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Darchini-Maragheh E, Moussa A, Wall D, Meah N, Sinclair R. Low-dose oral minoxidil for the treatment of monilethrix: A retrospective review. J Eur Acad Dermatol Venereol 2024. [PMID: 39291903 DOI: 10.1111/jdv.20329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 08/22/2024] [Indexed: 09/19/2024]
Affiliation(s)
- Emadodin Darchini-Maragheh
- Sinclair Dermatology, East Melbourne, Victoria, Australia
- University of Melbourne, Melbourne, Victoria, Australia
| | - Anthony Moussa
- Sinclair Dermatology, East Melbourne, Victoria, 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, UK
- Faculty of Biology, Medicine and Health, Manchester University, Manchester, UK
| | - Rodney Sinclair
- Sinclair Dermatology, East Melbourne, Victoria, Australia
- University of Melbourne, Melbourne, Victoria, Australia
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2
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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.
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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
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3
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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.
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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
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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.
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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
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5
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Shen Q, Fu Z, Du P, Wang J. Gene detection in a family with monilethrix and treatment with 5% topical minoxidil. Skin Res Technol 2023; 29:e13233. [PMID: 36382623 PMCID: PMC9838763 DOI: 10.1111/srt.13233] [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: 09/23/2022] [Accepted: 10/29/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the causative gene mutation in a family with monilethrix and observe the therapeutic effect of 5% topical minoxidil. METHOD Clinical data from a family with monilethrix were collected. Peripheral blood samples were taken from the proband, the parents, and 100 unrelated healthy controls. Genomic DNA was extracted. The genetic variation sites were screened with exome sequencing and verified by Sanger sequencing. The proband was treated with 5% topical minoxidil (1 mL twice daily). Hair quality was examined by dermoscopy before and after treatment. RESULTS The proband and her father have the heterozygous missense variant c.1204G > A (p.E402K) in exon 7 of the KRT86 gene. However, the mutation was not found in the mother and healthy controls. The proband was treated with 5% topical minoxidil. Hair density and hair shaft quality improved significantly after 6 months of treatment. No adverse events occurred during treatment. CONCLUSION This study shows that p.E402K is a mutation "hot spot" in patients with autosomal dominant monilethrix in China. Treatment with 5% topical minoxidil, is safe and effective.
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Affiliation(s)
- Qingli Shen
- Department of Pharmacy, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, Henan, China
| | - Zhonghua Fu
- Department of Pharmacy, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, Henan, China
| | - Pengqiang Du
- Department of Pharmacy, Henan Provincial People's Hospital, Fuwai Central China Cardiovascular Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jianbo Wang
- Department of Dermatology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, Henan, China
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6
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Modha JD, Pathania YS. Comprehensive review of oral minoxidil in alopecia. J Cosmet Dermatol 2022; 21:5527-5531. [PMID: 36065675 DOI: 10.1111/jocd.15324] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 07/08/2022] [Accepted: 08/19/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND There have been various treatment modalities available for alopecia in the form of topical and systemic with a variable response. The compliance of the patients is important in reaping results in alopecia. Minoxidil has come a long-way finding its use from topical formulations to systemic at lower dose in different alopecia. OBJECTIVE The objective of this article is to discuss various conditions in alopecia where oral minoxidil has found its role. METHODS A comprehensive literature search was performed relating to oral minoxidil role in various alopecia. Various clinical trials, case series, and case reports were searched on PubMed and Google Scholar. The references of available studies were also reviewed to collect the additional resources. Available data from various studies and case reports were collected and consolidated to provide a concise overview of oral minoxidil indications in various alopecia. RESULTS Oral minoxidil has been used in various non-scarring and scarring alopecia at a lower dosage with less side effects and with promising results. Androgenetic alopecia and female pattern hair loss were the two conditions where it has been used more commonly than other alopecia, providing a ray of hope along with overcoming the issues related to topical formulations and compliance.
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Affiliation(s)
- Jay D Modha
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Rajkot, India
| | - Yashdeep Singh Pathania
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Rajkot, India
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Claves diagnósticas en displasias pilosas I. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:141-149. [DOI: 10.1016/j.ad.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 06/01/2021] [Accepted: 06/06/2021] [Indexed: 11/19/2022] Open
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8
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Giacaman A, Ferrando J. [Translated article] Keys to the Diagnosis of Hair Shaft Disorders: Part I. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2022.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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9
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Kowe P, Madke B, Bansod S. Oral minoxidil in trichology: A review. INDIAN JOURNAL OF DRUGS IN DERMATOLOGY 2022. [DOI: 10.4103/ijdd.ijdd_35_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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10
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Bhattarai D, Banday AZ, Sadanand R, Arora K, Kaur G, Sharma S, Rawat A. Hair microscopy: an easy adjunct to diagnosis of systemic diseases in children. Appl Microsc 2021; 51:18. [PMID: 34843009 PMCID: PMC8630179 DOI: 10.1186/s42649-021-00067-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 11/17/2021] [Indexed: 12/11/2022] Open
Abstract
Hair, having distinct stages of growth, is a dynamic component of the integumentary system. Nonetheless, derangement in its structure and growth pattern often provides vital clues for the diagnosis of systemic diseases. Assessment of the hair structure by various microscopy techniques is, hence, a valuable tool for the diagnosis of several systemic and cutaneous disorders. Systemic illnesses like Comel-Netherton syndrome, Griscelli syndrome, Chediak Higashi syndrome, and Menkes disease display pathognomonic findings on hair microscopy which, consequently, provide crucial evidence for disease diagnosis. With minimal training, light microscopy of the hair can easily be performed even by clinicians and other health care providers which can, thus, serve as a useful tool for disease diagnosis at the patient's bedside. This is especially true for resource-constrained settings where access and availability of advanced investigations (like molecular diagnostics) is a major constraint. Despite its immense clinical utility and non-invasive nature, hair microscopy seems to be an underutilized diagnostic modality. Lack of awareness regarding the important findings on hair microscopy may be one of the crucial reasons for its underutilization. Herein, we, therefore, present a comprehensive overview of the available methods for hair microscopy and the pertinent findings that can be observed in various diseases.
