1
|
Nohria A, Desai D, Sikora M, Anyanwu N, Caplan A, Shapiro J, Lo Sicco K. Improving efficacy and maintaining safety in the treatment of alopecia with low-dose oral minoxidil and spironolactone combination therapy: A retrospective review. JAAD Int 2024; 17:24-26. [PMID: 39399339 PMCID: PMC11470514 DOI: 10.1016/j.jdin.2024.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2024] Open
Affiliation(s)
- Ambika Nohria
- Ronald O. Perelman Department of Dermatology, University Grossman School of Medicine, New York, New York
| | - Deesha Desai
- Ronald O. Perelman Department of Dermatology, University Grossman School of Medicine, New York, New York
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Michelle Sikora
- Ronald O. Perelman Department of Dermatology, University Grossman School of Medicine, New York, New York
- New York Medical College, Valhalla, New York
| | - Nnaemeka Anyanwu
- Ronald O. Perelman Department of Dermatology, University Grossman School of Medicine, New York, New York
| | - Avrom Caplan
- Ronald O. Perelman Department of Dermatology, University Grossman School of Medicine, New York, New York
| | - Jerry Shapiro
- Ronald O. Perelman Department of Dermatology, University Grossman School of Medicine, New York, New York
| | - Kristen Lo Sicco
- Ronald O. Perelman Department of Dermatology, University Grossman School of Medicine, New York, New York
| |
Collapse
|
2
|
Müller Ramos P, Melo DF, Bhoyrul B, Sanabria BD, Jimenez-Cauhe J, Saceda-Corralo D, Sharma P, Ramos M, Miot HA, Vaño-Galvan S. Prospective evaluation of blood pressure, heart rate, and side effects in hypertensive patients using low-dose oral minoxidil for hair loss. J Am Acad Dermatol 2024; 91:1011-1012. [PMID: 39069264 DOI: 10.1016/j.jaad.2024.07.1472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/31/2024] [Accepted: 07/20/2024] [Indexed: 07/30/2024]
Affiliation(s)
- Paulo Müller Ramos
- Dermatology Department, Universidade Estadual Paulista - UNESP, Botucatu, São Paulo, Brazil.
| | | | | | | | - Juan Jimenez-Cauhe
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Madrid, Spain; Hair Disorders Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - David Saceda-Corralo
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Madrid, Spain; Hair Disorders Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | | | - Monica Ramos
- Cardiology Department, Hospital Universitario de la Cruz Roja San Jose y Santa Adela, Universidad Alfonso X El Sabio, Madrid, Spain
| | - Hélio Amante Miot
- Dermatology Department, Universidade Estadual Paulista - UNESP, Botucatu, São Paulo, Brazil
| | - Sergio Vaño-Galvan
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Madrid, Spain; Hair Disorders Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| |
Collapse
|
3
|
Li T, Zhang G, Zhou X, Guan J, Zhao W, Zheng Y, Lee J, Wang P, Zhao Y. Cedrol in ginger (Zingiber officinale) as a promising hair growth drug: The effects of oral and external administration on hair regeneration and its mechanism. Bioorg Chem 2024; 151:107709. [PMID: 39137599 DOI: 10.1016/j.bioorg.2024.107709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 08/07/2024] [Accepted: 08/08/2024] [Indexed: 08/15/2024]
Abstract
Ginger is an important cooking spice and herb worldwide, and scientific research has gradually confirmed the effect of ginger on preventing hair loss. Cedrol (CE) is a small sesquiterpene molecule in ginger and its external administration (EA) has shown hope in promoting hair growth, and alternative administration mode has become a potential treatment scheme to improve the efficacy of CE. The purpose of this study is to evaluate the effects of oral administration (OA) and EA of CE on hair regeneration of C57BL/6 alopecia areata (AA) mice induced by cyclophosphamide (CP) and to clarify the potential hair growth mechanism of CE in AA model in vitro and in vivo. The results showed that CE-OA has a shorter hair-turning black time and faster hair growth rate, and can lessen hair follicle damage induced by CP and promote hair follicle cell proliferation. Its effect is superior to CE-EA. At the same time, CE can increase the cytokines IFN-γ, IL-2, and IL-7 in the serum of mice, and decrease the expression of adhesion factors ICAM-1 and ELAM-1, thus alleviating the immunosuppression induced by CP. Mechanism research shows that CE regulates the JAK3/STAT3 signaling pathway, activates the Wnt3α/β-catenin germinal center, and ameliorates oxidative stress induced by CP, thus promoting the proliferation of hair follicle cells and reversing AA. These results provide a theoretical basis for understanding the anti-AA mechanism of CE-OA, indicating that CE can be used as raw material for developing oral hair growth drugs.
Collapse
Affiliation(s)
- Tao Li
- Key Laboratory of Natural Medicines of the Changbai Mountain, Ministry of Education, College of Pharmacy, Yanbian University, Yanji 133002, China
| | - Guiming Zhang
- Liaoning Xinzhong Modern Medicine Co., Ltd., Benxi 117002, China
| | - Xinyang Zhou
- Key Laboratory of Natural Medicines of the Changbai Mountain, Ministry of Education, College of Pharmacy, Yanbian University, Yanji 133002, China
| | - Jian Guan
- Liaoning Xinzhong Modern Medicine Co., Ltd., Benxi 117002, China
| | - Wenjie Zhao
- Key Laboratory of Natural Medicines of the Changbai Mountain, Ministry of Education, College of Pharmacy, Yanbian University, Yanji 133002, China
| | - Yifei Zheng
- Key Laboratory of Natural Medicines of the Changbai Mountain, Ministry of Education, College of Pharmacy, Yanbian University, Yanji 133002, China
| | - Jungjoon Lee
- Key Laboratory of Natural Medicines of the Changbai Mountain, Ministry of Education, College of Pharmacy, Yanbian University, Yanji 133002, China
| | - Peng Wang
- ORxes Therapeutics (Shanghai) Co., Ltd., Shanghai, 200120, China.
| | - Yuqing Zhao
- Key Laboratory of Natural Medicines of the Changbai Mountain, Ministry of Education, College of Pharmacy, Yanbian University, Yanji 133002, China.
| |
Collapse
|
4
|
Gupta AK, Bamimore MA, Abdel-Qadir H, Williams G, Tosti A, Piguet V, Talukder M. Low-Dose Oral Minoxidil and Associated Adverse Events: Analyses of the FDA Adverse Event Reporting System (FAERS) With a Focus on Pericardial Effusions. J Cosmet Dermatol 2024. [PMID: 39327649 DOI: 10.1111/jocd.16574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Revised: 08/20/2024] [Accepted: 08/27/2024] [Indexed: 09/28/2024]
Abstract
BACKGROUND Low-dose oral minoxidil (LDOM) is used to treat hair loss, but the literature on its safety profile is relatively sparse. AIMS Using the FDA Adverse Event Reporting System (FAERS) database, we determined signals for adverse events (AEs) with LDOM use. METHODS 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). RESULTS 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. CONCLUSIONS 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).
Collapse
Affiliation(s)
- Aditya K Gupta
- Mediprobe Research Inc., London, Ontario, Canada
- Division of Dermatology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto School of Medicine, Toronto, Ontario, Canada
| | | | - Husam Abdel-Qadir
- Division of Cardiology, Women's College Hospital and University Health Network, Toronto, Ontario, Canada
- Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | | | - Antonella Tosti
- Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Vincent Piguet
- Division of Dermatology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto School of Medicine, Toronto, Ontario, Canada
- Division of Dermatology, Women's College Hospital, Toronto, Ontario, Canada
| | | |
Collapse
|
5
|
Desai DD, Nohria A, Sikora M, Anyanwu N, Shapiro J, Lo Sicco KI. Comparative analysis of low-dose oral minoxidil with spironolactone versus finasteride or dutasteride in female androgenetic alopecia management. Arch Dermatol Res 2024; 316:622. [PMID: 39276230 DOI: 10.1007/s00403-024-03361-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Revised: 08/14/2024] [Accepted: 08/26/2024] [Indexed: 09/16/2024]
Abstract
LDOM has enhanced treatment options for female AGA, yet its combined efficacy with therapies such as spironolactone, finasteride, or dutasteride remains inadequately explored. This study aims to compare the efficacy and safety of LDOM in combination with spironolactone versus LDOM with finasteride or dutasteride in women with AGA. Our analysis revealed that both combination therapies produced similar improvements in hair growth and had comparable safety profiles. Although the LDOM with finasteride/dutasteride group showed a greater average increase in hair width and density, these differences were not statistically significant. These results endorse the use of LDOM in combination with either spironolactone or finasteride/dutasteride for female AGA, and underscore the necessity for further research to validate these findings and assess long-term treatment outcomes.
Collapse
Affiliation(s)
- Deesha D Desai
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, 240 East 38th Street, 12th Floor, New York, NY, 10016, USA.
