3,899
Views
59
CrossRef citations to date
0
Altmetric
Review Articles

Minoxidil: a comprehensive review

ORCID Icon, , &
Pages 1896-1906 | Received 01 Jun 2021, Accepted 06 Jun 2021, Published online: 20 Jul 2021

References

  • Rogers NE, Gupta AK. Medical treatments for male and female pattern hair loss. In: Unger WP, editor. Hair transplantation. 6 ed. London: Informa Healthcare; 2021. p. 38–46.
  • Piérard-Franchimont C, De Doncker P, Cauwenbergh G, et al. Ketoconazole shampoo: effect of long-term use in androgenic alopecia. Dermatology. 1998;196(4):474–477.
  • Ablon G. A 3-month, randomized, double-blind, placebo-controlled study evaluating the ability of an extra-strength marine protein supplement to promote hair growth and decrease shedding in women with self-perceived thinning hair. Dermatol Res Pract. 2015;2015:1–8.
  • Viviscal extra-strength formulation to promote hair growth and decrease shedding in women with thinning hair [cited 2021 May 30]. Available from: https://clinicaltrials.gov/ct2/show/NCT02297360
  • Glynis A. A double-blind, placebo-controlled study evaluating the efficacy of an oral supplement in women with self-perceived thinning hair. J Clin Aesthet Dermatol. 2012;5(11):28–34.
  • Hosking AM, Juhasz M, Atanaskova Mesinkovska N. Complementary and alternative treatments for alopecia: a comprehensive review. Skin Appendage Disord. 2019;5(2):72–89. Feb
  • Cooley JE, editor. Cell-based treatments for hair loss: research update on “hair cloning”. North Carolina, USA: Hair Transplant Forum International;. 2013. p. 47–49.
  • Stenn K, Parimoo S, Zheng Y, et al. Bioengineering the hair follicle. Organogenesis. 2007;3(1):6–13.
  • Cooley J. Follicular cell implantation: an update on “hair follicle cloning”. Facial Plast Surg Clin North Am. 2004;12(2):219–224.
  • Yale K, Pourang A, Plikus MV, et al. At the crossroads of 2 alopecias: androgenetic alopecia pattern of hair regrowth in patients with alopecia areata treated with oral Janus kinase inhibitors. JAAD Case Rep. 2020;6(5):444–446.
  • Walker N. JAK inhibitor promotes hair growth in both men, women with androgenetic alopecia [cited 2021 May 30]. Available from: https://www.healio.com/news/dermatology/20190619/jak-inhibitor-promotes-hair-growth-in-both-men-women-with-androgenetic-alopecia
  • Donovan J. Topical JAK inhibitors for hair loss [cited 2021 May 30]. Available from: https://donovanmedical.com/hair-blog/jaki
  • Egger A, Tomic-Canic M, Tosti A. Advances in stem cell-based therapy for hair loss. CellR4 Repair Replace Regen Reprogram. 2020;8:e2894.
  • Gentile P, Garcovich S. Advances in regenerative stem cell therapy in androgenic alopecia and hair loss: Wnt pathway, growth-factor, and mesenchymal stem cell signaling impact analysis on cell growth and hair follicle development. Cells. 2019;8(5):466.
  • Stevens J, Khetarpal S. Platelet-rich plasma for androgenetic alopecia: a review of the literature and proposed treatment protocol. Int J Womens Dermatol. 2019;5(1):46–51.
  • Chaudhari ND, Sharma YK, Dash K, et al. Role of platelet-rich plasma in the management of androgenetic alopecia. Int J Trichology. 2012;4(4):291–292.
  • Rassman WR, Pak JP, Kim J, et al. Scalp micropigmentation: a concealer for hair and scalp deformities. J Clin Aesthet Dermatol. 2015;8(3):35–42.
  • Rassman WR, Pak JP, Kim J. Scalp micropigmentation: a useful treatment for hair loss. Facial Plast Surg Clin North Am. 2013;21(3):497–503.
