Emerging Oral Treatments: Oral Minoxidil for Androgenetic Alopecia
Rubina Alves in Techniques in the Evaluation and Management of Hair Diseases, 2021
Androgenetic alopecia (AGA) is a complex disorder of hair loss characterized by progressive follicular miniaturization in a patterned distribution that occurs due to systemic androgen and genetic factors. AGA manifests clinically as male pattern hair loss (MPHL) in men and female pattern hair loss (FPHL) in women. Men develop bitemporal recession, diffuse thinning over the frontal scalp and vertex balding, while women experience increased hair shedding and diffuse thinning over the upper biparietal and/or midfrontal scalp. Topical minoxidil has been widely used as a treatment for AGA for more than 30 years, but lack of efficacy, poor compliance, irritant/allergic contact dermatitis, and cost are common barriers for this therapy. Reported adverse effects were dose-related and include hypertrichosis, pretibial edema, and postural hypotension. Multiple strategies have been explored to improve treatment response without increasing minoxidil dose.
Nonmedical approaches to hair loss: What is available?
Jerry Shapiro, Nina Otberg in Hair Loss and Restoration, 2015
Medical and surgical therapies for hair loss may sometimes not be enough to achieve a cosmetically acceptable result for the patient. Every physician dealing with hair loss should be able to give advice on different camouflage techniques and help the patient to find the best and most suitable solution. If the patient is using any topical medical therapy, such as minoxidil or topical corticosteroids, the scalp needs to be dry before any of the camouflaging agents are applied. Hair fibers and scalp paint can also be useful to camouflage temporary shock loss after hair restoration surgery. Nonmedical approaches to hair loss can be used as a temporary solution in patients with alopecia areata or anagen and telogen effluvium or as a permanent solution in patients with cicatricial alopecia, alopecia areata, and androgenetic alopecia. Hairpieces are used for patients with partial hair loss and are created to blend into the natural hair.
Hair and hairy scalp
Richard Ashton, Barbara Leppard in Differential Diagnosis in Dermatology, 2021
Hair is a modified type of keratin produced by the hair matrix. On the scalp, apart from its social and cosmetic function, hair protects the underlying skin from sun damage. Eczema is differentiated from psoriasis on the scalp because it usually covers the entire hairy scalp and is more easily seen than felt. Basal cell carcinoma may occur in the hairy scalp as a persistent area of crusting or hair loss. The hair cycle occurs randomly in each follicle over the scalp so that up to 100 hairs are being lost daily, but in normal circumstances, moulting does not occur. Hair in the wrong place or hair which is coarser or longer than is socially acceptable is regarded as excessive. There are two different patterns, hirsutism and hypertrichosis. Minoxidil can be helpful in boosting growth where there are still active follicles to improve volume but in many patients the hair loss is so advanced that a wig may be necessary.
Efficacy of topical latanoprost versus minoxidil and betamethasone valerate on the treatment of alopecia areata
Published in Journal of Dermatological Treatment, 2018
Amal Ahmad El-Ashmawy, Iman Hamed El-Maadawy, Gamal Mohamed El-Maghraby
Background: Alopecia areata (AA) is one of the most common causes of localized hair loss. There is no universally proven therapy that induces and sustains remission of hair growth in AA. Objective: To compare the efficacy and safety of topical latanoprost, minoxidil and betamethasone valerate on hair growth in patients with AA. Patients and methods: Hundred patients with AA classified into five groups of 20 treated with: Group I, latanoprost 0.1% lotion; Group II, minoxidil 5% lotion; Group III, betamethasone valerate 0.1% solution; Group IV, combination of latanoprost lotion and betamethasone valerate solution and Group V, a vehicle lotion control group. Results: There was a statistically significant improvement in all therapeutic groups when compared with control group and reduction of severity of alopecia tool score of scalp and beard before and after treatment for all therapeutic groups. Conclusion: Latanoprost, minoxidil and betamethasone valerate are effective and safe in the treatment of patchy AA. The use of latanoprost added to the therapeutic efficacy of topical betamethasone valerate in the treatment of AA and could be an effective adjunctive topical therapy for AA.
Chitosan microparticles for sustaining the topical delivery of minoxidil sulphate
Published in Journal of Microencapsulation, 2011
Guilherme Martins Gelfuso, Taís Gratieri, Patrícia Sper Simão, Luís Alexandre Pedro de Freitas, Renata Fonseca Vianna Lopez
Given the hypothesis that microparticles can penetrate the skin barrier along the transfollicular route, this work aimed to obtain and characterise chitosan microparticles loaded with minoxidil sulphate (MXS) and to study their ability to sustain the release of the drug, attempting a further application utilising them in a targeted delivery system for the topical treatment of alopecia. Chitosan microparticles, containing different proportions of MXS/polymer, were prepared by spray drying and were characterised by yield, encapsulation efficiency, size and morphology. Microparticles selected for further studies showed high encapsulation efficiency (∼82%), a mean diameter of 3.0 µm and a spherical morphology without porosities. When suspended in an ethanol/water solution, chitosan microparticles underwent instantaneous swelling, increasing their mean diameter by 90%. Release studies revealed that the chitosan microparticles were able to sustain about three times the release rate of MXS. This feature, combined with suitable size, confers to these microparticles the potential to target and improve topical therapy of alopecia with minoxidil.
Randomized trial of electrodynamic microneedle combined with 5% minoxidil topical solution for the treatment of Chinese male Androgenetic alopecia
Published in Journal of Cosmetic and Laser Therapy, 2020
Linlin Bao, Lin Gong, Menger Guo, Taoming Liu, Anyu Shi, Haifeng Zong, Xuegang Xu, Hongduo Chen, Xinghua Gao, Yuanhong Li
Background: In treating androgenetic alopecia, 5% minoxidil is a commonly used topical drug. By using electrodynamic microneedle at the same time may increase absorption of minoxidil and further stimulate hair growth. Objective: A 24-week, randomized, evaluator blinded, comparative study was performed to evaluate the efficacy of treating Chinese male androgenetic alopecia using microneedle combined with 5% minoxidil topical solution. Methods: Randomized subjects received topical 5% minoxidil (group 1, n = 20), local electrodynamic microneedle treatments (group 2, n = 20), or local electrodynamic microneedle treatments plus topical 5% minoxidil (group 3, n = 20). A total of 12 microneedle treatments were performed every 2 weeks with 2ml 5% minoxidil delivery in group three during each microneedle treatment. Patient receiving topical 5% minoxidil applied 1 ml of the solution twice daily over the course of the study. A total of 60 Chinese male subjects with Norwood-Hamilton type III-VI androgenetic alopecia were treated. Results: The mean improvement in total hair density from baseline to 24 weeks was 18.8/cm2 in group 1, 23.4/cm2 in group 2, and 38.3/cm2 in group 3. The hair growth in the three groups was significantly different (P = 0.002), but there were no significant differences in toxicity found between the three groups. Conclusions: Treatment with microneedle plus topical 5% minoxidil was associated with the best hair growth.
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