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Ambika Nohria
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, 240 East 38th Street, 12th Floor, New York, NY, 10016, USA
| | - Michelle Sikora
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, 240 East 38th Street, 12th Floor, New York, NY, 10016, USA
- New York Medical College, Valhalla, NY, USA
| | - Nnaemeka Anyanwu
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, 240 East 38th Street, 12th Floor, New York, NY, 10016, USA
| | - Jerry Shapiro
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, 240 East 38th Street, 12th Floor, New York, NY, 10016, USA
| | - Kristen I Lo Sicco
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, 240 East 38th Street, 12th Floor, New York, NY, 10016, USA
| |
Collapse
|
6
|
Andrés-Lencina JJ, Brisco F, Ricart JM, Gómez-Zubiaur A. Tolerance and Safety Profile of Sublingual Minoxidil in the Treatment of Androgenic Alopecia. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00699-9. [PMID: 39233222 DOI: 10.1016/j.ad.2023.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/06/2023] [Accepted: 09/19/2023] [Indexed: 09/06/2024] Open
Affiliation(s)
| | - F Brisco
- Pharmacy Unit, Instituto Médico Ricart, Spain
| | - J M Ricart
- Trichology Unit, Instituto Médico Ricart, Spain
| | - A Gómez-Zubiaur
- Trichology Unit, Instituto Médico Ricart, Spain; Dermatology Department, Hospital Universitario Príncipe de Asturias (Madrid), Spain
| |
Collapse
|
7
|
Buontempo M, Nohria A, Desai D, Shapiro J, Lo Sicco K. Response to Nathalie Y. Ly et al., "Medical and procedural treatment of androgenetic alopecia - Where are we?". J Am Acad Dermatol 2024; 91:e55-e57. [PMID: 38636906 DOI: 10.1016/j.jaad.2023.11.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/02/2023] [Accepted: 11/05/2023] [Indexed: 04/20/2024]
Affiliation(s)
| | - Ambika Nohria
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Deesha Desai
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York.
| | - Jerry Shapiro
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Kristen Lo Sicco
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| |
Collapse
|
8
|
Desai DD, Nohria A, Sikora M, Anyanwu N, Shapiro J, Lo Sicco KI. Assessing low-dose oral minoxidil efficacy in androgenetic alopecia: a comparative study of AGA and AGA unmasked by telogen effluvium. Arch Dermatol Res 2024; 316:514. [PMID: 39133308 DOI: 10.1007/s00403-024-03257-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2024] [Revised: 07/09/2024] [Accepted: 07/30/2024] [Indexed: 08/13/2024]
Abstract
Androgenetic alopecia (AGA) significantly impacts patients' psychological well-being, and treatment options have historically been limited. However, the advent of low-dose oral minoxidil (LDOM) has revolutionized AGA management. This study compares the treatment response and safety of LDOM in patients with AGA alone versus those with AGA unmasked by telogen effluvium. Our findings indicate that LDOM is effective and safe for both groups, showing comparable efficacy and safety profiles. These results support the use of LDOM as a reliable treatment option for AGA, potentially improving patient outcomes and quality of life.
Collapse
Affiliation(s)
- Deesha D Desai
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, 240 East 38th Street, 12th Floor, New York, NY, 10016, USA.
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Ambika Nohria
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, 240 East 38th Street, 12th Floor, New York, NY, 10016, USA
| | - Michelle Sikora
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, 240 East 38th Street, 12th Floor, New York, NY, 10016, USA
- New York Medical College, Valhalla, NY, USA
| | - Nnaemeka Anyanwu
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, 240 East 38th Street, 12th Floor, New York, NY, 10016, USA
| | - Jerry Shapiro
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, 240 East 38th Street, 12th Floor, New York, NY, 10016, USA
| | - Kristen I Lo Sicco
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, 240 East 38th Street, 12th Floor, New York, NY, 10016, USA
| |
Collapse
|
9
|
Kuo AMS, Reingold RE, Ketosugbo KF, Pan A, Kraehenbuehl L, Dusza S, Gajria D, Lake DE, Bromberg JF, Traina TA, Fornier MN, Gucalp A, D'Alessandro BM, Rotemberg V, Dauscher M, Shapiro J, Goldfarb SB, Markova A, Lacouture ME. Oral minoxidil for late alopecia in cancer survivors. Breast Cancer Res Treat 2024:10.1007/s10549-024-07440-5. [PMID: 39097564 DOI: 10.1007/s10549-024-07440-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 07/16/2024] [Indexed: 08/05/2024]
Abstract
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.
Collapse
Affiliation(s)
- Alyce Mei-Shiuan Kuo
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Rachel E Reingold
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kwami F Ketosugbo
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alexander Pan
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lukas Kraehenbuehl
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Ludwig Collaborative and Swim Across America Laboratory, Human Oncology and Pathogenesis Program, Department of Medicine, MSKCC, Parker Institute for Cancer Immunotherapy, New York, NY, USA
| | - Stephen Dusza
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Devika Gajria
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Diana E Lake
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jacqueline F Bromberg
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Tiffany A Traina
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Monica N Fornier
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ayca Gucalp
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Veronica Rotemberg
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Megan Dauscher
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jerry Shapiro
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, NY, USA
| | - Shari B Goldfarb
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alina Markova
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mario E Lacouture
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Dermatology Division, Department of Medicine, NYU Grossman Long Island School of Medicine, Mineola, New York, USA.
- Symptom Management Program, Perlmutter Cancer Center, NYU Langone Hospital - Long Island, Mineola, New York, USA.
| |
Collapse
|
10
|
Gressenberger P, Kopera D. Low dose oral minoxidil for the treatment of female pattern hair loss. Skin Res Technol 2024; 30:e70013. [PMID: 39185756 PMCID: PMC11345697 DOI: 10.1111/srt.70013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Accepted: 08/05/2024] [Indexed: 08/27/2024]
Affiliation(s)
| | - Daisy Kopera
- Department of DermatologyMedical University of GrazGrazAustria
| |
Collapse
|
11
|
Moussa A, Darchini-Maragheh E, Wall D, Meah N, Sinclair R. Low-dose oral minoxidil improves hair length and global hair density in short anagen syndrome. J Am Acad Dermatol 2024; 91:346-348. [PMID: 38588822 DOI: 10.1016/j.jaad.2024.03.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 03/19/2024] [Indexed: 04/10/2024]
Affiliation(s)
| | - Emadodin Darchini-Maragheh
- Sinclair Dermatology, East Melbourne, VIC, Australia; Faculty of Medicine, University of Melbourne, Melbourne, VIC, Australia
| | - Dmitri Wall
- Hair Restoration Blackrock, Dublin, Ireland; National and International Skin Registry Solutions (NISR), Charles Institute of Dermatology, University College Dublin, Dublin, Ireland
| | - Nekma Meah
- Mersey & West Lancashire Teaching Hospitals NHS Trust, Prescot, United Kingdom; Faculty of Biology, Medicine and Health, Manchester University, Manchester, United Kingdom
| | - Rodney Sinclair
- Sinclair Dermatology, East Melbourne, VIC, Australia; Faculty of Medicine, University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
12
|
Desai D, Nohria A, Sikora M, Mandal S, Shapiro J, Caplan AS, Garshick M, Lo Sicco K. Response to "Low-dose oral minoxidil for androgenetic alopecia is not associated with clinically significant blood-pressure changes: A retrospective study". J Am Acad Dermatol 2024; 91:e11-e12. [PMID: 38499178 DOI: 10.1016/j.jaad.2024.01.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 03/20/2024]
Affiliation(s)
- Deesha Desai
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York.
| | - Ambika Nohria
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Michelle Sikora
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York; New York Medical College, Valhalla, New York
| | - Soutrik Mandal
- Department of Population Health, NYU Grossman School of Medicine, New York, New York
| | - Jerry Shapiro
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Avrom S Caplan
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Michael Garshick
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York; Leon H. Charney Division of Cardiology, New York University Grossman School of Medicine, New York, New York
| | - Kristen Lo Sicco
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| |
Collapse
|
13
|
Ong M, Lipner SR. Response to Desai et al, "Response to 'Low-dose oral minoxidil for androgenetic alopecia is not associated with clinically significant blood-pressure changes: a retrospective study'". J Am Acad Dermatol 2024; 91:e9-e10. [PMID: 38499180 DOI: 10.1016/j.jaad.2024.02.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/20/2024]
Affiliation(s)
- Michael Ong
- MD Program, Weill Cornell Medicine, New York, New York
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, New York.
