Minoxidil oral en ptes pediatricos con Alopecia

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• This retrospective review evaluated the safety of systemic minoxidil, as either low-dose oral or sublingual, in 63 children. Most patients in the study were treated for alopecia areata and loose anagen syndrome, although other hair loss disorders were included. The average maximum dose of minoxidil was 12.45 ng/kg, with a treatment duration range of 3 to 65 months. Hypertrichosis was the most common side effect, but none of the side effects required discontinuation or dose adjustment.

• Systemic minoxidil appears to be a safe treatment option for children with alopecia; however, more research regarding its efficacy in this patient population is needed.

–  Ruth McTighe, MD

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Sarah L. Chamlin MD

This group reported their experience of using low-dose oral minoxidil or sublingual minoxidil in 63 pediatric patients aged 0–12 years with hair disorders. Most patients had the diagnosis of alopecia areata followed by loose anagen syndrome, and the adverse events, including facial and back hypertrichosis (n=13), postural hypotension (n=4), and headaches (n=2), did not lead to drug discontinuation. Dosing was started at 0.1 mg once daily for most patients with a dosing range of 0.025–0.5 mg/day and a maximum reported dose of 1.8 mg/day. Unfortunately, efficacy was not reported.  

This contributes to a growing but small body of evidence supporting oral minoxidil for hair disorders in the pediatric population. I still hesitate to use this for the young children, but plan to start this for select teenage patients. The side effects mirror those seen in adults, and larger safety and efficacy studies are needed.   

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.

International Journal of Dermatology

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

Int. J. Dermatol 2022 Aug 14;[EPub Ahead of Print], JM John, RD Sinclair 

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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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