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Affiliation(s)
- Dharmagat Bhattarai
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Aaqib Zaffar Banday
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
| | - Rohit Sadanand
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Kanika Arora
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Gurjit Kaur
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Satish Sharma
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Amit Rawat
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
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11
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Giacaman A, Ferrando J. WITHDRAWN: Keys to the Diagnosis of Hair Shaft Disorders: Part I. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.11.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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12
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Vahabi-Amlashi S, Layegh P, Kiafar B, Hoseininezhad M, Abbaspour M, Khaniki SH, Forouzanfar M, Sabeti V. A randomized clinical trial on therapeutic effects of 0.25 mg oral minoxidil tablets on treatment of female pattern hair loss. Dermatol Ther 2021; 34:e15131. [PMID: 34529341 DOI: 10.1111/dth.15131] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/08/2021] [Accepted: 09/13/2021] [Indexed: 11/29/2022]
Abstract
Topical minoxidil solution is recommended treatment for female pattern hair loss. However, some complications, such as skin allergies, have prevented some patients from completely receiving this treatment. This study intends to evaluate the therapeutic and side effects of oral minoxidil 0.25 mg tablets treatment on FPHL and compare it with conventional treatment of 2% topical minoxidil. This study is a triple-blind randomized clinical trial in which 72 women with FPHL were treated as two separate groups. Group 1 was treated with oral minoxidil 0.25 mg tablets and topical placebo solution, while topical minoxidil solutions and oral placebo tablets were used to treat group 2 patients. In the oral minoxidil group, the average hair diameter and hair density after the 9-month treatment reached from 0.044 mm and 102 per cm2 to 0.048 mm and 115 per cm2 , respectively. In the topical minoxidil group, the average hair diameter and hair density from initial values of 0.044 mm and 107 per cm2 increased to 0.047 mm and 113 per cm2 . In both groups, the changes of hair diameter and hair density were significant compared to initial values (p < 0.001), while the trend of changes was not statically different between the two groups (p = 0.077, p = 0.674 for hair diameter and hair density, respectively) and side effects were trivial. In conclusion, oral minoxidil is an effective and new treatment for FPHL, even with a minimal dose, which can be used as an alternative treatment, especially for patients with poor compliance against topical minoxidil.
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Affiliation(s)
- Sadegh Vahabi-Amlashi
- Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Pouran Layegh
- Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bita Kiafar
- Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mohammadreza Abbaspour
- Department of Pharmaceutics, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeedeh Hajebi Khaniki
- Student Research Committee, Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehdi Forouzanfar
- Electronics Group, Engineering Faculty, Birjand University, Birjand, Iran
| | - Vahideh Sabeti
- Resident of Dermatology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Dermatology, Imam Reza Hospital, Mashhad, Iran
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13
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McKenzie PL, Castelo-Soccio L. Localized hair loss in infancy: a review. Curr Opin Pediatr 2021; 33:416-422. [PMID: 34016809 DOI: 10.1097/mop.0000000000001025] [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] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The current review will address the different causes of localized hair loss in infancy. The data presented here will provide clinicians with the latest understanding of different disorders leading to localized hair loss and will provide recommendations for further management of infants who present with alopecia. RECENT FINDINGS Localized hair loss in infancy is common, but its underlying causes vary greatly. Alopecia in infants can be categorized into congenital, genetic, inflammatory, mechanical, and physiologic causes. Decisions regarding further management are complex, as they often involve not only cosmetic concerns, but also work-up of possible systemic medical issues related to hair loss. SUMMARY Clinicians must be able to distinguish between the different causes of infantile hair loss so that appropriate work-up and further management can be pursued. Factors such as physical appearance, timing of presentation, dermoscopic exam, histopathology, and associated systemic features can help lead clinicians to the correct diagnosis in the case of an infant with localized alopecia.