  • Shiell RC. A review of modern surgical hair restoration techniques. J Cutan Aesthet Surg. 2008;1(1):12–16.
  • Ahmad M, Mohmand MH. Extended hair tranplant: combination of two techniques. J Aesthet Reconstr Surg. 2017;3(2):9.
  • Campese VM. Minoxidil: a review of its pharmacological properties and therapeutic use. Drugs. 1981;22(4):257–278.
  • Zins GR. The history of the development of minoxidil. Clin Dermatol. 1988;6(4):132–147.
  • Freyburger WA, Weeks JR, Ducharme DW. Cardiovascular actions of the hypotensive agent, N,N-diallylmelamine (U-7720). Naunyn Schmiedebergs Arch Exp Pathol Pharmakol. 1965;251(1):39–47.
  • Gilmore E, Weil J, Chidsey C. Treatment of essential hypertension with a new vasodilator in combination with beta-adrenergic blockade. N Engl J Med. 1970;282(10):521–527.
  • Conrad P. The medicalization of society: on the transformation of human conditions into treatable disorders. USA: JHU Press; 2007.
  • Gottlieb TB, Katz FH, Chidsey IIC. Combined therapy with vasodilator drugs and beta-adrenergic blockade in hypertension. A comparative study of minoxidil and hydralazine. Circulation. 1972;45(3):571–582.
  • Lester W. Hair-rasing tale: no fame for men who discovered Rogaine. The Daily Gazette. 1996 [cited 2021 April 21]. Available from: https://news.google.com/newspapers?nid=1957&dat=19960513&id=dT5GAAAAIBAJ&pg=1622,3318023&hl=en
  • Shorter K, Farjo NP, Picksley SM, et al. Human hair follicles contain two forms of ATP-sensitive potassium channels, only one of which is sensitive to minoxidil. FASEB J. 2008;22(6):1725–1736.
  • Semalty M, Semalty A, Joshi GP, et al. Hair growth and rejuvenation: an overview. J Dermatolog Treat. 2011;22(3):123–132.
  • Villani A, Fabbrocini G, Ocampo-Candiani J, et al. Review of oral minoxidil as treatment of hair disorders: in search of the perfect dose. J Eur Acad Dermatol Venereol. 2021;35(7):1485–1492.
  • Galbraith GM, Thiers BH. In vitro suppression of human lymphocyte activity by minoxidil. Int J Dermatol. 1985;24(4):249–251.
  • Pekmezci E, Turkoğlu M, Gökalp H, et al. Minoxidil downregulates interleukin-1 alpha gene expression in HaCaT cells. Int J Trichology. 2018;10(3):108–112.
  • Kvedar JC, Baden HP, Levine L. Selective inhibition by minoxidil of prostacyclin production by cells in culture. Biochem Pharmacol. 1988;37(5):867–874.
  • Kwack MH, Kang BM, Kim MK, et al. Minoxidil activates β-catenin pathway in human dermal papilla cells: a possible explanation for its anagen prolongation effect. J Dermatol Sci. 2011;62(3):154–159.
  • Lachgar S, Charveron M, Gall Y, et al. Minoxidil upregulates the expression of vascular endothelial growth factor in human hair dermal papilla cells. Br J Dermatol. 1998;138(3):407–411.
  • Oh HA, Kwak J, Kim BJ, et al. Migration Inhibitory factor in conditioned medium from human umbilical cord blood-derived mesenchymal stromal cells stimulates hair growth. Cells. 2020;9(6):1344.
  • Choi BY. Targeting Wnt/β-catenin pathway for developing therapies for hair loss. IJMS. 2020;21(14):4915.
  • Pekmezci E, Türkoğlu M. Minoxidil acts as an antiandrogen: a study of 5α-reductase zype 2 gene expression in a human keratinocyte cell line. Acta Dermatovenerol Croatica. 2017;25(4):271.
