years and older) and adolescents (aged 12 to 17 years), contraindications, precautions, baseline evaluation, monitoring, adjunctive therapy, and specialty consultation. Pediatric use and dosing items for children younger than 12 years, and LDOM titration protocols fell short of consensus.</jats:p></jats:sec><jats:sec id="ab-dcs240009-8"><jats:title>Conclusions and Relevance</jats:title><jats:p>This international expert consensus statement regarding the off-label prescribing of LDOM for patients with hair loss can help guide clinical practice until more data emerge. Hair loss experts with experience treating pediatric patients were underrepresented on this expert panel. Future research should investigate best practices for LDOM use in pediatric patients. Other critical topics for further investigation include the comparative efficacy of topical minoxidil vs oral minoxidil, the safety of oral minoxidil for patients with a history of allergic contact dermatitis to topical minoxidil, the long-term safety of LDOM, and the use of other off-label forms of minoxidil, such as compounded formulations of oral minoxidil and sublingual minoxidil. As additional evidence-based data emerge, these recommendations should be updated.</jats:p></jats:sec>

Hair loss: common causes and treatment.

Am Fam Physician

Treatment of hair loss.

N Engl J Med

Diagnosis and treatment of nonscarring hair loss in primary care in 2021.

JAMA

Topical and oral minoxidil for hair disorders in pediatric patients: what do we know so far?

Dermatol Ther

Hair disorders in cancer survivors.

Minoxidil: a comprehensive review.

J Dermatolog Treat

Oral minoxidil treatment for hair loss: a review of efficacy and safety.

Safety of low-dose oral minoxidil for hair loss: a multicenter study of 1404 patients.

Safety of low-dose oral minoxidil treatment for hair loss: a systematic review and pooled-analysis of individual patient data.

Prospective cardiovascular evaluation with 24-hour Holter and 24-hour ambulatory blood pressure monitoring in men using 5-mg oral minoxidil for androgenetic alopecia.

Combination tofacitinib and oral minoxidil treatment for severe alopecia areata.

Systemic minoxidil for hair disorders in pediatric patients: a safety and tolerability review.

Low-dose oral minoxidil for treatment of androgenetic alopecia and telogen effluvium in a pediatric population: a descriptive study.

Treatment for central centrifugal cicatricial alopecia—Delphi consensus recommendations.

Survey of dermatology practitioners’ opinions and prescribing habits of oral minoxidil for the treatment of androgenetic alopecia.

J Drugs Dermatol

Female pattern hair loss: a pilot study investigating combination therapy with low-dose oral minoxidil and spironolactone.

Treatment of chronic telogen effluvium with oral minoxidil: a retrospective study.

F1000Res

Low-dose oral minoxidil improves hair density in traction alopecia.

Low-dose oral minoxidil for androgenetic alopecia is not associated with clinically significant blood-pressure changes: a retrospective study.

Low-dose oral minoxidil improves hair length and global hair density in short anagen syndrome.

Trichorrhexis nodosa improving with oral minoxidil: a case report.

Clin Exp Dermatol

Serious complication of low-dose oral minoxidil for hair loss.

JAAD Case Rep

Pericardial, pleural effusion and anasarca: a rare complication of low-dose oral minoxidil for hair loss.

The Delphi technique: myths and realities.

J Adv Nurs

SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process.

BMJ Qual Saf

The REDCap consortium: building an international community of software platform partners.

J Biomed Inform

The Alopecia Areata Consensus of Experts (ACE) study: results of an international expert opinion on treatments for alopecia areata.

The Alopecia Areata Consensus of Experts (ACE) study part II: results of an international expert opinion on diagnosis and laboratory evaluation for alopecia areata.

A global eDelphi exercise to identify core domains and domain items for the development of a Global Registry of Alopecia Areata Disease Severity and Treatment Safety (GRASS).

JAMA Dermatol

The Alopecia Areata Severity and Morbidity Index (ASAMI) study: results from a global expert consensus exercise on determinants of alopecia areata severity.

The International TREatment of ATopic Eczema (TREAT) Registry Taskforce: an initiative to harmonize data collection across national atopic eczema photo- and systemic therapy registries.

J Invest Dermatol

TREatment of ATopic eczema (TREAT) Registry Taskforce: protocol for an international Delphi exercise to identify a core set of domains and domain items for national atopic eczema registries.

Trials

TREatment of ATopic eczema (TREAT) Registry Taskforce: an international Delphi exercise to identify a core set of domains and domain items for national atopic eczema photo- and systemic therapy registries.

Br J Dermatol

How safe is prescribing oral minoxidil in patients allergic to topical minoxidil?