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Affiliation(s)
- Paige L McKenzie
- Section of Dermatology, Division of Pediatrics, The Children's Hospital of Philadelphia
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Leslie Castelo-Soccio
- Section of Dermatology, Division of Pediatrics, The Children's Hospital of Philadelphia
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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14
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Villani A, Fabbrocini G, Ocampo-Candiani J, Ruggiero A, Ocampo-Garza SS. Review of oral minoxidil as treatment of hair disorders: in search of the perfect dose. J Eur Acad Dermatol Venereol 2021; 35:1485-1492. [PMID: 33660357 DOI: 10.1111/jdv.17216] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/14/2021] [Accepted: 02/24/2021] [Indexed: 01/08/2023]
Abstract
Topical minoxidil has been used for many years as treatment for different hair disorders. Even though it is an effective therapy, many patients show poor compliance due to the cosmesis, cost and side-effects. During the last few years, low-dose oral minoxidil has proven to be an alternative for patients with alopecia. We performed a literature search including all the articles that used oral minoxidil as a primary treatment in various hair diseases in order to evaluate the efficacy and safety of low-dose oral minoxidil as an alternative to topical minoxidil. Androgenetic alopecia was the most common studied condition, but others included telogen effluvium, tractional alopecia, postchemotherapy-induced alopecia, monilethrix, loose anagen hair syndrome, alopecia areata and scarring alopecias (frontal fibrosing alopecia and lichen planopilaris). Larger randomized comparative studies including standardized objective measurements should be done in order to clarify the best treatment protocol, including dosage and treatment duration. Oral minoxidil has proven to be a successful and well-tolerated alternative for patients with hair loss, including those with poor adherence to other therapies. Different dosing regimens have been utilized in scarring and non-scarring alopecia, varying from 0.25 to 5 mg daily. Higher doses have not been studied in men or women. Available literature suggests women require lower doses, from 0.25 to 2.5 mg daily, while men require higher doses for maximal efficacy, from 1.25 to 5 mg a day.
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Affiliation(s)
- A Villani
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - G Fabbrocini
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - J Ocampo-Candiani
- Departamento de Dermatología, Hospital Universitario ¨Dr. José Eleuterio González¨, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - A Ruggiero
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - S S Ocampo-Garza
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.,Departamento de Dermatología, Hospital Universitario ¨Dr. José Eleuterio González¨, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
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15
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Vañó-Galván S, Pirmez R, Hermosa-Gelbard A, Moreno-Arrones ÓM, Saceda-Corralo D, Rodrigues-Barata R, Jimenez-Cauhe J, Koh WL, Poa JE, Jerjen R, Trindade de Carvalho L, John JM, Salas-Callo CI, Vincenzi C, Yin L, Lo-Sicco K, Waskiel-Burnat A, Starace M, Zamorano JL, Jaén-Olasolo P, Piraccini BM, Rudnicka L, Shapiro J, Tosti A, Sinclair R, Bhoyrul B. Safety of low-dose oral minoxidil for hair loss: A multicenter study of 1404 patients. J Am Acad Dermatol 2021; 84:1644-1651. [PMID: 33639244 DOI: 10.1016/j.jaad.2021.02.054] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 02/10/2021] [Accepted: 02/18/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The major concern regarding the use of low-dose oral minoxidil (LDOM) for the treatment of hair loss is the potential risk of systemic adverse effects. OBJECTIVE To describe the safety of LDOM for the treatment of hair loss in a large cohort of patients. METHODS Retrospective multicenter study of patients treated with LDOM for at least 3 months for any type of alopecia. RESULTS A total of 1404 patients (943 women [67.2%] and 461 men [32.8%]) with a mean age of 43 years (range 8-86) were included. The dose of LDOM was titrated in 1065 patients, allowing the analysis of 2469 different cases. The most frequent adverse effect was hypertrichosis (15.1%), which led to treatment withdrawal in 14 patients (0.5%). Systemic adverse effects included lightheadedness (1.7%), fluid retention (1.3%), tachycardia (0.9%), headache (0.4%), periorbital edema (0.3%), and insomnia (0.2%), leading to drug discontinuation in 29 patients (1.2%). No life-threatening adverse effects were observed. LIMITATIONS Retrospective design and lack of a control group. CONCLUSION LDOM has a good safety profile as a treatment for hair loss. Systemic adverse effects were infrequent and only 1.7% of patients discontinued treatment owing to adverse effects.
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Affiliation(s)
- Sergio Vañó-Galván
- #TricoHRC Research Group, Trichology Unit, Dermatology Department, Ramón y Cajal University Hospital, Instituto Ramon y Cajal de Investigación Sanitaria, University of Alcala, Madrid, Spain; Trichology and Hair Transplantation Unit, Grupo Pedro Jaen Clinic, Madrid, Spain.