  • Chen X, Liu B, Li Y, et al. Dihydrotestosterone regulates hair growth through the Wnt/β-catenin pathway in C57BL/6 mice and in vitro organ culture. Front Pharmacol. 2019;10:1528.
  • Nuck BA, Fogelson SL, Lucky AW. Topical minoxidil does not act as an antiandrogen in the flank organ of the golden Syrian hamster. Arch Dermatol. 1987;123(1):59–61.
  • Sato T, Tadokoro T, Sonoda T, et al. Minoxidil increases 17 beta-hydroxysteroid dehydrogenase and 5 alpha-reductase activity of cultured human dermal papilla cells from balding scalp. J Dermatol Sci. 1999;19(2):123–125.
  • Mori O, Uno H. The effect of topical minoxidil on hair follicular cycles of rats. J Dermatol. 1990;17(5):276–281.
  • Uno H, Cappas A, Brigham P. Action of topical minoxidil in the bald stump-tailed macaque. J Am Acad Dermatol. 1987;16(3 Pt 2):657–668.
  • Navarro M, Asín M, Martínez M, et al. Management of androgenetic alopecia: a comparative clinical study between plasma rich in growth factors and topical minoxidil. Eur J Plast Surg. 2016;39(3):173–180.
  • Fiedler-Weiss VC. Topical minoxidil solution (1% and 5%) in the treatment of alopecia areata. J Am Acad Dermatol. 1987;16(3 Pt 2):745–748.
  • Clissold SP, Heel RC. Topical minoxidil. A preliminary review of its pharmacodynamic properties and therapeutic efficacy in alopecia areata and alopecia androgenetica. Drugs. 1987;33(2):107–122.
  • Vita Health Products Inc. Hair regrowth formula (minoxidil topical solution USP), 2% w/v 2016 [cited 2021 May 14]. Available from: https://pdf.hres.ca/dpd_pm/00033538.PDF
  • Product monograph; hair regrowth treatment, minoxidil topical solution USP, 20 mg/mL (2% w/v) [cited 2021 May 30]. Available from: https://pdf.hres.ca/dpd_pm/00037622.PDF
  • Novak E, Franz TJ, Headington JT, et al. Topically applied minoxidil in baldness. Int J Dermatol. 1985;24(1):82–87.
  • Price VH. Double-blind, placebo-controlled evaluation of topical minoxidil in extensive alopecia areata. J Am Acad Dermatol. 1987;16(3 Pt 2):730–736.
  • Franz TJ. Percutaneous absorption of minoxidil in man. Arch Dermatol. 1985;121(2):203–206.
  • Buhl AE, Waldon DJ, Baker CA, et al. Minoxidil sulfate is the active metabolite that stimulates hair follicles. J Invest Dermatol. 1990;95(5):553–557.
  • Pfizer Loniten (Minoxidil) Tablet, 2.5 mg & 10 mg, for oral use [Internet]. 2013. [cited 2021 Apr 26]. Available from: https://www-e-therapeutics-ca.myaccess.library.utoronto.ca/search
  • Rogers NE, Avram MR. Medical treatments for male and female pattern hair loss. J Am Acad Dermatol. 2008;59(4):547–566.
  • Regenepure 5% minoxidil spray, for topical use 2021 [cited 2021 May 4]. Available from: https://www.minoxidilspray.com/
  • Friedman ES, Friedman PM, Cohen DE, et al. Allergic contact dermatitis to topical minoxidil solution: etiology and treatment. J Am Acad Dermatol. 2002;46(2):309–312.
  • Ghonemy S, Alarawi A, Bessar H. Efficacy and safety of a new 10% topical minoxidil versus 5% topical minoxidil and placebo in the treatment of male androgenetic alopecia: a trichoscopic evaluation. J Dermatolog Treat. 2021;32(2):236–241.