| |
Collapse
|
14
|
Alhanshali L, Desai D, Nohria A, Shapiro J, Lo Sicco K. Oral minoxidil and the exacerbation of alcohol hangover symptoms. Int J Dermatol 2024; 63:975-976. [PMID: 38643369 DOI: 10.1111/ijd.17195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 03/27/2024] [Accepted: 03/27/2024] [Indexed: 04/22/2024]
Affiliation(s)
- Lina Alhanshali
- State University of New York System (SUNY) Downstate College of Medicine, Brooklyn, NY, USA
| | - Deesha Desai
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- The Ronald O Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY, USA
| | - Ambika Nohria
- The Ronald O Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY, USA
| | - Jerry Shapiro
- The Ronald O Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY, USA
| | - Kristen Lo Sicco
- The Ronald O Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY, USA
| |
Collapse
|
15
|
Nohria A, Desai D, Sikora M, Mandal S, Shapiro J, Lo Sicco K. Combating "dread shed": The impact of overlapping topical and oral minoxidil on temporary hair shedding during oral minoxidil initiation. JAAD Int 2024; 15:220-224. [PMID: 38707927 PMCID: PMC11067493 DOI: 10.1016/j.jdin.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2024] [Indexed: 05/07/2024] Open
Abstract
Background Low dose oral minoxidil (LDOM) is a preferred treatment for alopecia due to ease of use and efficacy. While LDOM is typically well tolerated, patients may experience a temporary increase in hair shedding starting treatment, colloquially regarded as "dread shed". One proposed method to combat this is to overlap therapies by maintaining use of topical minoxidil when initiating LDOM. Objective To evaluate the impact of maintaining topical minoxidil when initiating LDOM on "dread shed". Methods We performed a retrospective chart review of patients seen at New York University Langone Health Dermatology from January 1, 2008 to August 1, 2023 prescribed LDOM. Results A total of 115 patients met inclusion criteria, of whom 37 maintained use of topical minoxidil when initiating LDOM. Six patients experienced "dread shed" when initiating LDOM, 2 of whom overlapped therapies. We did not find that overlapping therapies had a significant impact on decreasing rates of "dread shed". Limitations Limitations include retrospective design, sample size, and subjective patient-reported assessment of hair shedding. Conclusions A total of 5.2% of patients experienced dread shed, which is lower than previously reported in literature. Maintaining topical minoxidil during LDOM initiation does not significantly impact "dread shed". This remains a significant side effect deserving of further research.
Collapse
Affiliation(s)
- Ambika Nohria
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Deesha Desai
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Michelle Sikora
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
- New York Medical College, Valhalla, New York
| | - Soutrik Mandal
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Jerry Shapiro
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Kristen Lo Sicco
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| |
Collapse
|
16
|
Penha MA, Miot HA, Kasprzak M, Müller Ramos P. Oral Minoxidil vs Topical Minoxidil for Male Androgenetic Alopecia: A Randomized Clinical Trial. JAMA Dermatol 2024; 160:600-605. [PMID: 38598226 PMCID: PMC11007651 DOI: 10.1001/jamadermatol.2024.0284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 01/29/2024] [Indexed: 04/11/2024]
Abstract
Importance 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. Objective 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. Design, Setting, and Participants 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. Interventions 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. Main Outcomes and Measures 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. Results 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%]). Conclusions and Relevance 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. Trial Registration Brazilian Registry of Clinical Trials Identifier: RBR-252w9r.
Collapse
Affiliation(s)
- Mariana Alvares Penha
- Department of Dermatology, Faculty of Medicine of Botucatu, São Paulo State University (UNESP), Botucatu, Brazil
| | - Hélio Amante Miot
- Department of Dermatology, Faculty of Medicine of Botucatu, São Paulo State University (UNESP), Botucatu, Brazil
| | | | - Paulo Müller Ramos
- Department of Dermatology, Faculty of Medicine of Botucatu, São Paulo State University (UNESP), Botucatu, Brazil
| |
Collapse
|
17
|
Westerkam LL, McShane DB, Nieman EL, Morrell DS. Treatment Options for Alopecia Areata in Children and Adolescents. Paediatr Drugs 2024; 26:245-257. [PMID: 38466519 DOI: 10.1007/s40272-024-00620-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2024] [Indexed: 03/13/2024]
Abstract
Alopecia areata (AA) lifetime incidence is around 2%, with many patients first experiencing symptoms during childhood. However, ritlecitinib is the only FDA-approved treatment for pediatric patients 12 years and older. This review outlines reported topical, injectable, and oral treatment options for pediatric patients with AA. Clinical studies were obtained via a PubMed search using the following search terms: alopecia areata, areata, universalis, or totalis and medication, therapy, treatment, drug, or management. Only studies with pediatric patients were included in this review. Commonly used therapies, including corticosteroids, methotrexate, and minoxidil, newer promising medications, such as Janus kinase inhibitors, and less frequently used topical and systemic treatments are included. A summary of the drug development pipeline and ongoing interventional clinical trials with pediatric patients is provided. Treatments demonstrate variable efficacy, and many patients require combination therapy for maximal response. More robust clinical data is needed for many of the medications reviewed in order to provide better care for these patients.
Collapse
Affiliation(s)
| | - Diana B McShane
- Department of Dermatology, University of North Carolina, Chapel Hill, NC, USA
| | - Elizabeth L Nieman
- Department of Dermatology, University of North Carolina, Chapel Hill, NC, USA
| | - Dean S Morrell
- Department of Dermatology, University of North Carolina, Chapel Hill, NC, USA
| |
Collapse
|
18
|
Moreno-Arrones OM, Saceda-Corralo D, Jimenez-Cauhe J, Vañó-Galván S. Low-Dose Oral Minoxidil Severe Adverse Effects as a Consequence of Compounding Errors. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T407-T408. [PMID: 38325538 DOI: 10.1016/j.ad.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/05/2023] [Indexed: 02/09/2024] Open
Affiliation(s)
- O M Moreno-Arrones
- Dermatology Department, Ramon y Cajal University Hospital, University of Alcala, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Clínica Pedro Jaén, Madrid, Spain.
| | - D Saceda-Corralo
- Dermatology Department, Ramon y Cajal University Hospital, University of Alcala, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Clínica Pedro Jaén, Madrid, Spain
| | - J Jimenez-Cauhe
- Dermatology Department, Ramon y Cajal University Hospital, University of Alcala, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Clínica Pedro Jaén, Madrid, Spain
| | - S Vañó-Galván
- Dermatology Department, Ramon y Cajal University Hospital, University of Alcala, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Clínica Pedro Jaén, Madrid, Spain
| |
Collapse
|
19
|
Vañó-Galván S, Fernandez-Crehuet P, Garnacho G, Gómez-Zubiaur A, Hermosa-Gelbard A, Moreno-Arrones OM, Saceda-Corralo D, Serrano-Falcón C. [Translated article] Recommendations on the Clinical Management of Androgenetic Alopecia: A Consensus Statement From the Spanish Hair Disorders Group of the Spanish Academy of Dermatology and Venererology (AEDV). ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T347-T355. [PMID: 38336246 DOI: 10.1016/j.ad.2023.10.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 10/12/2023] [Indexed: 02/12/2024] Open
Abstract
Androgenetic alopecia can be challenging to treat due to the wide range of available treatments, most of which are not based on evidence from clinical trials. In addition many of the options do not include androgenetic alopecia among the approved indications according to their summaries of product characteristics. A panel of 34 dermatologists from the Spanish Hair Disorders Society of the Spanish Academy of Dermatology and Venereology (AEDV) used the Delphi method to develop a consensus statement on the management of androgenetic alopecia. Over a 2-round process the experts agreed on 138 (86%) of the 160 proposed items, which were structured into 4 blocks of recommendations: general considerations, pharmacologic treatment, procedures and hair transplant, and special cases. The resulting consensus statement based on expert opinion of the scientific evidence can guide professionals in the routine management of androgenetic alopecia.
Collapse
Affiliation(s)
- S Vañó-Galván
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Alcalá, Madrid, Spain; Unidad de Tricología, Grupo de Dermatología Pedro Jaén, Madrid, Spain.
| | - P Fernandez-Crehuet
- Servicio de Dermatología, Hospital Universitario Reina Sofia, Córdoba, Spain; Clinica Fernández-Crehuet, Córdoba, Spain
| | - G Garnacho
- Servicio de Dermatología, Hospital Universitario Reina Sofia, Córdoba, Spain; Clinica Garnacho, Córdoba, Spain
| | - A Gómez-Zubiaur
- Unidad Capilar, Instituto Médico Ricart, Madrid, Spain; Servicio de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Príncipe Asturias, Madrid, Spain
| | - A Hermosa-Gelbard
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Unidad de Tricología, Grupo de Dermatología Pedro Jaén, Madrid, Spain
| | - O M Moreno-Arrones
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Unidad de Tricología, Grupo de Dermatología Pedro Jaén, Madrid, Spain
| | - D Saceda-Corralo
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Unidad de Tricología, Grupo de Dermatología Pedro Jaén, Madrid, Spain; Departamento de Biología de Sistemas, Facultad de Medicina, Universidad de Alcalá, Madrid, Spain
| | - C Serrano-Falcón
- Unidad de Dermatología Medico Quirúrgica, Hospital Inmaculada, Granada, Spain; Clínica Dermatológica Serrano, Granada, Spain
| |
Collapse
|
20
|
Vañó-Galván S, Fernandez-Crehuet P, Garnacho G, Gómez-Zubiaur A, Hermosa-Gelbard A, Moreno-Arrones OM, Saceda-Corralo D, Serrano-Falcón C. Recommendations on the Clinical Management of Androgenetic Alopecia: A Consensus Statement From the Spanish Trichology Group of the Spanish Academy of Dermatology and Venererology (AEDV). ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:347-355. [PMID: 37890616 DOI: 10.1016/j.ad.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
Androgenetic alopecia can be challenging to treat due to the wide range of available treatments, most of which are not based on evidence from clinical trials. In addition many of the options do not include androgenetic alopecia among the approved indications according to their summaries of product characteristics. A panel of 34 dermatologists from the Spanish Trichology Society of the Spanish Academy of Dermatology and Venereology (AEDV) used the Delphi method to develop a consensus statement on the management of androgenetic alopecia. Over a 2-round process the experts agreed on 138 (86%) of the 160 proposed items, which were structured into 4 blocks of recommendations: general considerations, pharmacologic treatment, procedures and hair transplant, and special cases. The resulting consensus statement based on expert opinion of the scientific evidence can guide professionals in the routine management of androgenetic alopecia.