| | - Rodrigo Pirmez
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Angela Hermosa-Gelbard
- #TricoHRC Research Group, Trichology Unit, Dermatology Department, Ramón y Cajal University Hospital, Instituto Ramon y Cajal de Investigación Sanitaria, University of Alcala, Madrid, Spain; Trichology and Hair Transplantation Unit, Grupo Pedro Jaen Clinic, Madrid, Spain
| | - Óscar M Moreno-Arrones
- #TricoHRC Research Group, Trichology Unit, Dermatology Department, Ramón y Cajal University Hospital, Instituto Ramon y Cajal de Investigación Sanitaria, University of Alcala, Madrid, Spain; Trichology and Hair Transplantation Unit, Grupo Pedro Jaen Clinic, Madrid, Spain
| | - David Saceda-Corralo
- #TricoHRC Research Group, Trichology Unit, Dermatology Department, Ramón y Cajal University Hospital, Instituto Ramon y Cajal de Investigación Sanitaria, University of Alcala, Madrid, Spain; Trichology and Hair Transplantation Unit, Grupo Pedro Jaen Clinic, Madrid, Spain
| | | | - Juan Jimenez-Cauhe
- #TricoHRC Research Group, Trichology Unit, Dermatology Department, Ramón y Cajal University Hospital, Instituto Ramon y Cajal de Investigación Sanitaria, University of Alcala, Madrid, Spain
| | - Wei L Koh
- Sinclair Dermatology, Melbourne, Australia; Department of Dermatology, Changi General Hospital, Singapore
| | | | | | | | | | - Corina I Salas-Callo
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Lu Yin
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Kristen Lo-Sicco
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | | | - Michela Starace
- Dermatology -IRCCS Policlinico di Sant´Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Jose Luis Zamorano
- Department of Cardiology, Ramón y Cajal Hospital, University of Alcala, Madrid, Spain
| | - Pedro Jaén-Olasolo
- #TricoHRC Research Group, Trichology Unit, Dermatology Department, Ramón y Cajal University Hospital, Instituto Ramon y Cajal de Investigación Sanitaria, University of Alcala, Madrid, Spain; Trichology and Hair Transplantation Unit, Grupo Pedro Jaen Clinic, Madrid, Spain
| | - Bianca Maria Piraccini
- Dermatology -IRCCS Policlinico di Sant´Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Jerry Shapiro
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida
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16
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Das A, Toshniwal A, Madke B. What is new in dermatotherapy? Indian J Dermatol Venereol Leprol 2021; 87:135-143. [PMID: 33580938 DOI: 10.25259/ijdvl_342_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 07/01/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - Anand Toshniwal
- Aesthetic Aura Skin and Hair Clinic, Hyderabad, Telangana, India
| | - Bhushan Madke
- Department of Dermatology, Jawaharlal Nehru Medical College and AVBR Hospital, Wardha, Maharashtra, India
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17
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Imhof R, Tolkachjov SN. Optimal Management of Frontal Fibrosing Alopecia: A Practical Guide. Clin Cosmet Investig Dermatol 2020; 13:897-910. [PMID: 33293846 PMCID: PMC7718862 DOI: 10.2147/ccid.s235980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 11/02/2020] [Indexed: 01/06/2023]
Abstract
Frontal fibrosing alopecia (FFA) is a primary lymphocytic cicatricial alopecia that is often considered a clinical variant of lichen planopilaris (LPP) due to their shared histopathologic features. FFA is characterized by the recession of the frontal, temporal, or frontotemporal hairline; the clinical pattern is distinct and usually includes eyebrow hair loss, as well as other associated symptoms. Pruritus, facial papules, eyelash loss, body hair involvement, and trichodynia may also occur in addition to the frontotemporal recession and eyebrow loss classically seen. Early diagnosis and prompt treatment are critical as FFA is a progressive disorder that can result in permanent hair loss. FFA is challenging as patients may not present or be recognized until the disease has progressed. Additionally, there is currently no consensus or standard treatment regimen for FFA. While many different therapies have been reported as beneficial, there are a limited number of published guidelines for the treatment of FFA. This article is a review of the literature on treatment modalities for FFA and the objective is to offer a practical guide for clinicians on the evidence-based management options currently available in the literature.
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Affiliation(s)
- Reese Imhof
- Mayo Clinic Alix School of Medicine, Rochester, MN, USA
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18
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Jimenez‐Cauhe J, Saceda‐Corralo D, Rodrigues‐Barata R, Moreno‐Arrones OM, Ortega‐Quijano D, Fernandez‐Nieto D, Jaen‐Olasolo P, Vaño‐Galvan S. Safety of low‐dose oral minoxidil treatment for hair loss. A systematic review and pooled‐analysis of individual patient data. Dermatol Ther 2020; 33:e14106. [DOI: 10.1111/dth.14106] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/08/2020] [Accepted: 07/27/2020] [Indexed: 01/27/2023]
Affiliation(s)
- Juan Jimenez‐Cauhe
- Facultad de Medicina, Departamento de Medicina, Servicio de Dermatologia, Hospital Universitario Ramon y Cajal Universidad de Alcalá, IRYCIS Madrid Spain
| | - David Saceda‐Corralo