  • Olsen EA, Weiner MS, Amara IA, et al. Five-year follow-up of men with androgenetic alopecia treated with topical minoxidil. J Am Acad Dermatol. 1990;22(4):643–646.
  • Lucky AW, Piacquadio DJ, Ditre CM, et al. A randomized, placebo-controlled trial of 5% and 2% topical minoxidil solutions in the treatment of female pattern hair loss. J Am Acad Dermatol. 2004;50(4):541–553.
  • Vañó-Galván S, Pirmez R, Hermosa-Gelbard A, et al. Safety of low-dose oral minoxidil for hair loss: a multicenter study of 1404 patients. J Am Acad Dermatol. 2021;84(6):1644–1651.
  • Beach RA. Case series of oral minoxidil for androgenetic and traction alopecia: tolerability & the five C's of oral therapy. Dermatol Ther. 2018;31(6):e12707.
  • Perera E, Sinclair R. Treatment of chronic telogen effluvium with oral minoxidil: a retrospective study. F1000Res. 2017;6:1650.
  • Ramos PM, Sinclair RD, Kasprzak M, et al. Minoxidil 1 mg oral versus minoxidil 5% topical solution for the treatment of female-pattern hair loss: a randomized clinical trial . J Am Acad Dermatol. 2020;82(1):252–253.
  • Jha AK, Sonthalia S, Zeeshan M, et al. Efficacy and safety of very-low-dose oral minoxidil 1.25 mg in male androgenetic alopecia. J Am Acad Dermatol. 2020;83(5):1491–1493.
  • Pathomvanich D, Imagawa K. Hair restoration surgery in Asians. Japan: Springer; 2010.
  • Rogers NE, Avram MR. Medical treatments for male and female pattern hair loss. In: Unger WP, editor. Hair transplantation. 5 ed. London: Informa Healthcare; 2011. p. 91–105.
  • Kanti V, Hillmann K, Kottner J, et al. Effect of minoxidil topical foam on frontotemporal and vertex androgenetic alopecia in men: a 104-week open-label clinical trial. J Eur Acad Dermatol Venereol. 2016;30(7):1183–1189.
  • Rogaine package insert, minoxidil foam 5% w/w. 2015.
  • Avram MR, Cole JP, Gandelman M, et al. The potential role of minoxidil in the hair transplantation setting. Dermatol Surg. 2002;28(10):894–900; discussion 900.
  • Bouhanna P. Topical minoxidil used before and after hair transplantation. J Dermatol Surg Oncol. 1989;15(1):50–53.
  • Goren A, Castano JA, McCoy J, et al. Novel enzymatic assay predicts minoxidil response in the treatment of androgenetic alopecia. Dermatol Ther. 2014;27(3):171–173.
  • Olsen EA, Whiting D, Bergfeld W, et al. multicenter, randomized, placebo-controlled, double-blind clinical trial of a novel formulation of 5% minoxidil topical foam versus placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol. 2007;57(5):767–774.
  • Baker C, Uno H, Johnson G. Minoxidil sulfation in the hair follicle. Skin Pharmacol. 1994;7(6):335–339.
  • Dooley TP, Walker CJ, Hirshey SJ, et al. Localization of minoxidil sulfotransferase in rat liver and the outer root sheath of anagen pelage and vibrissa follicles. J Invest Dermatol. 1991;96(1):65–70.
  • Anderson RJ, Kudlacek PE, Clemens DL. Sulfation of minoxidil by multiple human cytosolic sulfotransferases. Chem Biol Interact. 1998;109(1–3):53–67.
  • Goren A, McCoy J, Kovacevic M, et al. The effect of topical minoxidil treatment on follicular sulfotransferase enzymatic activity. J Biol Regul Homeost Agents. 2018;32(4):937–940.
