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Androgenetic alopecia (AGA) is commonly treated with topical minoxidil, while platelet-rich plasma (PRP) and oral minoxidil offer alternative options. To compare the efficacy and safety of low-dose oral minoxidil (group 1) (G1), topical minoxidil (group 2) (G2), and PRP with topical minoxidil (group 3) (G3) in AGA. Seventy-five participants were randomly assigned to three treatment groups ( n  = 25),. Clinical and videodermoscopic assessments were performed at pre-scheduled intervals over 32 weeks, which was completed by 60 patients. At 32 weeks, 25% of patients in groups 1 and 3, and 10% in group 2 showed one grade improvement in AGA severity ( p  = 0.62). The median percentage increase in terminal hair density was 47.5 in G1, 48 in G2, and 57 in G3 at week 32 favoring G3 over G1 ( p  = 0.03) and G2 ( p  = 0.02). Median percentage decrease in vellus hair density was 26 in G1, 21 in G2, and 19 in G3, favoring G1 over G3 ( p  = 0.03), All 3 groups demonstrated a significant decrease in hair diameter diversity by 32 weeks, with no intergroup variation. The major side effects noted in G1 were headaches (20%), dizziness (15%), and pedal edema (5%). Scalp itching and dryness was observed in 75% of patients after topical minoxidil. Transient pain was observed in all patients during PRP procedure, along with minimal bleeding and dizziness in 15% and 5% respectively. Side effects experienced in all 3 groups were mild and were tolerated by most of the patients. The study emphasizes low-dose oral minoxidil as an effective alternative to topical minoxidil and also suggests the benefits of combining topical minoxidil with PRP.

Androgenetic alopecia is one of the most common cause of hair loss disorder. This hereditary and androgen-dependent disorder tends to progress into partial or even complete baldness Several therapeutic options are now available for AGA, including conventional medications such as finasteride, dutasteride, and minoxidil. However, side effects of these medications are also commonly reported. The use of adipose derived stem cells and their secreted bioactive molecules, “secretome” has gained attention which could produce many effects for hair growth promotion and has been proven in clinical trials. This study aims to compare the effectiveness and safety of with minoxidil in androgenetic alopecia cases. 60 subjects were divided into three treatment groups (minoxidil only, secretome only, and combination of both) and were given intervention on week 0, 4, and 8. All subjects were evaluated by physical examination, photography, trichoscopy, and trichoscan until week 12. All groups showed a statistically significant improvement ( p  < 0.05) on hair growth parameters with the best improvement observed on week 12. The combination group had the best improvement substantially on hair growth parameters. Side effects are minimum and reported by the subjects in minoxidil group. Clinicaltrials.gov, NCT06066827. Registered 05 October 2023, Retrospectively. https://register.clinicaltrials.gov/prs/app/template/Home.vm?uid=U0004ES6_ts=7_sid=S000DOK9_cx=-igh2d .

Fractional 1550-nm erbium-glass (Er:Glass) laser therapy is effective in inducing hair regrowth. Combining fractional Er:Glass laser therapy with topical minoxidil may yield therapeutic benefits for patients with androgenetic alopecia (AGA). To compare the efficacy and safety of fractional Er:Glass laser used in combination with topical 5% minoxidil versus 5% minoxidil alone for the treatment of male AGA, 30 men with AGA were randomized to 24 weeks of split-scalp treatment using fractional Er:Glass laser and 5% minoxidil on one side (combined therapy) or 5% minoxidil alone on the other side (monotherapy). The primary outcome was the difference in hair density and diameter, from baseline, between two treatment sides, at week 24. The secondary outcome was a global photographic assessment, evaluated by two dermatologists and the participants. Adverse events were evaluated. Twenty-nine participants completed the 24-week study period. Combination therapy provided significantly superior results for both the primary and secondary outcomes (all p < 0.05). No serious adverse events were identified for either treatment. In conclusion, combination therapy, consisting of fractional Er:Glass laser and topical minoxidil, is a promising treatment option for AGA. Laser-induced photothermolysis and the formation of effective routes for transdermal drug delivery are possible mechanisms. clinicaltrials.in.th, identifier TCTR20160912001

Minoxidil has become an increasingly popular treatment option for hair loss disorders including androgenetic alopecia, cicatricial alopecia, and alopecia areata. There are various minoxidil formulations available including topical, oral, and injectable minoxidil. While injectable minoxidil may offer certain advantages, potential risks and costs should also be considered. First, we explore the enhanced bioavailability of injectable minoxidil in comparison to topical and oral formulations, as well as the variability in sulfotransferase enzyme levels and its role in the activation of minoxidil at hair follicles. Furthermore, we expand upon the potential adverse effects associated with injectable minoxidil given its widespread systemic distribution. We also highlight the importance of considering cost, access, and availability of injectable minoxidil given that injections are significantly more expensive than oral minoxidil tablets and involve the additional obstacle of frequent dermatology visits. Depending on geographic region and socioeconomic status, many patients may not live in sufficiently close proximity to a dermatologist for this level of care. Finally, we emphasize the need for ongoing research efforts to compare the efficacy, access, and tolerability of injectable minoxidil, alternative minoxidil formulations, and other alopecia medications.