- Facultad de Medicina, Departamento de Medicina, Servicio de Dermatologia, Hospital Universitario Ramon y Cajal Universidad de Alcalá, IRYCIS Madrid Spain
- Grupo de Dermatologia Pedro Jaen Madrid Spain
| | - Rita Rodrigues‐Barata
- Facultad de Medicina, Departamento de Medicina, Servicio de Dermatologia, Hospital Universitario Ramon y Cajal Universidad de Alcalá, IRYCIS Madrid Spain
- Grupo de Dermatologia Pedro Jaen Madrid Spain
| | - Oscar M. Moreno‐Arrones
- Facultad de Medicina, Departamento de Medicina, Servicio de Dermatologia, Hospital Universitario Ramon y Cajal Universidad de Alcalá, IRYCIS Madrid Spain
- Grupo de Dermatologia Pedro Jaen Madrid Spain
| | - Daniel Ortega‐Quijano
- Facultad de Medicina, Departamento de Medicina, Servicio de Dermatologia, Hospital Universitario Ramon y Cajal Universidad de Alcalá, IRYCIS Madrid Spain
| | - Diego Fernandez‐Nieto
- Facultad de Medicina, Departamento de Medicina, Servicio de Dermatologia, Hospital Universitario Ramon y Cajal Universidad de Alcalá, IRYCIS Madrid Spain
| | - Pedro Jaen‐Olasolo
- Facultad de Medicina, Departamento de Medicina, Servicio de Dermatologia, Hospital Universitario Ramon y Cajal Universidad de Alcalá, IRYCIS Madrid Spain
- Grupo de Dermatologia Pedro Jaen Madrid Spain
| | - Sergio Vaño‐Galvan
- Facultad de Medicina, Departamento de Medicina, Servicio de Dermatologia, Hospital Universitario Ramon y Cajal Universidad de Alcalá, IRYCIS Madrid Spain
- Grupo de Dermatologia Pedro Jaen Madrid Spain
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19
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Maged A, Mahmoud AA, Salah S, Abd-elmonsif NM, Ghorab MM. Spray-Dried Rosuvastatin Nanoparticles for Promoting Hair Growth. AAPS PharmSciTech 2020; 21:205. [PMID: 32715367 DOI: 10.1208/s12249-020-01746-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 07/05/2020] [Indexed: 01/17/2023] Open
Abstract
In this research, we examined the effect of rosuvastatin calcium-loaded nanoparticles on the hair growth-promoting activity on Albino rats. Nanoparticles were prepared using 2:1 weight ratio of drug to methyl-β-cyclodextrin with 10, 20, and 30% stabilizers (phospholipid, polyvinyl pyrrolidone K30, and Compritol 888 ATO) using nanospray dryer. Subsequently, the prepared nanoparticles were evaluated for their process yield, particle size, polydispersity index, zeta potential, and in vitro drug release as well as in vivo studies. The dried nanoparticles showed process yield values up to 84% with particle size values ranging from 218 to 6258 nm, polydispersity index values ranging from 0.32 to 0.99, and zeta potential values ranging from - 6.1 to - 11.9 mV. Combination of methyl-β-cyclodextrin with 10% polyvinyl pyrrolidone K30 accomplished nanoparticles with the lowest particle size (218 nm) and polydispersity index (0.32) values. These nanoparticles had suitable process yield value (70.5%) and were able to retard drug release. The hair growth-promoting activity for the selected nanoparticles revealed the highest hair length values in Albino rats after 14 days of the hair growth study compared with non-medicated nanoparticles, nanoparticles' physical mixture, rosuvastatin solution, and marketed minoxidil preparation groups as well as the control group. The immunohistochemistry images for both selected nanoparticles and marketed minoxidil groups showed a significant increase in the diameter of hair follicle and percent area fraction of cytokeratin 19 in the outer root sheath of hair follicle compared with other tested groups. Rosuvastatin nanoparticles prepared by nanospray drying technique could be a good competitor to minoxidil for hair growth-promoting activity. Graphical abstract.
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20
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Oral minoxidil treatment for hair loss: A review of efficacy and safety. J Am Acad Dermatol 2020; 84:737-746. [PMID: 32622136 DOI: 10.1016/j.jaad.2020.06.1009] [Citation(s) in RCA: 108] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/19/2020] [Accepted: 06/29/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Although topical minoxidil is an effective treatment option for hair loss, many patients are poorly compliant because of the necessity to apply the medication twice a day, undesirable hair texture, and scalp irritation. OBJECTIVE In recent years, oral minoxidil at low dose has been proposed as a safe alternative. This study reviewed articles in which oral minoxidil was used to treat hair loss to determine its efficacy and safety as an alternative to topical minoxidil. METHODS PubMed searches were performed to identify articles discussing oral minoxidil as the primary form of treatment for hair loss published up to April 2020. RESULTS A total of 17 studies with 634 patients were found discussing the use of oral minoxidil as the primary treatment modality for hair loss. Androgenetic alopecia was the most studied condition, but other conditions included telogen effluvium, lichen planopilaris, loose anagen hair syndrome, monilethrix, alopecia areata, and permanent chemotherapy-induced alopecia. LIMITATIONS Larger randomized studies comparing the efficacy/safety of different doses with standardized objective measurements will be needed to clarify the best treatment protocol. CONCLUSION Oral minoxidil was found to be an effective and well-tolerated treatment alternative for healthy patients having difficulty with topical formulations.