  • Goren A, Sharma A, Dhurat R, et al. Low-dose daily aspirin reduces topical minoxidil efficacy in androgenetic alopecia patients. Dermatol Ther. 2018;31(6):e12741
  • Ramos PM, Goren A, Sinclair R, et al. Oral minoxidil bio-activation by hair follicle outer root sheath cell sulfotransferase enzymes predicts clinical efficacy in female pattern hair loss. J Eur Acad Dermatol Venereol. 2020;34(1):e40–e41.
  • Ramos PM, Gohad P, McCoy J, et al. Minoxidil Sulfotransferase Enzyme (SULT1A1) genetic variants predicts response to oral minoxidil treatment for female pattern hair loss. J Eur Acad Dermatol Venereol. 2021;35(1):e24–e26.
  • Pirmez R, Salas-Callo C-I. Very-low-dose oral minoxidil in male androgenetic alopecia: a study with quantitative trichoscopic documentation. J Am Acad Dermatol. 2020;82(1):e21–e22.
  • Panchaprateep R, Lueangarun S. Efficacy and safety of oral minoxidil 5 mg once daily in the treatment of male patients with androgenetic alopecia: an open-label and global photographic assessment. Dermatol Ther. 2020;10(6):1345–1357.
  • Anderson C, Scandinavian, Group Topical minoxidil in androgenetic alopecia Scandinavian and Middle East experience. Int J Dermatol. 1988;27(s6):447–451.
  • Civatte J, Laux B, Simpson N, et al. 2% topical minoxidil solution in male-pattern baldness: preliminary European results. Dermatology. 1987;175(2):42–49.
  • Dutrée‐Meulenberg R, Nieboer C, Koedijk F, et al. Treatment of male pattern alopecia using topical minoxidil in the Netherlands. Int J Dermatol. 1988;27(s6):435–440.
  • Hillmann K, Bartels NG, Kottner J, et al. A single-centre, randomized, double-blind, placebo-controlled clinical trial to investigate the efficacy and safety of minoxidil topical foam in frontotemporal and vertex androgenetic alopecia in men. Skin Pharmacol Physiol. 2015;28(5):236–244.
  • Olsen EA, DeLong ER, Weiner MS. Dose-response study of topical minoxidil in male pattern baldness. J Am Acad Dermatol. 1986;15(1):30–37.
  • Petzoldt D. The German double‐blind placebo‐controlled evaluation of topical minoxidil solution in the treatment of early male pattern baldness. Int J Dermatol. 1988;27(s6):430–434.
  • Saraswat A, Kumar B. Minoxidil vs finasteride in the treatment of men with androgenetic alopecia. Arch Dermatol. 2003;139(9):1219–1221.
  • Shupack JL, Kassimir JJ, Thirumoorthy T, et al. Dose-response study of topical minoxidil in male pattern alopecia. J Am Acad Dermatol. 1987;16(3 Pt 2):673–676.
  • Tsuboi R, Arano O, Nishikawa T, et al. Randomized clinical trial comparing 5% and 1% topical minoxidil for the treatment of androgenetic alopecia in Japanese men. J Dermatol. 2009;36(8):437–446.
  • Salanti G, Del Giovane C, Chaimani A, et al. Evaluating the quality of evidence from a network meta-analysis. PLOS One. 2014;9(7):e99682.
  • Nikolakopoulou A, Higgins JPT, Papakonstantinou T, et al. CINeMA: An approach for assessing confidence in the results of a network meta-analysis. PLOS Med. 2020;17(4):e1003082
  • RStudio Team. RStudio: integrated development environment for R Boston, MA. 2021. Available from: http://www.rstudio.com/
  • Leahy J, Thom H, Jansen JP, et al. Incorporating single-arm evidence into a network meta-analysis using aggregate level matching: assessing the impact. Stat Med. 2019;38(14):2505–2523.
  • Cameron C, Fireman B, Hutton B, et al. Network meta-analysis incorporating randomized controlled trials and non-randomized comparative cohort studies for assessing the safety and effectiveness of medical treatments: challenges and opportunities. Syst Rev. 2015;4:147.