Collapse
Affiliation(s)
- S Vañó-Galván
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, España; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España; Departamento de Medicina, Facultad de Medicina, Universidad de Alcalá, Madrid, España; Unidad de Tricología, Grupo de Dermatología Pedro Jaén, Madrid, España.
| | - P Fernandez-Crehuet
- Servicio de Dermatología, Hospital Universitario Reina Sofia, Córdoba, España; Clinica Fernández-Crehuet, Córdoba, España
| | - G Garnacho
- Servicio de Dermatología, Hospital Universitario Reina Sofia, Córdoba, España; Clinica Garnacho, Córdoba, España
| | - A Gómez-Zubiaur
- Unidad Capilar, Instituto Médico Ricart, Madrid, España; Servicio de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Príncipe Asturias, Madrid, España
| | - A Hermosa-Gelbard
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, España; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España; Unidad de Tricología, Grupo de Dermatología Pedro Jaén, Madrid, España
| | - O M Moreno-Arrones
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, España; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España; Unidad de Tricología, Grupo de Dermatología Pedro Jaén, Madrid, España
| | - D Saceda-Corralo
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, España; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España; Unidad de Tricología, Grupo de Dermatología Pedro Jaén, Madrid, España; Departamento de Biología de Sistemas, Facultad de Medicina, Universidad de Alcalá, Madrid, España
| | - C Serrano-Falcón
- Unidad de Dermatología Medico Quirúrgica, Hospital Inmaculada, Granada, España; Clínica Dermatológica Serrano, Granada, España
| |
Collapse
|
21
|
Moreno-Arrones OM, Saceda-Corralo D, Jimenez-Cauhe J, Vañó-Galván S. Low-Dose Oral Minoxidil Severe Adverse Effects as a Consequence of Compounding Errors. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:407-408. [PMID: 37797880 DOI: 10.1016/j.ad.2023.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/05/2023] [Indexed: 10/07/2023] Open
Affiliation(s)
- O M Moreno-Arrones
- Dermatology Department, Ramon y Cajal University Hospital, University of Alcala, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Clínica Pedro Jaén, Madrid, Spain.
| | - D Saceda-Corralo
- Dermatology Department, Ramon y Cajal University Hospital, University of Alcala, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Clínica Pedro Jaén, Madrid, Spain
| | - J Jimenez-Cauhe
- Dermatology Department, Ramon y Cajal University Hospital, University of Alcala, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Clínica Pedro Jaén, Madrid, Spain
| | - S Vañó-Galván
- Dermatology Department, Ramon y Cajal University Hospital, University of Alcala, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Clínica Pedro Jaén, Madrid, Spain
| |
Collapse
|
22
|
Altalhab S. Dermatologists' Knowledge, Attitude, and Practice Pattern Toward Low-Dose Oral Minoxidil in Hair Loss in Saudi Arabia. Clin Cosmet Investig Dermatol 2024; 17:653-662. [PMID: 38505809 PMCID: PMC10949881 DOI: 10.2147/ccid.s456470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 02/29/2024] [Indexed: 03/21/2024]
Abstract
Background The utilization of low-dose oral minoxidil (LDOM) has emerged as a relatively new treatment option for hair loss, gaining recognition among dermatologists worldwide. Objective To assess the knowledge, attitude, and practice patterns among dermatologists in Saudi Arabia regarding the use of LDOM in the management of hair loss. Methods An online survey, which was distributed to dermatologists practicing in Saudi Arabia through email and mobile messages. Both univariate and bivariate analyses were performed to investigate the factors that may be associated with enhanced knowledge and practice patterns concerning the utilization of LDOM for the management of hair loss. Results A total of 84 dermatologists was included in this study, with 50 (60%) being male. It was found that 83 (99%) of the participants identified patterned hair loss as the most common indication for LDOM usage. Additionally, 77 (92%) recognized hypertrichosis as a well-known side effect. 48 (82%) of the dermatologists had never prescribed LDOM due to its unavailability in local pharmacies. Conclusion The usage of LDOM for hair disorders is increasing. Nonetheless, many dermatologists abstain from prescribing this medication due to its limited availability in local pharmacies.
Collapse
Affiliation(s)
- Saad Altalhab
- Department of Dermatology, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| |
Collapse
|
23
|
Asilian A, Farmani A, Saber M. Clinical efficacy and safety of low-dose oral minoxidil versus topical solution in the improvement of androgenetic alopecia: A randomized controlled trial. J Cosmet Dermatol 2024; 23:949-957. [PMID: 38031516 DOI: 10.1111/jocd.16086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/14/2023] [Accepted: 11/06/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Topical minoxidil is the recommended first-line pharmacologic treatment for male and female pattern hair loss. However, low-dose oral minoxidil has been used off-label with good clinical efficacy and safety. AIM To compare the effectiveness and safety of topical minoxidil as a first-choice treatment of androgenetic alopecia versus 1 mg daily oral minoxidil. METHOD Sixty-five AGA patients were randomly allocated to receive either 5% topical solution or 1 mg/day oral minoxidil for 6 months. Treatment efficacy was evaluated by measuring hair diameter, photographic assessment, and patient self-assessment questionnaires. The safety of treatment was checked through history taking and physical examination. RESULTS Both topical and oral minoxidil groups showed significant improvement in hair diameter after 6 months of treatment (p < 0.001). However, there was no significant difference between the two groups. The photographic assessment demonstrated a significant improvement in hair density in the topical minoxidil group in all marked points located at 12 cm (p = 0.025), 16 cm (p = 0.034), and 24 cm (p = 0.014) distance from the glabella but not in the oral minoxidil group. Nevertheless, the difference between the two groups was not significant. In each group, over 60% of patients expressed satisfaction with their treatments, and no significant difference was detected between the two groups. CONCLUSION Although topical minoxidil has a better overall therapeutic effect than 1 mg oral minoxidil, the difference between the two groups was not significant. Therefore, 1 mg oral minoxidil may be as effective and safe as standard topical minoxidil in female and male pattern hair loss.
Collapse
Affiliation(s)
- Ali Asilian
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Aida Farmani
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mina Saber
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
24
|
Sethupathi SK, Poole M, Darji K, Fehlman J. Cosmetic Dermatology Concerns in Older Adults. Clin Geriatr Med 2024; 40:197-210. [PMID: 38000860 DOI: 10.1016/j.cger.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Abstract
It is important to understand that each layer of facial tissue, from the underlying facial skeleton to the overlying skin, undergoes significant changes during the aging process. Bony support is lost along the mandible and maxilla and the orbital aperture widens. Superficial and deep fat pads undergo volume loss and migration and the overlying skin begins to reveal signs of both intrinsic aging with skin laxity and fine rhytids as well as extrinsic aging in the form of coarse, deeper rhytids and dyspigmentation.
Collapse
Affiliation(s)
- Sheetal K Sethupathi
- Department of Dermatology, Saint Louis University, 1008 S Spring Avenue, Saint Louis, MO 63110, USA
| | - Mackenzie Poole
- Saint Louis University School of Medicine, 1008 S Spring Avenue, Saint Louis, MO 63110, USA
| | - Kavita Darji
- Department of Dermatology, Saint Louis University, 1008 S Spring Avenue, Saint Louis, MO 63110, USA
| | - Jennifer Fehlman
- Saint Louis University SLU Care Physician Group -SSM Health, 2315 Dougherty Ferry Road, Suite 200C, Saint Louis, MO 63122, USA.
| |
Collapse
|
25
|
Gupta AK, Talukder M, Shemer A. Efficacy and safety of low-dose oral minoxidil in the management of androgenetic alopecia. Expert Opin Pharmacother 2024; 25:139-147. [PMID: 38315101 DOI: 10.1080/14656566.2024.2314087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 01/31/2024] [Indexed: 02/07/2024]
Abstract
INTRODUCTION Treating alopecia can be challenging. The available treatments are topical minoxidil, low-dose oral minoxidil (LDOM), and 5-α reductase inhibitors like finasteride and dutasteride. Only topical minoxidil and finasteride 1 mg daily are FDA-approved, while the rest are used off-label. Recent research has suggested that oral minoxidil may be a safe and effective treatment for both female androgenetic alopecia (female AGA) and male androgenetic alopecia (male AGA). AREAS COVERED In this review, we explore the pharmacokinetics, mechanism of action, safety, and efficacy of oral minoxidil. Additionally, we discuss its effectiveness compared to other treatments available for female AGA and male AGA. EXPERT OPINION LDOM has demonstrated a favorable efficacy and safety profile in several trials. Subsequently, its use for the treatment of male AGA and female AGA is increasing. However, its use remains off-label, and through increased usage, we will get a better idea of the best dosage and monitoring guidelines. LDOM has also been used with some effectiveness in other forms of hair loss.