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21
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Sharma AN, Michelle L, Juhasz M, Muller Ramos P, Atanaskova Mesinkovska N. Low-dose oral minoxidil as treatment for non-scarring alopecia: a systematic review. Int J Dermatol 2020; 59:1013-1019. [PMID: 32516434 DOI: 10.1111/ijd.14933] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/25/2020] [Accepted: 04/17/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND Topical minoxidil has been used for almost 40 years to treat alopecia. There is growing evidence supporting off-label use of low-dose oral minoxidil. OBJECTIVE To conduct a systematic review evaluating the use of oral minoxidil for all types of alopecia. METHODS A primary literature search was conducted using PubMed in May 2019, utilizing the search term "oral minoxidil AND (hair loss OR alopecia OR baldness)". Reviews, non-English studies, and articles concerning only topical minoxidil were excluded. RESULTS Ten articles were included for review comprising a total 19,218 patients (215 women and 19,003 men). Oral minoxidil dose ranged from 0.25 to 5 mg daily to twice daily. The strongest evidence existed for androgenetic alopecia and alopecia areata (AA), with 61-100% and 18-82.4% of patients demonstrating objective clinical improvement. Successful treatment of female pattern hair loss, chronic telogen effluvium, monilethrix, and permanent chemotherapy-induced alopecia was also reported. The most common adverse effects with oral minoxidil included hypertrichosis and postural hypotension. CONCLUSION Oral minoxidil is a safe and successful treatment of androgenic alopecia and AA. In addition to its therapeutic benefits, practical advantages over topical minoxidil stem from improved patient compliance.
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Affiliation(s)
- Ajay N Sharma
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA
| | - Lauren Michelle
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA
| | - Margit Juhasz
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA
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22
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Rajamohanan RR, Behera B, Nagendran P, Malathi M. Monilethrix: A Report of Three Cases in Children Confirmed with Dermoscopy. Indian Dermatol Online J 2020; 11:65-67. [PMID: 32055512 PMCID: PMC7001412 DOI: 10.4103/idoj.idoj_93_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Monilethrix is a rare hereditary disorder affecting hair resulting in hair fragility and alopecia. We report three patients of monilethrix who presented with complaints of sparse and brittle hair from early childhood. All three patients had multiple discrete hyperkeratotic papules over the scalp. Dermoscopy revealed beaded appearance of hair with the presence of elliptical nodes and intermittent constrictions on the hair shafts as well as broken hairs, which were confirmed with routine microscopic examination of hair. Dermoscopy helps in easier and faster diagnosis of monilethrix.
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Affiliation(s)
- Remya R Rajamohanan
- Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Biswanath Behera
- Department of Dermatology and STD, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Prabhakaran Nagendran
- Department of Dermatology and STD, All India Institute of Medical Sciences (AIIMS), Mangalagiri, Andhra Pradesh, India
| | - Munisamy Malathi
- Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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23
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FR – Minoxidil oral para el tratamiento de la alopecia androgénica femenina y otras alopecias. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:861-862. [DOI: 10.1016/j.ad.2018.06.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 06/01/2018] [Indexed: 11/21/2022] Open
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24
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Pindado-Ortega C, Saceda-Corralo D, Vañó-Galván S. RF – Oral Minoxidil for Female Pattern Hair Loss and Other Alopecias. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2018.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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25
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Nam GH, Jo KJ, Park YS, Kawk HW, Yoo JG, Jang JD, Kang SM, Kim SY, Kim YM. The peptide AC 2 isolated from Bacillus-treated Trapa japonica fruit extract rescues DHT (dihydrotestosterone)-treated human dermal papilla cells and mediates mTORC1 signaling for autophagy and apoptosis suppression. Sci Rep 2019; 9:16903. [PMID: 31729428 PMCID: PMC6858360 DOI: 10.1038/s41598-019-53347-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 10/09/2019] [Indexed: 12/21/2022] Open
Abstract
The Trapa japonica fruit is a natural plant growing in ponds with its roots in the mud. It has long been used as a home remedy for many diseases; however, a major problem with this kind of natural extract is the multicomponents-multitargets for diseases. Such problems make it difficult to identify the mechanism of action. Another problem is quality control and consistency. The aim of this research was to isolate a single bioactive compound (peptide) derived from the Trapa japonica fruit. The research was conducted with various experimental techniques, such as fermentation and liquid chromatography, to isolate a peptide. We isolated the AC 2 peptide from Trapa japonica fruit and found it to be promising on human dermal papilla cells. Dihydrotestosterone (DHT) stresses human dermal papilla cells and is a major cause of hair loss resulting from hormones and environmental factors. The purpose of this research was to develop an understanding of the mechanism by which the AC 2 peptide rescues dihydrotestosterone (DHT)-treated human dermal papilla cells. We explored the effects of the AC 2 peptide on the cell biological functions of human dermal papilla cells (HDPs). HDPs were treated with the AC 2 peptide and DHT. Then, a cytotoxicity assay, flow cytometry, Western blot, immunoprecipitation, and 3D cell culture for immunohistochemistry were conducted to investigate the mTORC1 pathway and suppression of autophagy and apoptosis. In addition, we also synthesized the AC2 peptide as an alternative to the expensive and difficult isolation and purification procedures and confirmed its potential in biomedical applications. We also validated the effects of the synthetic AC2 peptide as well as the isolated and purified AC2 peptide and established their similarity. Although extensive research has been carried out on natural extracts, few single studies have isolated and separated a bioactive peptide (single compound).