  • Olsen EA, Dunlap FE, Funicella T, et al. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol. 2002;47(3):377–385.
  • Roberts JL. Androgenetic alopecia: treatment results with topical minoxidil. J Am Acad Dermatol. 1987;16(3 Pt 2):705–710.
  • Shah KB, Shah AN, Solanki RB, et al. A comparative study of microneedling with platelet-rich plasma plus topical minoxidil (5%) and topical minoxidil (5%) alone in androgenetic alopecia. Int J Trichol. 2017;9(1):14.
  • Jimenez-Cauhe J, Saceda-Corralo D, Rodrigues-Barata R, et al. Effectiveness and safety of low-dose oral minoxidil in male androgenetic alopecia. J Am Acad Dermatol. 2019;81(2):648–649.
  • Lueangarun S, Panchaprateep R, Tempark T, et al. Efficacy and safety of oral minoxidil 5 mg daily during 24-week treatment in male androgenetic alopecia: 638. J Am Acad Dermatol. 2015;72(5).
  • Therianou A, Vincenzi C, Tosti A. How safe is prescribing oral minoxidil in patients allergic to topical minoxidil? J Am Acad Dermatol. 2020.
  • Arca E, Açıkgöz G, Taştan HB, et al. An open, randomized, comparative study of oral finasteride and 5% topical minoxidil in male androgenetic alopecia. Dermatology. 2004;209(2):117–125.
  • Blume-Peytavi U, Hillmann K, Dietz E, et al. A randomized, single-blind trial of 5% minoxidil foam once daily versus 2% minoxidil solution twice daily in the treatment of androgenetic alopecia in women. J Am Acad Dermatol. 2011;65(6):1126–1134.e2.
  • Savin RC. Use of topical minoxidil in the treatment of male pattern baldness. J Am Acad Dermatol. 1987;16(3 Pt 2):696–704.
  • Sinclair R, Trindade de Carvalho L, Ferial Ismail F, et al. Treatment of male and female pattern hair loss with sublingual minoxidil: a retrospective case-series of 64 patients. J Eur Acad Dermatol Venereol. 2020;34(12):e795–e796.
  • Suchonwanit P, Srisuwanwattana P, Chalermroj N, et al. A randomized, double‐blind controlled study of the efficacy and safety of topical solution of 0.25% finasteride admixed with 3% minoxidil vs. 3% minoxidil solution in the treatment of male androgenetic alopecia. J Eur Acad Dermatol Venereol. 2018;32(12):2257–2263.
  • Abdel‐Raouf H, Aly UF, Medhat W, et al. A novel topical combination of minoxidil and spironolactone for androgenetic alopecia: clinical, histopathological and physico‐chemical study. Dermatol Ther. 2021;34(1):e14678.
  • Bazzano GS, Terezakis N, Galen W. Topical tretinoin for hair growth promotion. J Am Acad Dermatol. 1986;15(4 Pt 2):880–893.
  • Sharma A, Goren A, Dhurat R, et al. Tretinoin enhances minoxidil response in androgenetic alopecia patients by upregulating follicular sulfotransferase enzymes. Dermatol Ther. 2019;32(3):e12915.
  • Kochar P, Nayak K, Thakkar S, et al. Exploring the potential of minoxidil tretinoin liposomal based hydrogel for topical delivery in the treatment of androgenic alopecia. Cutan Ocul Toxicol. 2020;39(1):43–53.
  • Kim YS, Jeong KH, Kim JE, et al. Repeated microneedle stimulation induces enhanced hair growth in a murine model. Ann Dermatol. 2016;28(5):586–592.
  • Sharma A, Surve R, Dhurat R, et al. Microneedling improves minoxidil response in androgenetic alopecia patients by upregulating follicular sulfotransferase enzymes. J Biol Regul Homeost Agents. 2020;34(2):659–661.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.