Safety of Low-Dose Oral Minoxidil for Hair Loss Journal of the American Academy of Dermatology

TAKE-HOME MESSAGE

• In this multicenter retrospective analysis, the most common adverse reaction in patients with alopecia treated with low-dose oral minoxidil for at least 3 months was hypertrichosis (15.1%). Systemic adverse reactions occurred in 5.5% of patients. These reactions include lightheadedness, fluid retention, tachycardia, headache, periorbital edema, and insomnia. Adverse reactions led to medication discontinuation in 1.7% of patients. No life-threatening adverse reactions occurred.

• Low-dose oral minoxidil has a favorable safety profile. While hypertrichosis was common in these patients, systemic adverse reactions were uncommon and few patients stopped treatment due to adverse reactions.

– Kelly B. Scarberry, MD

Written by

 

 

Melissa Piliang MD, FAAD

Low-dose oral minoxidil (LDOM) is an emerging treatment for hair loss. Dermatologists may be uncomfortable prescribing oral minoxidil due to potential side effects and risks. This study evaluated over 1400 patients taking LDOM for hair loss at dosages of 0.25–5 mg/d to assess the side-effect profile and tolerability. The results show that LDOM has a favorable side-effect profile and is well-tolerated. Fewer than 2% of patients stopped therapy due to side effects. Unsurprisingly, hypertrichosis was the most common side effect reported, occurring in 15% of patients, and was the most common reason for stopping therapy.  Other systemic side effects were lightheadedness, fluid retention, tachycardia, headache, periorbital edema, and insomnia. Of note, this study did not assess the efficacy of LDOM. 

Based on the results in this study, dermatologists should feel comfortable including LDOM in their treatment regimen for hair loss and should find the information in this study useful when counseling patients.

Abstract 

BACKGROUND

The major concern regarding the use of low-dose oral minoxidil (LDOM) in 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 as a treatment 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. From them, 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, 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 stopped the treatment due to adverse effects.

Journal of the American Academy of Dermatology

Safety of Low-Dose Oral Minoxidil for Hair Loss: A Multicenter Study of 1404 Patients

J Am Acad Dermatol 2021 Feb 24;[EPub Ahead of Print], S Vano-Galvan, R Pirmez, A Hermosa-Gelbard, OM Moreno-Arrones, D Saceda-Corralo, R Rodrigues-Barata, J Jimenez-Cauhe, WL Koh, J Poa, R Jerjen, CL Trindade de, J John, CI Salas-Callo, C Vincenzi, L Yin, K Lo-Sicco, A Waskiel-Burnat, M Starace, JL Zamorano, P Jaén-Olasolo, BM Piraccini, L Rudnicka, J Shapiro, A Tosti, R Sinclair, B Bhoyrul

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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