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Affiliation(s)
- Gun He Nam
- Department of Biological science and Biotechnology, College of Life science and Nano technology, Hannam University, 1646 Yuseong-daero, Yuseong-gu, Daejeon, 34054, South Korea
| | - Kyung-Jo Jo
- Department of Biological science and Biotechnology, College of Life science and Nano technology, Hannam University, 1646 Yuseong-daero, Yuseong-gu, Daejeon, 34054, South Korea
| | - Ye-Seul Park
- Department of Biological science and Biotechnology, College of Life science and Nano technology, Hannam University, 1646 Yuseong-daero, Yuseong-gu, Daejeon, 34054, South Korea
| | - Hye Won Kawk
- Department of Biological science and Biotechnology, College of Life science and Nano technology, Hannam University, 1646 Yuseong-daero, Yuseong-gu, Daejeon, 34054, South Korea
| | - Je-Geun Yoo
- Department of Biological science and Biotechnology, College of Life science and Nano technology, Hannam University, 1646 Yuseong-daero, Yuseong-gu, Daejeon, 34054, South Korea
| | - Jin Dong Jang
- Doori Cosmetics Co.,Ltd., 11F Galaxy Tower, 175, Saimdang-ro, Seocho-gu, Seoul, South Korea
| | - Sang Moon Kang
- ANPEP INC. 13, Oksansandan 1-ro, Oksan-myeon, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - Sang-Yong Kim
- Department of Food Science & Bio Technology, Shinansan University, Daehakro Danwon-gu, Ansan-city, Gyenggi-do, South Korea
| | - Young-Min Kim
- Department of Biological science and Biotechnology, College of Life science and Nano technology, Hannam University, 1646 Yuseong-daero, Yuseong-gu, Daejeon, 34054, South Korea.
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26
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Ahmed A, Almohanna H, Griggs J, Tosti A. Genetic Hair Disorders: A Review. Dermatol Ther (Heidelb) 2019; 9:421-448. [PMID: 31332722 PMCID: PMC6704196 DOI: 10.1007/s13555-019-0313-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Indexed: 12/23/2022] Open
Abstract
Hair loss in early childhood represents a broad differential diagnosis which can be a diagnostic and therapeutic challenge for a physician. It is important to consider the diagnosis of a genetic hair disorder. Genetic hair disorders are a large group of inherited disorders, many of which are rare. Genetic hair abnormalities in children can be an isolated phenomenon or part of genetic syndromes. Hair changes may be a significant finding or even the initial presentation of a syndrome giving a clue to the diagnosis, such as Netherton syndrome and trichothiodystrophy. Detailed history including family history and physical examination of hair and other ectodermal structures such as nails, sweat glands, and sebaceous glands with the use of dermoscopic devices and biopsy all provide important clues to establish the correct diagnosis. Understanding the pathophysiology of genetic hair defects will allow for better comprehension of their treatment and prognosis. For example, in patients with an isolated hair defect, the main problem is aesthetic. In contrast, when the hair defect is associated with a syndrome, the prognosis will depend mainly on the associated condition. Treatment of many genetic hair disorders is focused on treating the primary cause and minimizing trauma to the hair.
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Affiliation(s)
- Azhar Ahmed
- Department of Dermatology, King Fahad General Hospital, Medina, Saudi Arabia.
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, University of Miami Hospital, Miami, FL, USA.
| | - Hind Almohanna
- Department of Dermatology and Dermatologic Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Jacob Griggs
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, University of Miami Hospital, Miami, FL, USA
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, University of Miami Hospital, Miami, FL, USA
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27
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Suchonwanit P, Thammarucha S, Leerunyakul K. Minoxidil and its use in hair disorders: a review. Drug Des Devel Ther 2019; 13:2777-2786. [PMID: 31496654 PMCID: PMC6691938 DOI: 10.2147/dddt.s214907] [Citation(s) in RCA: 186] [Impact Index Per Article: 37.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/22/2019] [Indexed: 12/20/2022] Open
Abstract
Minoxidil was first introduced as an antihypertensive medication and the discovery of its common adverse event, hypertrichosis, led to the development of a topical formulation for promoting hair growth. To date, topical minoxidil is the mainstay treatment for androgenetic alopecia and is used as an off-label treatment for other hair loss conditions. Despite its widespread application, the exact mechanism of action of minoxidil is still not fully understood. In this article, we aim to review and update current information on the pharmacology, mechanism of action, clinical efficacy, and adverse events of topical minoxidil.