The results of small studies suggest that off-label use of low-dose oral minoxidil (LDOM) may be safe and effective for patients with hair loss, but larger trials and standardized guidelines are lacking.
To create an expert consensus statement for LDOM prescribing for patients with hair loss.
The current literature on the pharmacological properties, adverse effect profile, and use of LDOM for patients with hair loss was reviewed. Topics of interest were identified, and a modified Delphi consensus process was created. A total of 43 hair loss specialist dermatologists from 12 countries participated in a modified Delphi process. Consensus was reached if at least 70% agreed or strongly agreed on a 5-point Likert scale.
Over 4 survey rounds, 180 items in the first round, 121 items in the second round, 16 items in the third round, and 11 items in the fourth round were considered and revised. A total of 76 items achieved consensus including diagnoses for which LDOM may provide direct or supportive benefit, indications for LDOM compared to topical minoxidil, dosing for adults (18 years and older) and adolescents (aged 12 to 17 years), contraindications, precautions, baseline evaluation, monitoring, adjunctive therapy, and specialty consultation. Pediatric use and dosing items for children younger than 12 years, and LDOM titration protocols fell short of consensus.
This international expert consensus statement regarding the off-label prescribing of LDOM for patients with hair loss can help guide clinical practice until more data emerge. Hair loss experts with experience treating pediatric patients were underrepresented on this expert panel. Future research should investigate best practices for LDOM use in pediatric patients. Other critical topics for further investigation include the comparative efficacy of topical minoxidil vs oral minoxidil, the safety of oral minoxidil for patients with a history of allergic contact dermatitis to topical minoxidil, the long-term safety of LDOM, and the use of other off-label forms of minoxidil, such as compounded formulations of oral minoxidil and sublingual minoxidil. As additional evidence-based data emerge, these recommendations should be updated.

Low-Dose Oral Minoxidil Initiation for Patients With Hair Loss: An International Modified Delphi Consensus Statement.

Low-Dose Oral Minoxidil Initiation for Patients With Hair Loss

<jats:sec><jats:title>Importance</jats:title><jats:p>There has been increased interest in low-dose oral minoxidil for androgenetic alopecia (AGA) treatment. However, the efficacy of oral minoxidil for male AGA is yet to be evaluated in comparative therapeutic trials.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To compare the efficacy, safety, and tolerability of daily oral minoxidil, 5 mg, vs twice-daily topical minoxidil, 5%, for 24 weeks in the treatment of male AGA.</jats:p></jats:sec><jats:sec><jats:title>Design, Setting, and Participants</jats:title><jats:p>This double-blind, placebo-controlled randomized clinical trial was conducted at a single specialized clinic in Brazil. Eligible men with AGA aged 18 to 55 years classified using the Norwood-Hamilton scale as 3V, 4V, or 5V were included and randomized. Data were collected from January to December 2021, and data were analyzed from September 2022 to February 2023.</jats:p></jats:sec><jats:sec><jats:title>Interventions</jats:title><jats:p>Participants were randomized 1:1 into 2 groups: oral minoxidil, 5 mg, daily and topical placebo solution; or 1 mL of topical minoxidil, 5%, twice daily and oral placebo for 24 weeks.</jats:p></jats:sec><jats:sec><jats:title>Main Outcomes and Measures</jats:title><jats:p>The primary outcome was change in terminal hair density on the frontal and vertex regions of the scalp. The secondary outcomes were change in total hair density and photographic evaluation.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Among 90 enrolled participants, 68 completed the study; of these, the mean (SD) age was 36.6 (7.8) years. A total of 33 participants were enrolled in the oral minoxidil group and 35 in the topical treatment group. Both groups were homogenous in terms of demographic data and AGA severity. For the frontal area, the mean change from baseline to week 24 between groups was 3.1 hairs per cm<jats:sup>2</jats:sup> (95% CI, −18.2 to 21.5; <jats:italic>P</jats:italic> = .27) for terminal hair density and 2.6 hairs per cm<jats:sup>2</jats:sup> (95% CI, −10.3 to 15.8; <jats:italic>P</jats:italic> = .32) for total hair density. For the vertex area, the mean change from baseline to week 24 was 23.4 hairs per cm<jats:sup>2</jats:sup> (95% CI, −0.3 to 43.0; <jats:italic>P</jats:italic> = .09) for terminal density and 5.5 hairs per cm<jats:sup>2</jats:sup> (95% CI, −12.5 to 23.5; <jats:italic>P</jats:italic> = .32) for total hair density. According to the photographic analysis, oral minoxidil was superior to topical minoxidil on the vertex (24%; 95% CI, 0 to 48; <jats:italic>P</jats:italic> = .04) but not on the frontal scalp (12%; 95% CI, −12 to 36; <jats:italic>P</jats:italic> = .24). The most common adverse effects in the oral minoxidil group were hypertrichosis (22 of 45 [49%]) and headache (6 of 45 [14%]).</jats:p></jats:sec><jats:sec><jats:title>Conclusions and Relevance</jats:title><jats:p>In this study, oral minoxidil, 5 mg, once per day for 24 weeks did not demonstrate superiority over topical minoxidil, 5%, twice per day in men with AGA.</jats:p></jats:sec><jats:sec><jats:title>Trial Registration</jats:title><jats:p>Brazilian Registry of Clinical Trials Identifier: <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://ensaiosclinicos.gov.br/rg/RBR-252w9r">RBR-252w9r</jats:ext-link></jats:p></jats:sec>

Prevalence of male and female pattern hair loss in Maryborough.