Collapse
Affiliation(s)
- Aditya K Gupta
- Mediprobe Research Inc, London, ON, Canada
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Mesbah Talukder
- Mediprobe Research Inc, London, ON, Canada
- School of Pharmacy, BRAC University, Dhaka, Bangladesh
| | - Avner Shemer
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
26
|
Desir N, Desai AD, Lipner SR. Increased Interest in Oral Minoxidil for Hair Loss Treatment Following Publication of August 2022 New York Times Article: A Google Trends Analysis. Skin Appendage Disord 2024; 10:46-49. [PMID: 38313574 PMCID: PMC10836857 DOI: 10.1159/000534526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/05/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Androgenetic alopecia (AGA) is the most common form of hair loss, with negative impact on patient quality of life. Oral minoxidil is used off-label for AGA treatment. We hypothesized increased public interest in oral minoxidil for hair loss treatment following the New York Times (NYT) Article on oral minoxidil: "An Old Medicine Grows New Hair for Pennies a Day, Doctors Say." The objective of this study was to quantify interest in oral minoxidil for hair loss treatment before and after the NYT article and help inform dermatologists about treatments of interest to their patients. Method We performed a cross-sectional analysis of Google Trends evaluating relative prevalence of "oral minoxidil," "minoxidil," "hair loss," and "Rogaine®" 2/2022-5/2023. t tests compared mean search volume and linear regression analysis quantified changes in public interest over time. Results Oral minoxidil and minoxidil search volumes increased from 0.86 to 3.00 and 22.43 to 32.60, respectively, before and after the NYT article (both p < 0.05). Minoxidil searches continually increased by 500,000 searches per month (p < 0.001). Conclusions There was a significant and sustained increase in Google searches for oral minoxidil after publication of the NYT article, indicating increased patient interest. Larger clinical trials are needed to provide evidence-based care to AGA patients.
Collapse
Affiliation(s)
- Noelle Desir
- Weill Cornell Medical College, New York, NY, USA
| | - Amar D Desai
- Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, NY, USA
| |
Collapse
|
27
|
Rosenthal A, Conde G, Greco JF, Gharavi NM. Management of androgenic alopecia: a systematic review of the literature. J COSMET LASER THER 2024; 26:1-16. [PMID: 38852607 DOI: 10.1080/14764172.2024.2362126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 06/01/2024] [Accepted: 05/28/2024] [Indexed: 06/11/2024]
Abstract
We aimed to determine the efficacy of the various available oral, topical, and procedural treatment options for hair loss in individuals with androgenic alopecia. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review of the National Library of Medicine was performed. Overall, 141 unique studies met our inclusion criteria. We demonstrate that many over the counter (e.g. topical minoxidil, supplements, low-level light treatment), prescription (e.g. oral minoxidil, finasteride, dutasteride), and procedural (e.g. platelet-rich plasma, fractionated lasers, hair transplantation) treatments successfully promote hair growth, highlighting the superiority of a multifaceted and individualized approach to management.
Collapse
Affiliation(s)
- Amanda Rosenthal
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA
| | - Geena Conde
- Department of Dermatology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Joseph F Greco
- Department of Research, Greco Hair Restoration, Sarasota, FL, USA
| | - Nima M Gharavi
- Department of Dermatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| |
Collapse
|
28
|
Jimenez-Cauhe J, Pirmez R, Müller-Ramos P, Melo DF, Ortega-Quijano D, Moreno-Arrones OM, Saceda-Corralo D, Gil-Redondo R, Hermosa-Gelbard A, Dias-Sanabria B, Restom D, Porriño-Bustamante ML, Pindado-Ortega C, Berna-Rico E, Fernandez-Nieto D, Ramos M, Jaen-Olasolo P, Vaño-Galvan S. Safety of Low-Dose Oral Minoxidil in Patients With Hypertension and Arrhythmia: A Multicenter Study of 264 Patients. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T28-T35. [PMID: 37923070 DOI: 10.1016/j.ad.2023.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 07/20/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Systemic adverse effects (AE) are a major concern of low-dose oral minoxidil (LDOM) treatment, especially in patients with arterial hypertension or arrhythmia. The objective of this study was to evaluate the safety of LDOM in patients with hypertension or arrhythmia. PATIENTS AND METHODS Retrospective multicenter study of patients with hypertension or arrhythmia treated with LDOM for any type of alopecia. RESULTS A total of 254 patients with hypertension [176 women (69.3%) and 78 men (30.7%)] with a mean age of 56.9 years (range 19-82) were included. From them, the dose of LDOM was titrated in 128 patients, allowing the analysis of 382 doses. Patients were receiving a mean of 1.45 (range 0-5) antihypertensive drugs. Systemic AE were detected in 26 cases (6.8%) and included lightheadedness (3.1%), fluid retention (2.6%), general malaise (0.8%), tachycardia (0.8%) and headache (0.5%), leading to LDOM discontinuation in 6 cases (1.5%). Prior treatment with doxazosin (P<0.001), or with three or more antihypertensive drugs (P=0.012) was associated with a higher risk of discontinuation of LDOM. CONCLUSIONS LDOM treatment showed a favorable safety profile in patients with hypertension or arrhythmia, similar to general population.
Collapse
Affiliation(s)
- J Jimenez-Cauhe
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - R Pirmez
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - P Müller-Ramos
- Universidade Estadual Paulista - UNESP, Botucatu, São Paulo, Brazil
| | - D F Melo
- Dermatology Department, University of State of Rio de Janeiro (UERJ), Spain
| | - D Ortega-Quijano
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - O M Moreno-Arrones
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - D Saceda-Corralo
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain.
| | - R Gil-Redondo
- Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain; Dermatology Department, Hospital Universitario La Paz, Madrid, Spain
| | - A Hermosa-Gelbard
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - B Dias-Sanabria
- Universidade Federal do Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - D Restom
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - C Pindado-Ortega
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - E Berna-Rico
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain
| | - D Fernandez-Nieto
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - M Ramos
- Cardiology Department, Hospital Universitario de la Cruz Roja San Jose y Santa Adela, Universidad Alfonso X El Sabio, Madrid, Spain
| | - P Jaen-Olasolo
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - S Vaño-Galvan
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| |
Collapse
|
29
|
Jimenez-Cauhe J, Pirmez R, Müller-Ramos P, Melo DF, Ortega-Quijano D, Moreno-Arrones OM, Saceda-Corralo D, Gil-Redondo R, Hermosa-Gelbard A, Dias-Sanabria B, Restom D, Porriño-Bustamante ML, Pindado-Ortega C, Berna-Rico E, Fernandez-Nieto D, Ramos M, Jaen-Olasolo P, Vaño-Galvan S. Safety of Low-Dose Oral Minoxidil in Patients With Hypertension and Arrhythmia: A Multicenter Study of 264 Patients. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:28-35. [PMID: 37652097 DOI: 10.1016/j.ad.2023.07.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/16/2023] [Accepted: 07/20/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Systemic adverse effects (AE) are a major concern of low-dose oral minoxidil (LDOM) treatment, especially in patients with arterial hypertension or arrhythmia. The objective of this study was to evaluate the safety of LDOM in patients with hypertension or arrhythmia. PATIENTS AND METHODS Retrospective multicenter study of patients with hypertension or arrhythmia treated with LDOM for any type of alopecia. RESULTS A total of 254 patients with hypertension [176 women (69.3%) and 78 men (30.7%)] with a mean age of 56.9 years (range 19-82) were included. From them, the dose of LDOM was titrated in 128 patients, allowing the analysis of 382 doses. Patients were receiving a mean of 1.45 (range 0-5) antihypertensive drugs. Systemic AE were detected in 26 cases (6.8%) and included lightheadedness (3.1%), fluid retention (2.6%), general malaise (0.8%), tachycardia (0.8%) and headache (0.5%), leading to LDOM discontinuation in 6 cases (1.5%). Prior treatment with doxazosin (P<0.001), or with three or more antihypertensive drugs (P=0.012) was associated with a higher risk of discontinuation of LDOM. CONCLUSIONS LDOM treatment showed a favorable safety profile in patients with hypertension or arrhythmia, similar to general population.
