Minoxidil: a comprehensive review
AK Gupta, M Talukder, M Venkataraman… - Journal of …, 2022 - Taylor & Francis
AK Gupta, M Talukder, M Venkataraman, MA Bamimore
Journal of Dermatological Treatment, 2022•Taylor & FrancisAbstract Topical minoxidil (5% foam, 5% solution, and 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 that is metabolized by follicular sulfotransferase to …
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 that is metabolized by follicular sulfotransferase to …
Abstract
Topical minoxidil (5% foam, 5% solution, and 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 that 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 of administration, minoxidil 5 mg/day was significantly more effective than topical 5% and 2% in male AGA. Low-dose 0.5–5 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.
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