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.

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.

Androgenetic alopecia (AGA) is the most common form of non-scarring alopecia, affecting up to 80% of men and 50% of women by the age of 70. Minoxidil, initially developed as an oral antihypertensive, has become one of the most widely used therapies for AGA due to its safety and efficacy. This review presents an overview of current evidence on topical, oral and sublingual minoxidil. Topical minoxidil, the only FDA-approved treatment for AGA in both men and women, promotes hair growth through several proposed mechanisms described in the article. Randomised controlled trials show that 5% formulations consistently increase hair counts, although results vary due to differences in follicular sulfotransferase activity. Low-dose oral minoxidil (0.25–5 mg) has emerged as a practical option for patients unresponsive to topical therapy. Hypertrichosis is the most frequent adverse effect, while cardiovascular events are uncommon at low doses. Sublingual administration, a novel delivery route that bypasses first-pass metabolism, may enhance follicular bioavailability while limiting systemic exposure. Early evidence indicates similar efficacy to oral therapy, with a potentially lower risk of cardiovascular effects. Overall, topical minoxidil remains first line, while oral and sublingual formulations expand therapeutic options and support individualised management. Further large-scale, long-term studies are needed to define optimal dosing, confirm safety and determine whether sublingual administration offers consistent advantages over oral use.

Background The relationship between female pattern hair loss (FPHL) and androgenic hormones is not well established, but some evidence indicates oral finasteride may be efficacious in FPHL. Use of a topical formulation has been proposed to minimize unwanted effects. Objectives Our objective was to compare the efficacy and safety of topical 0.25% finasteride combined with 3% minoxidil solution and 3% minoxidil solution as monotherapy in the treatment of FPHL. Methods This was a prospective, randomized, double-blind study in 30 postmenopausal women with FPHL. Each participant was randomized to receive either topical 0.25% finasteride combined with topical 3% minoxidil or topical 3% minoxidil solution as monotherapy for 24 weeks. To determine efficacy, the hair density and diameter was measured and global photographic assessment was conducted at baseline and 8, 16, and 24 weeks. Side effects and serum dihydrotestosterone levels were also evaluated. Results By 24 weeks, hair density and diameter had increased in both groups, and finasteride/minoxidil was significantly superior to minoxidil solution in terms of hair diameter ( p  = 0.039). No systemic side effects were reported. However, serum dihydrotestosterone levels in the finasteride/minoxidil group significantly decreased from baseline ( p  = 0.016). Conclusion A topical combination of 0.25% finasteride and 3% minoxidil may be a promising option in the treatment of FPHL with an additional benefit of increasing hair diameter. Nevertheless, as it may be absorbed percutaneously, it should be reserved for postmenopausal women. Trial Registration clinicaltrials.in.th; identifier TCTR20160912002.

Background Microinfusion is a superficial microneedling procedure that infuses medications into the surface of the dermis through disposable needles attached to tattoo equipment. Various medications can be microinfused; minoxidil is frequently utilized as an adjuvant treatment for androgenetic alopecia, but little data is available on its systemic effects when administered via this technique. Objective To compare blood pressure readings before and after microinfusion of minoxidil in the scalp to assess this drug’s systemic effects when applied using this technique. Methods This randomized, controlled, blinded study was conducted with 24 patients divided into 2 groups to compare microinfusion with 0.5% minoxidil and saline solution (control group). Participants underwent 3 sessions at monthly intervals, and their blood pressure was measured before and after each microinfusion procedure. Results A statistically significant reduction in diastolic blood pressure was observed after the procedure in the minoxidil group ( p  = 0.037). In the control group, a statistically significant increase in systolic blood pressure was found ( p  = 0.013). Conclusion Reduction of diastolic blood pressure in the minoxidil group proved dermal delivery and systemic absorption of the medication after scalp microinfusion. Increased systolic pressure in the control group may be related to pain during the procedure. Brazilian registry of clinical trials (ReBEC): RBR-368fdb3; Date of registration: April, 11th, 2024 (retrospectively registered).

Androgenetic alopecia (AGA), also known as male pattern hair loss (MPHL) or female pattern hair loss (FPHL), is the most common form of alopecia worldwide, and arises from an excessive response to androgens. AGA presents itself in a characteristic distribution unique to both sexes. Despite its prevalence, AGA can be quite challenging to treat. The condition is chronic in nature and stems from an interplay of genetic and environmental factors. There are only two US Food and Drug Administration (FDA)-approved drugs for the condition: topical minoxidil and oral finasteride. However, numerous non-FDA-approved treatments have been shown to be effective in treating AGA in various studies. Some of these treatments are relatively new and still to be explored, thus emphasizing the need for an updated review of the literature. In this comprehensive review, we discuss the evaluation of AGA and the mechanisms of action, costs, efficacies, and safety profiles of existing, alternative, and upcoming therapeutics for this widespread condition.