Collapse
Affiliation(s)
- J Jimenez-Cauhe
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - R Pirmez
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - P Müller-Ramos
- Universidade Estadual Paulista - UNESP, Botucatu, São Paulo, Brazil
| | - D F Melo
- Dermatology Department, University of State of Rio de Janeiro (UERJ), Spain
| | - D Ortega-Quijano
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - O M Moreno-Arrones
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - D Saceda-Corralo
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain.
| | - R Gil-Redondo
- Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain; Dermatology Department, Hospital Universitario La Paz, Madrid, Spain
| | - A Hermosa-Gelbard
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - B Dias-Sanabria
- Universidade Federal do Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - D Restom
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - C Pindado-Ortega
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - E Berna-Rico
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain
| | - D Fernandez-Nieto
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - M Ramos
- Cardiology Department, Hospital Universitario de la Cruz Roja San Jose y Santa Adela, Universidad Alfonso X El Sabio, Madrid, Spain
| | - P Jaen-Olasolo
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - S Vaño-Galvan
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| |
Collapse
|
30
|
Gupta AK, Talukder M, Shemer A, Piraccini BM, Tosti A. Low-Dose Oral Minoxidil for Alopecia: A Comprehensive Review. Skin Appendage Disord 2023; 9:423-437. [PMID: 38376087 PMCID: PMC10806356 DOI: 10.1159/000531890] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/06/2023] [Indexed: 02/21/2024] Open
Abstract
Low-dose oral minoxidil (LDOM) has demonstrated a promising safety and efficacy profile in the treatment of various hair disorders, including male androgenetic alopecia (AGA) and female-pattern hair loss (FPHL); however, it lacks FDA approval. The usual LDOM starting dose for male AGA is 1-5 mg/day, depending on physician preference and the patient's condition. For FPHL, it is 0.5-1 mg/day. The maximum dose is generally 5 mg/day. If patients respond well without major side effects, the dose may be gradually increased since the LDOM's efficacy appears to be dose-dependent. Patients may use LDOM long term if the treatment outcome is satisfactory. The common side effects of LDOM are hypertrichosis and cardiovascular symptoms. Females are more prone to hypertrichosis than males. The side effects of LDOM can be categorized as (a) dose-dependent type A side effects (hypertrichosis and cardiovascular symptoms) and (b) idiosyncratic type B side effects (pericardial effusion). Minoxidil acts via multiple pathways. Although minoxidil has a relatively short half-life of around 4 h, its hypotensive effect may last approximately 72 h. Effective treatments for alopecia are limited. Therefore, LDOM could be an important addition to the available therapies for managing some hair disorders, including AGA.
Collapse
Affiliation(s)
- Aditya K. Gupta
- Mediprobe Research Inc., London, ON, Canada
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mesbah Talukder
- Mediprobe Research Inc., London, ON, Canada
- School of Pharmacy, BRAC University, Dhaka, Bangladesh
| | - Avner Shemer
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Antonella Tosti
- Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| |
Collapse
|
31
|
Imhof R, Villalpando B, Torgerson R. Safety and tolerability of low dose oral minoxidil monotherapy in female pattern hair loss: A retrospective review with longitudinal ambulatory blood pressure monitoring. JAAD Int 2023; 13:50-52. [PMID: 37692972 PMCID: PMC10483043 DOI: 10.1016/j.jdin.2023.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Affiliation(s)
- Reese Imhof
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | | | | |
Collapse
|
32
|
Gao JL, Streed CG, Thompson J, Dommasch ED, Peebles JK. Androgenetic alopecia in transgender and gender diverse populations: A review of therapeutics. J Am Acad Dermatol 2023; 89:774-783. [PMID: 34756934 DOI: 10.1016/j.jaad.2021.08.067] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 08/14/2021] [Accepted: 08/17/2021] [Indexed: 10/20/2022]
Abstract
Androgenetic alopecia (AGA) management is a significant clinical and therapeutic challenge for transgender and gender-diverse (TGD) patients. Although gender-affirming hormone therapies affect hair growth, there is little research about AGA in TGD populations. After reviewing the literature on approved treatments, off-label medication usages, and procedures for treating AGA, we present treatment options for AGA in TGD patients. The first-line treatments for any TGD patient include topical minoxidil 5% applied to the scalp once or twice daily, finasteride 1 mg oral daily, and/or low-level laser light therapy. Spironolactone 200 mg daily is also first-line for transfeminine patients. Second-line options include daily oral minoxidil dosed at 1.25 or 2.5 mg for transfeminine and transmasculine patients, respectively. Topical finasteride 0.25% monotherapy or in combination with minoxidil 2% solution are second-line options for transmasculine and transfeminine patients, respectively. Other second-line treatments for any TGD patient include oral dutasteride 0.5 mg daily, platelet-rich plasma, or hair restoration procedures. After 6-12 months of treatment, AGA severity and treatment progress should be assessed via scales not based on sex; eg, the Basic and Specific Classification or the Bouhanna scales. Dermatologists should coordinate care with the patient's primary gender-affirming clinician(s) so that shared knowledge of all medications exists across the care team.
Collapse
Affiliation(s)
- Julia L Gao
- Fenway Institute, Fenway Health, Boston, Massachusetts; Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; George Washington University School of Medicine & Health Sciences, Washington, District of Columbia.
| | - Carl G Streed
- Section of General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts; Center for Transgender Medicine and Surgery, Boston Medical Center, Boston, Massachusetts
| | | | - Erica D Dommasch
- Fenway Institute, Fenway Health, Boston, Massachusetts; Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Jon Klinton Peebles
- Department of Dermatology, Kaiser-Permanente Mid-Atlantic Permanente Medical Group, Rockville, Maryland
| |
Collapse
|
33
|
Alhanshali L, Buontempo M, Majerson D, Shapiro J, Lo Sicco K. Intradermal Delivery of Alopecia Therapeutics: Current State and Future Prospects. Dermatol Surg 2023; 49:851-854. [PMID: 37387642 DOI: 10.1097/dss.0000000000003866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
BACKGROUND Mesotherapy, a technique of transdermal microinjections of specific preparations, is increasingly used in fields such as dermatology and specifically for alopecia treatment. Its popularity stems from its ability to deliver drugs in a targeted manner while minimizing systemic side effects. OBJECTIVE To assess and review current knowledge regarding the use of mesotherapy to deliver alopecia medications and highlight future directions for research. MATERIALS AND METHODS The authors used research databases including PubMed and Google Scholar to identify current literature on mesotherapy and alopecia. The following search terms were used among other terms: "Mesotherapy" or "Intradermal" AND "Alopecia". RESULTS Recent studies are promising for the intradermal delivery of dutasteride and minoxidil in the treatment of androgenetic alopecia. CONCLUSION Although limitations exist with dutasteride and minoxidil therapies, further research regarding the preparation, delivery, and maintenance of these drugs is warranted as mesotherapy could establish this technique as a safe, effective, and viable treatment option for androgenetic alopecia.
Collapse
Affiliation(s)
- Lina Alhanshali
- Department of Dermatology, SUNY Downstate College of Medicine, Brooklyn, New York
| | - Michael Buontempo
- Department of Dermatology, Hackensack Meridian School of Medicine, Nutley, New Jersey
| | | | - Jerry Shapiro
- Department of Dermatology, The Ronald O. Perelman, NYU Grossman School of Medicine, New York, New York
| | - Kristen Lo Sicco
- Department of Dermatology, The Ronald O. Perelman, NYU Grossman School of Medicine, New York, New York
| |
Collapse
|
34
|
Ly NY, Fruechte S, Hordinsky MK, Sadick N, Arruda S, Farah RS. Medical and procedural treatment of androgenetic alopecia - Where are we? J Am Acad Dermatol 2023; 89:S36-S39. [PMID: 37591565 DOI: 10.1016/j.jaad.2023.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/25/2023] [Accepted: 05/03/2023] [Indexed: 08/19/2023]
Abstract
Novel medical and procedural options for androgenetic alopecia have arrived. Low-dose oral minoxidil has made its clinical debut, while data on spironolactone, finasteride, and nutritional supplements have advanced. Minimally invasive technological advancements include photobiomodulation and platelet-rich plasma. Within hair transplantation, follicular unit extraction and robotics are now at the clinicians' fingertips.
Collapse
Affiliation(s)
- Nathalie Y Ly
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota; Ohio State University College of Medicine, Columbus, Ohio
| | - Sophia Fruechte
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota; Des Moines University College of Osteopathic Medicine, Des Moines, Iowa
| | - Maria K Hordinsky
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
| | - Neil Sadick
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota; Weill Cornell Medical College, New York, New York; Sadick Dermatology, New York, New York
| | | | - Ronda S Farah
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota; Department of Dermatology, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota.
| |
Collapse
|
35
|
Goldberg LJ. Alopecia - New building blocks. J Am Acad Dermatol 2023; 89:S1-S2. [PMID: 37591559 DOI: 10.1016/j.jaad.2023.05.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 05/10/2023] [Indexed: 08/19/2023]
Abstract
Hair loss is devastating to the patient, but the diagnosis and treatment of alopecia are also difficult for primary care providers and even dermatologists. Given recent advances in the field, there has never been a more pressing time to reevaluate and improve upon the significant clinical skills needed to accurately diagnose and treat our patients with hair loss. This CME activity on alopecia is designed to (1) educate dermatologists in a simple, succinct fashion on the identification of, and the distinction between, the diverse types of hair loss and (2) discuss how to manage them.
