Minoxidil: a comprehensive review

J Dermatolog Treat. 2021 Jun 23:1-45. doi: 10.1080/09546634.2021.1945527. Online ahead of print.ABSTRACTTopical minoxidil (5% foam, 5% solution, 2% solution) is FDA-approved for androgenetic alopecia (AGA) in men and women.Mechanism of action: Minoxidil acts through multiple pathways (vasodilator, anti-inflammatory agent, inducer of the Wnt/β-catenin signaling pathway, an antiandrogen), and may also affect the length of the anagen and telogen phases.Pharmacokinetics: Approximately 1.4% of topical minoxidil is absorbed through the skin. Minoxidil is a prodrug which is metabolized by follicular sulfotransferase to minoxidil sulfate (active form). Those with higher sulfotransferase activity may respond better than patients with lower sulfotransferase activity.Clinical efficacy (topical minoxidil): In a five-year study, 2% minoxidil exhibited peak hair growth in males at year one with a decline in subsequent years. Topical minoxidil causes hair regrowth in both frontotemporal and vertex areas. The 5% solution and foam were not significantly different in efficacy from the 2% solution.Oral and Sublingual minoxidil (not FDA approved; off-label): After 6 months administration, minoxidil 5mg/day was significantly more effective than topical 5% and 2% in male AGA. Low-dose 0.5 to 5 mg/day may also be safe and effective for female pattern hair loss and chronic telogen effluvium. Sublingual minoxidil may be safe and effective in male and female pattern hair loss.PMID:34159872 | DOI:10.1...
Source: Journal of Dermatological Treatment - Category: Dermatology Authors: Source Type: research