Low-dose, daily oral minoxidil is about as effective as topical minoxidil, 5%, twice per day in men with androgenetic alopecia (AGA), according to a 24-week study published online in JAMA Dermatology.
The double-blind trial included men with AGA aged 18 to 55 years. Participants were randomized 1:1 into 2 groups: oral minoxidil, 5 mg, daily and topical placebo solution; or 1 mL of topical minoxidil, 5%, twice daily and oral placebo for 24 weeks.
Among 90 enrolled participants, 68 completed the study. At 24 weeks, the mean changes from baseline in terminal and total hair density were not different between the groups.
For the frontal area, the mean change from baseline to week 24 between groups was 3.1 hairs per cm2 for terminal hair density and 2.6 hairs per cm2 for total hair density, the study showed.
For the vertex area, the mean change from baseline to week 24 was 23.4 hairs per cm2 for terminal density and 5.5 hairs per cm2 for total hair density.
When three dermatologists who were blinded to treatment analyzed photographs, they found oral minoxidil was superior to topical minoxidil on the vertex, but not on the frontal scalp. The most common adverse effects in the oral minoxidil group were hypertrichosis and headache, the study showed.
The bottom line? Low-dose oral minoxidil is well tolerated and can be considered an option for patients who prefer oral therapy or can’t tolerate topical treatment, the researchers concluded.