Collapse
Affiliation(s)
- Lynne J Goldberg
- Department of Dermatology, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts; Boston Medical Center, Boston, Massachusetts.
| |
Collapse
|
36
|
Willems A, Moussa A, Sinclair R. Australian dermatologists' prescribing behaviours for male androgenetic alopecia. Australas J Dermatol 2023; 64:429-432. [PMID: 37309735 DOI: 10.1111/ajd.14098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 04/17/2023] [Accepted: 05/24/2023] [Indexed: 06/14/2023]
Abstract
Androgenetic alopecia (AGA) is highly prevalent among Australian men and can have significant psychological impacts. Despite its prevalence, treatment options have traditionally been limited. In this study, we examined the current prescribing patterns of Australian dermatologists for male AGA.
Collapse
Affiliation(s)
- Anneliese Willems
- Sinclair Dermatology, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
- Yarra Medical Clinic, Richmond, Victoria, Australia
| | | | - Rodney Sinclair
- Sinclair Dermatology, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
37
|
Iorizzo M, Waśkiel-Burnat A, Anedda J, Piraccini BM, Apalla Z, Rudnicka L, Starace M. Persistent Chemotherapy-Induced Alopecia Treated With Low Dose Oral Minoxidil: A Multicenter Retrospective Case Series of 15 Patients. Dermatol Pract Concept 2023; 13:e2023152. [PMID: 37557121 PMCID: PMC10412018 DOI: 10.5826/dpc.1303a152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 08/11/2023] Open
Affiliation(s)
- Matilde Iorizzo
- Private Dermatology Practice, Bellinzona/Lugano, Switzerland
| | | | - Jasmine Anedda
- Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit - IRCCS Policlinico Sant’Orsola - Department of Specialized, Experimental and Diagnostic Medicine, University of Bologna, Bologna, Italy
| | - Zoe Apalla
- Second Dermatology Department, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Michela Starace
- Dermatology Unit - IRCCS Policlinico Sant’Orsola - Department of Specialized, Experimental and Diagnostic Medicine, University of Bologna, Bologna, Italy
| |
Collapse
|
38
|
Godse K, De A, Vedamurthy M, Shankar DSK, Shah B, Girdhar M, Bhat R, Ganjoo A, Tahiliani S, Patil A. Low-dose Oral Minoxidil in the Treatment of Alopecia: Evidence and Experience-based Consensus Statement of Indian Experts. Int J Trichology 2023; 15:91-97. [PMID: 38179013 PMCID: PMC10763725 DOI: 10.4103/ijt.ijt_70_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 10/09/2023] [Indexed: 01/06/2024] Open
Abstract
Alopecia is a highly prevalent condition worldwide including in India. There are different types of alopecia with differing etiology, presentation, and hence treatment. Androgenetic alopecia represents the most common form of hair loss affecting male as well as female population termed as male and female pattern hair loss, respectively. Several treatment options are available for the treatment of alopecia with often unsatisfactory results resulting in psychological distress among such patients. Topical minoxidil is known to be effective in the treatment of alopecia. However, oral minoxidil is not currently approved for the treatment of alopecia. This expert consensus is prepared to provide guidance to the clinicians regarding the use of oral minoxidil in the treatment of alopecia. Extensive literature review was performed to prepare the draft consensus which was then revised based on the suggestions and comments from the experts. The final draft was circulated to the experts for review and approval. This consensus document provides overview of evidence related to oral minoxidil and consensus from the experts for its use in the treatment of minoxidil.
Collapse
Affiliation(s)
- Kiran Godse
- Department of Dermatology, Dr. DY Patil Medical College, Navi Mumbai, India
| | - Abhishek De
- Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Maya Vedamurthy
- RSV Skin and Research Centre, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - D. S. Krupa Shankar
- Department of Dermatology, Krupa Shankar Skin Care Center, Mallige Hospital, Bengaluru, India
| | - Bela Shah
- Department of Dermatology, BJ Medical College, Ahmedabad, Gujarat, India
| | - Mukesh Girdhar
- Department of Dermatology, Max Super Speciality Hospital, New Delhi, Delhi, India
| | - Ramesh Bhat
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
| | - Anil Ganjoo
- Department of Dermatology and Venereology, Saroj Hospital and Heart Institute, New Delhi, Delhi, India
| | - Sushil Tahiliani
- Department of Dermatology, Hinduja Hospital, Mumbai, Maharashtra, India
| | - Anant Patil
- Department of Pharmacology, Dr. DY Patil Medical College, Navi Mumbai, India
| |
Collapse
|
39
|
Shadi Z. Compliance to Topical Minoxidil and Reasons for Discontinuation among Patients with Androgenetic Alopecia. Dermatol Ther (Heidelb) 2023; 13:1157-1169. [PMID: 37012528 PMCID: PMC10149432 DOI: 10.1007/s13555-023-00919-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 03/22/2023] [Indexed: 04/05/2023] Open
Abstract
INTRODUCTION This study assessed the levels of compliance to topical minoxidil (TM) among male and female patients with androgenetic alopecia (AGA) and analyzed the factors associated with minoxidil discontinuation. METHOD A retrospective study was conducted among 400 consecutive patients with AGA who presented to a dermatology clinic and who were prescribed minoxidil 2% or 5% in the past 5 years. Demographic factors, other previous treatments, and minoxidil parameters including the dose (2% or 5%), total duration of use, treatment results, and side effects were collected. RESULT The mean age of the patients was 32.41 years [standard deviation (SD) 8.18], and 66.5% were female. The majority of patients (82.5%) did not receive any previous treatment for AGA. Of the total patients, 345 (86.3%) have discontinued minoxidil. Discontinuation rate showed no association with sex (p = 0.271), age category (p = 0.069), or previous treatment (p = 0.530). Furthermore, the likelihood of minoxidil discontinuation decreased with the increase in treatment duration (p < 0.001) and was significantly lower among patients who reported improvement (69.3%) or stabilization of hair shedding (64.1%) compared with those who reported baby hair (88.9%) or no efficacy (95.3%) (p < 0.001). Furthermore, having experienced an adverse effect of minoxidil was associated with 93.6% discontinuation rate compared with 75.8% in the case of no side effects (p < 0.001). Adjusted analysis showed that minoxidil discontinuation was independently association with longer duration of use [> 1 year; odds ratio (OR) 0.22; p < 0.001], perceived improvement (OR 0.17; p < 0.001) or stabilization (OR 0.14; p < 0.001), and the occurrence of side effects (OR 3.06; p = 0.002). CONCLUSIONS The clinical use of TM in AGA is limited by a substantially low compliance even in absence of adverse effects. We emphasize the importance of educating patients regarding the treatment's side effects and the need to use minoxidil for a minimum of 12 months to assess treatment efficacy.
Collapse
Affiliation(s)
- Zari Shadi
- Department of Dermatology, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia.
| |
Collapse
|
40
|
Lee YY, Sung YK, Hong D, Jung KE, Seo YJ, Lee Y. A case of aromatase inhibitor-induced alopecia successfully treated with low-dose oral minoxidil. J Cosmet Dermatol 2023. [PMID: 36924357 DOI: 10.1111/jocd.15729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/27/2023] [Accepted: 03/06/2023] [Indexed: 03/18/2023]
Affiliation(s)
- Young Yoon Lee
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Yeoun Kuk Sung
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Dongkyun Hong
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Kyung Eun Jung
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Young-Joon Seo
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Young Lee
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| |
Collapse
|
41
|
Feaster B, Onamusi T, Cooley JE, McMichael AJ. Oral minoxidil use in androgenetic alopecia and telogen effluvium. Arch Dermatol Res 2023; 315:201-205. [PMID: 35244759 DOI: 10.1007/s00403-022-02331-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 01/28/2022] [Accepted: 02/08/2022] [Indexed: 11/27/2022]
Abstract
While current studies have supported oral minoxidil as a novel, adjunctive therapy in non-scarring forms of alopecia, there continues to be limited data on oral minoxidil for these conditions. To assess oral minoxidil use in the treatment of androgenetic alopecia and telogen effluvium, a multi-center, retrospective analysis was conducted in 105 adult patients treated for androgenetic alopecia and/or telogen effluvium with oral minoxidil (dose range 0.625-2.5 mg) once daily for ≥ 52 weeks, case matched by age (± 5 years) and gender with 105 controls with androgenetic alopecia and/or telogen effluvium who were not treated with oral minoxidil. 80 women (76.2%) with a mean age of 57.5 ± 13.56 (range 24-80) and 25 men (23.8%) with a mean age of 40.4 ± 13.79 (range 19-63) were included. Efficacy was evaluated based on provider assessment of clinical response and clinical photographic evaluation using a 3-point scale (worsening, stabilization, and improvement). 52.4% of patients demonstrated clinical improvement and 42.9% demonstrated stabilization. There was a significant difference in clinical response between the patient and control group, p < 0.001. Retrospective study design. These results suggest that oral minoxidil can be an effective treatment in androgenetic alopecia and telogen effluvium.