J Investig Dermatol Symp Proc

Female pattern hair loss: a clinical and pathophysiological review.

An Bras Dermatol

The psychosocial consequences of androgenetic alopecia: a review of the research literature.

Relative efficacy of minoxidil and the 5-a reductase inhibitors in androgenetic alopecia treatment of male patients: a network meta-analysis.

Post-finasteride syndrome.

Is topical minoxidil solution effective on androgenetic alopecia in routine daily practice?

Oral minoxidil for hair loss: update and perspectives.

Hair Transplant Forum Int

Classification of male-pattern hair loss.

Int J Trichology

Estimating sample sizes for repeated measurement designs.

Control Clin Trials

Follicular map: a novel approach to quantitative trichoscopy.

Skin Appendage Disord

Efficiency of hair detection in hair-to-hair matched trichoscopy.

A randomized, double-blind, multicenter comparison of the efficacy and tolerability of Restylane versus Zyplast for the correction of nasolabial folds.

Dermatol Surg

Anomalous values and missing data in clinical and experimental studies.

J Vasc Bras

Assessing normality of data in clinical and experimental trials.

Analysis of longitudinal data from animals with missing values using SPSS.

Nat Protoc

P value and effect-size in clinical and experimental studies.

Reversal of baldness in patient receiving minoxidil for hypertension.

Efficacy and safety of oral minoxidil 5 mg once daily in the treatment of male patients with androgenetic alopecia: an open-label and global photographic assessment.

Dermatol Ther (Heidelb)

Post—COVID-19 hair loss: prevalence and associated factors among 5,891 patients.

Minoxidil 1 mg oral versus minoxidil 5% topical solution for the treatment of female-pattern hair loss: a randomized clinical trial.

Adverse effects of low-dose oral minoxidil for androgenetic alopecia in 435 patients.

A randomized, single-blind trial of 5% minoxidil foam once daily versus 2% minoxidil solution twice daily in the treatment of androgenetic alopecia in women.

There has been increased interest in low-dose oral minoxidil for androgenetic alopecia (AGA) treatment. However, the efficacy of oral minoxidil for male AGA is yet to be evaluated in comparative therapeutic trials.
To compare the efficacy, safety, and tolerability of daily oral minoxidil, 5 mg, vs twice-daily topical minoxidil, 5%, for 24 weeks in the treatment of male AGA.
This double-blind, placebo-controlled randomized clinical trial was conducted at a single specialized clinic in Brazil. Eligible men with AGA aged 18 to 55 years classified using the Norwood-Hamilton scale as 3V, 4V, or 5V were included and randomized. Data were collected from January to December 2021, and data were analyzed from September 2022 to February 2023.
Participants were randomized 1:1 into 2 groups: oral minoxidil, 5 mg, daily and topical placebo solution; or 1 mL of topical minoxidil, 5%, twice daily and oral placebo for 24 weeks.
The primary outcome was change in terminal hair density on the frontal and vertex regions of the scalp. The secondary outcomes were change in total hair density and photographic evaluation.
Among 90 enrolled participants, 68 completed the study; of these, the mean (SD) age was 36.6 (7.8) years. A total of 33 participants were enrolled in the oral minoxidil group and 35 in the topical treatment group. Both groups were homogenous in terms of demographic data and AGA severity. For the frontal area, the mean change from baseline to week 24 between groups was 3.1 hairs per cm2 (95% CI, -18.2 to 21.5; P = .27) for terminal hair density and 2.6 hairs per cm2 (95% CI, -10.3 to 15.8; P = .32) for total hair density. For the vertex area, the mean change from baseline to week 24 was 23.4 hairs per cm2 (95% CI, -0.3 to 43.0; P = .09) for terminal density and 5.5 hairs per cm2 (95% CI, -12.5 to 23.5; P = .32) for total hair density. According to the photographic analysis, oral minoxidil was superior to topical minoxidil on the vertex (24%; 95% CI, 0 to 48; P = .04) but not on the frontal scalp (12%; 95% CI, -12 to 36; P = .24). The most common adverse effects in the oral minoxidil group were hypertrichosis (22 of 45 [49%]) and headache (6 of 45 [14%]).
In this study, oral minoxidil, 5 mg, once per day for 24 weeks did not demonstrate superiority over topical minoxidil, 5%, twice per day in men with AGA.
Brazilian Registry of Clinical Trials Identifier: RBR-252w9r.

Oral Minoxidil vs Topical Minoxidil for Male Androgenetic Alopecia: A Randomized Clinical Trial.

Oral Minoxidil vs Topical Minoxidil for Male Androgenetic Alopecia

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