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Affiliation(s)
- Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sasima Thammarucha
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kanchana Leerunyakul
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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28
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Stoehr JR, Choi JN, Colavincenzo M, Vanderweil S. Off-Label Use of Topical Minoxidil in Alopecia: A Review. Am J Clin Dermatol 2019; 20:237-250. [PMID: 30604379 DOI: 10.1007/s40257-018-0409-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Topical minoxidil is a well-known and often-utilized drug in dermatological practice for the treatment of alopecia. It was approved by the United States Food and Drug Administration for the treatment of androgenetic alopecia in 1988. Since its approval, minoxidil has been used off-label for the treatment of many other types of alopecia, with minimal formal evidence of efficacy. Conditions for which the use of topical minoxidil has been reported include telogen effluvium, alopecia areata (AA), scarring alopecia, eyebrow hypotrichosis, monilethrix, and chemotherapy-induced alopecia (CIA). The evidence for the use of minoxidil in each condition is derived from a variety of studies, including clinical trials, case series, and case reports. A comprehensive review of the literature indicates that while minoxidil is routinely used in the management of many alopecic conditions, there is mixed evidence for its efficacy. For certain conditions, including AA and most scarring alopecias, the evidence seems to be inconclusive. For others, such as eyebrow hypotrichosis, monilethrix, early traction alopecia, and CIA, there is more support for the efficacy of minoxidil. Although the favorable safety profile of minoxidil is established in adults, its use in the treatment of pediatric alopecia may require heightened monitoring and patient education.
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Affiliation(s)
- Jenna R Stoehr
- Department of Dermatology, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA
| | - Jennifer N Choi
- Department of Dermatology, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA
| | - Maria Colavincenzo
- Department of Dermatology, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA
| | - Stefan Vanderweil
- Department of Dermatology, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA.
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29
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Zaouak A, Ben Brahim E, Jouini R, Hammami H, Fenniche S. "My Daughter Has Thin and Short Hair". Skin Appendage Disord 2019; 5:127-129. [PMID: 30815452 DOI: 10.1159/000490774] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 06/11/2018] [Indexed: 11/19/2022] Open
Affiliation(s)
- Anissa Zaouak
- Dermatology Department, Habib Thameur Hospital, Tunis, Tunisia.,Research Unit "Genodermatoses and cancers" LR12SP03, Tunis, Tunisia
| | - Ehsen Ben Brahim
- Anatomopathology Department, Habib Thameur Hospital, Tunis, Tunisia.,Research Unit "Genodermatoses and cancers" LR12SP03, Tunis, Tunisia
| | - Raja Jouini
- Anatomopathology Department, Habib Thameur Hospital, Tunis, Tunisia.,Research Unit "Genodermatoses and cancers" LR12SP03, Tunis, Tunisia
| | - Houda Hammami
- Dermatology Department, Habib Thameur Hospital, Tunis, Tunisia.,Research Unit "Genodermatoses and cancers" LR12SP03, Tunis, Tunisia
| | - Samy Fenniche
- Dermatology Department, Habib Thameur Hospital, Tunis, Tunisia.,Research Unit "Genodermatoses and cancers" LR12SP03, Tunis, Tunisia
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30
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Beach RA. Case series of oral minoxidil for androgenetic and traction alopecia: Tolerability & the five C's of oral therapy. Dermatol Ther 2018; 31:e12707. [PMID: 30246901 PMCID: PMC6586015 DOI: 10.1111/dth.12707] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 06/26/2018] [Accepted: 07/22/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Renée A Beach
- Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Canada
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Zhi HL, Liu ZH. Monilethrix. CMAJ 2018; 190:E912. [PMID: 30061326 PMCID: PMC6066397 DOI: 10.1503/cmaj.180273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Hui-Lin Zhi
- Department of Dermatology, Affiliated Third Hospital of Hangzhou, Anhui Medical University, Hefei, Anhui province, China
| | - Ze-Hu Liu
- Department of Dermatology, Affiliated Third Hospital of Hangzhou, Anhui Medical University, Hefei, Anhui province, China
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Cranwell WC, Sinclair R. Loose anagen hair syndrome: Treatment with systemic minoxidil characterised by marked hair colour change. Australas J Dermatol 2018; 59:e286-e287. [PMID: 29566258 DOI: 10.1111/ajd.12812] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- William C Cranwell
- Sinclair Dermatology, Melbourne, Victoria, Australia.,Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Rodney Sinclair
- Sinclair Dermatology, Melbourne, Victoria, Australia.,Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.,Epworth Dermatology, Melbourne, Victoria, Australia
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New Treatments for Hair Loss. ACTAS DERMO-SIFILIOGRAFICAS 2017; 108:221-228. [PMID: 28061966 DOI: 10.1016/j.ad.2016.11.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 11/06/2016] [Indexed: 12/16/2022] Open
Abstract
The treatment of hair loss is an important part of clinical dermatology given the prevalence of the problem and great impact on patients' quality of life. Many new treatments have been introduced in recent years. This review summarizes the main ones in 4 groups: a) For androgenetic alopecia, we discuss new excipients for oral minoxidil, dutasteride, and finasteride as well as new forms of topical application; prostaglandin agonists and antagonists; low-level laser therapy; and regenerative medicine with Wnt signaling activators and stem cell therapy. b) For alopecia areata, Janus kinase inhibitors are reviewed. c) For frontal fibrosing alopecia, we discuss the use of antiandrogens and, for some patients, pioglitazone. d) Finally, we mention new robotic devices for hair transplant procedures and techniques for optimal follicular unit extraction.
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Ramot Y. Quantitative image analysis for hereditary hair disorders. Br J Dermatol 2017; 176:10-11. [DOI: 10.1111/bjd.15103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Y. Ramot
- Department of Dermatology Hadassah – Hebrew University Medical Center P.O. Box 12000 Jerusalem 9112001 Israel
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