Collapse
Affiliation(s)
- Brittany Feaster
- Department of Dermatology, Wake Forest School of Medicine, 4618 Country Club Road, Winston-Salem, NC, 27104, USA
| | - Toluwalashe Onamusi
- Department of Dermatology, Wake Forest School of Medicine, 4618 Country Club Road, Winston-Salem, NC, 27104, USA
| | | | - Amy J McMichael
- Department of Dermatology, Wake Forest School of Medicine, 4618 Country Club Road, Winston-Salem, NC, 27104, USA.
| |
Collapse
|
42
|
[Translated article] Sensitive Scalp: Diagnosis and Practical Management. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:T141-T146. [PMID: 36470396 DOI: 10.1016/j.ad.2022.09.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/09/2022] [Indexed: 12/12/2022] Open
Abstract
Sensitive scalp is sensitive skin located on the scalp. Sensitivity is considered primary in the absence of an associated scalp disorder and secondary when caused by conditions such as psoriasis, seborrheic dermatitis, and atopic dermatitis. The clinical manifestations of primary sensitive scalp are subjective. Common presenting symptoms are burning, itching, trichodynia, and dysesthesia, often coinciding with hair loss. Clinically, the skin appears normal or red. An objective diagnosis based on laboratory or histologic findings is not possible. Triggers may be endogenous (e.g., stress and emotional or psychopathological disturbances) or exogeneous (e.g., topical products and cosmetics). Treatment must be individualized. Options include pimecrolimus, hydration with hyaluronic acid, and mesotherapy with plasma rich in growth factors.
Collapse
|
43
|
Sanabria BD, Palmegiani E, Seron AF, Perdomo YC, Miot HA, Müller Ramos P. Prospective cardiovascular evaluation with 24-hour Holter and 24-hour ambulatory blood pressure monitoring in men using 5-mg oral minoxidil for androgenetic alopecia. J Am Acad Dermatol 2023; 88:436-437. [PMID: 35597386 DOI: 10.1016/j.jaad.2022.05.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/17/2022] [Accepted: 05/02/2022] [Indexed: 01/17/2023]
Affiliation(s)
| | - Eduardo Palmegiani
- Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, São Paulo, Brazil
| | | | - Yuri Chiarelli Perdomo
- Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, São Paulo, Brazil
| | | | | |
Collapse
|
44
|
John JM, Sinclair R. Safety and tolerability of low-dose oral minoxidil in adolescents: A retrospective review. J Am Acad Dermatol 2023; 88:502-504. [PMID: 35803401 DOI: 10.1016/j.jaad.2022.06.1195] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 06/14/2022] [Accepted: 06/29/2022] [Indexed: 01/17/2023]
|
45
|
Guerra-Tapia A, González-Guerra E. Sensitive Scalp: Diagnosis and Practical Management. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:141-146. [PMID: 36174707 DOI: 10.1016/j.ad.2022.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/03/2022] [Accepted: 09/09/2022] [Indexed: 02/06/2023] Open
Abstract
Sensitive scalp is sensitive skin located on the scalp. Sensitivity is considered primary in the absence of an associated scalp disorder and secondary when caused by conditions such as psoriasis, seborrheic dermatitis, and atopic dermatitis. The clinical manifestations of primary sensitive scalp are subjective. Common presenting symptoms are burning, itching, trichodynia, and dysesthesia, often coinciding with hair loss. Clinically, the skin appears normal or red. An objective diagnosis based on laboratory or histologic findings is not possible. Triggers may be endogenous (e.g., stress and emotional or psychopathological disturbances) or exogeneous (e.g., topical products and cosmetics). Treatment must be individualized. Options include pimecrolimus, hydration with hyaluronic acid, and mesotherapy with plasma rich in growth factors.
Collapse
|
46
|
John JM, Sinclair RD. Systemic minoxidil for hair disorders in pediatric patients: a safety and tolerability review. Int J Dermatol 2023; 62:257-259. [PMID: 35965281 DOI: 10.1111/ijd.16373] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/23/2022] [Accepted: 07/26/2022] [Indexed: 01/20/2023]
Abstract
Topical minoxidil has been used for many years to treat adult alopecia, and there is growing evidence supporting the off-label use of low-dose oral minoxidil (LDOM). However, there is little data on its use in pediatrics, and there are no recommended treatment guidelines. Adverse events are of particular concern in this population. We retrospectively reviewed the medical records of 63 patients aged between 0 and 12 years from a specialist hair clinic who were treated with LDOM or sublingual minoxidil (SM) to evaluate its safety and tolerability. LDOM and SM were generally well-tolerated, with mild hypertrichosis being the most commonly reported adverse event. Further large-scale studies are warranted to determine the efficacy and optimum dosage of systemic minoxidil for alopecia in the pediatric population.
Collapse
Affiliation(s)
- Jared M John
- Sinclair Dermatology, East Melbourne, Victoria, Australia
| | | |
Collapse
|
47
|
Klein EJ, Oh CS, Karim M, Shapiro J, Lo Sicco K. A practical approach to the management of hair loss in patients with polycystic ovary syndrome. J Eur Acad Dermatol Venereol 2023; 37:1480-1489. [PMID: 36606524 DOI: 10.1111/jdv.18842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/13/2022] [Indexed: 01/07/2023]
Abstract
Female patterned hair loss (FPHL) is a common form of androgenetic alopecia in women and is characterized by a hormonally directed diffuse hair loss on the scalp. Management of FPHL is well described in the literature; however, treatment of FPHL in patients with co-morbid polycystic ovarian syndrome (PCOS), an endocrinologic condition found in reproductive-aged women, has not yet been reviewed. Due to the different pathomechanism of the diseases and complexity of FPHL in PCOS patients, this study aimed to review current diagnosis and management approaches for hair loss in PCOS patients specifically and highlight the growing need for more research in this growing patient population.
Collapse
Affiliation(s)
- Elizabeth J Klein
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York, USA
| | - Christina S Oh
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York, USA
| | - Maria Karim
- Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | - Jerry Shapiro
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York, USA
| | - Kristen Lo Sicco
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York, USA
| |
Collapse
|
48
|
Gomes TF, Soares RO. Pediatric androgenetic alopecia: an updated review. J Dtsch Dermatol Ges 2023; 21:19-25. [PMID: 36688435 DOI: 10.1111/ddg.14940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/23/2022] [Indexed: 01/24/2023]
Abstract
Pediatric androgenetic alopecia is an underrecognized disorder. A clinical evaluation with trichoscopy should be made in children and adolescents with hair loss and/or reduced hair density. Diagnosis is usually clinical, by observation of the hair loss pattern and performance of trichoscopy. In some cases, hyperandrogenism should be excluded. Although there is no approved therapy for androgenetic alopecia in pediatric age, topical minoxidil, oral minoxidil and topical finasteride may be very useful. Hair transplant may be an option for girls in selected cases. This article is a review of the current state of evidence concerning pediatric androgenetic alopecia.
Collapse
|
49
|
Gallo G, Burzi L, Torrelli F, Quaglino P, Ribero S. Low-dose oral minoxidil in female patients with lichen planopilaris: Real-life experience. J Eur Acad Dermatol Venereol 2023; 37:e98-e100. [PMID: 35974439 DOI: 10.1111/jdv.18489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/27/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Giuseppe Gallo
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Lorenza Burzi
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Francesca Torrelli
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Pietro Quaglino
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Simone Ribero
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| |
Collapse
|
50
|
Saceda-Corralo D, Domínguez-Santas M, Vañó-Galván S, Grimalt R. What's New in Therapy for Male Androgenetic Alopecia? Am J Clin Dermatol 2023; 24:15-24. [PMID: 36169916 DOI: 10.1007/s40257-022-00730-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 01/29/2023]
Abstract
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.
Collapse
Affiliation(s)
- David Saceda-Corralo
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Departamento de Medicina, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Carretera Colmenar Viejo km 9.100, 28034, Madrid, Spain. .,Trichology Unit, Grupo de Dermatología Pedro Jaén, Madrid, Spain.
| | - Miguel Domínguez-Santas
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Departamento de Medicina, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Carretera Colmenar Viejo km 9.100, 28034, Madrid, Spain.,Trichology Unit, Grupo de Dermatología Pedro Jaén, Madrid, Spain
| | - Sergio Vañó-Galván
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Departamento de Medicina, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Carretera Colmenar Viejo km 9.100, 28034, Madrid, Spain.,Trichology Unit, Grupo de Dermatología Pedro Jaén, Madrid, Spain
| | - Ramon Grimalt
- Facultat de Medicina i Ciències de la Salut, Universitat Internacional de Catalunya Barcelona, Barcelona, Spain
| |
Collapse
|