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Journal of the European Academy of... Oct 2022
Randomized Controlled Trial
Topics: Administration, Topical; Alopecia; Double-Blind Method; Dutasteride; Finasteride; Humans; Minoxidil; Treatment Outcome
PubMed: 35648446
DOI: 10.1111/jdv.18285 -
Journal of the European Academy of... Jun 2021Alopecia areata is the third most common cause of dermatology consultations in children but the treatment of paediatric alopecia areata remains challenging. A systematic... (Review)
Review
Alopecia areata is the third most common cause of dermatology consultations in children but the treatment of paediatric alopecia areata remains challenging. A systematic review of the literature about the treatment of alopecia areata in children (≤18 years old) was performed on 11 May 2020 by searching the PubMed, Scopus and EBSCO databases. The terms used for the search were: 'alopecia areata', 'alopecia totalis' or 'alopecia universalis' combined with 'paediatric', 'children' or 'childhood'. A total of 89 articles were included in final evaluation. The most commonly assessed treatment options in paediatric alopecia areata were topical immunotherapy (response rate in monotherapy: 54%; 187/345) intralesional glucocorticosteroids (75%; 211/280), systemic glucocorticosteroids (73%; 102/140), and anthralin (42%; 31/74). Topical glucocorticosteroids (81%; 35/43), systemic Janus kinase (JAK) inhibitors (90%; 27/30), topical calcineurin inhibitors (42%; 8/19), topical JAK inhibitors (65%; 11/17), PUVA therapy (56%; 9/16) and 308-nm excimer laser (77%; 10/13) were also evaluated. Additionally, evaluation in smaller numbers of paediatric patients included methotrexate (100%; 10/10), topical minoxidil (44%; 4/9) and cyclosporine (83%; 5/6). There were limited data considering children with alopecia areata treated with azathioprine, hydroxychloroquine, topical sildenafil, topical prostaglandin analogues, fractional carbon dioxide laser, leflunomide, mesalazine, apremilast, dupilumab, ustekinumab, efalizumab, botulinum toxin, and compound glycyrrhizin. On the basis of the limited data available glucocorticosteroids (systemic, intralesional or topical) and JAK inhibitors (systemic or topical) may be considered the best documented and most effective treatment options in alopecia areata in children. There are no sufficient paediatric data to compare treatment safety and relapse rates in these therapeutic modalities.
Topics: Adolescent; Alopecia; Alopecia Areata; Child; Humans; Janus Kinase Inhibitors; Leflunomide; Minoxidil; Treatment Outcome
PubMed: 33630354
DOI: 10.1111/jdv.17187 -
The Journal of Dermatological Treatment Mar 2021Androgenetic alopecia is a stressful condition for males. Minoxidil 2% and 5% have been FDA approved for treatment of this condition. In literature, all studies have... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Androgenetic alopecia is a stressful condition for males. Minoxidil 2% and 5% have been FDA approved for treatment of this condition. In literature, all studies have compared minoxidil 5% with 2%. Although other concentrations (2% to 12.5%) are available nowadays, we believe our study is the first to compare 10% versus 5% topical minoxidil in treatment of AGA.
OBJECTIVE
To compare the efficacy and safety of 5% topical minoxidil with 10% topical minoxidil and placebo in AGA treatment.
MATERIALS AND METHODS
36-weeks, double-blinded, placebo-controlled, randomized trial. A total of 90 men with AGA. First group have applied 5% minoxidil solution, second group applied 10% minoxidil solution; or third placebo group. Efficacy was evaluated clinically and trichoscopically.
RESULTS
After 36 weeks of therapy; 5% topical minoxidil (0.47 ± 0.26) (0.59 ± 0.64) was significantly superior to 10% topical minoxidil (0.05 ± 0.13) (0.45 ± 0.74) and placebo (0.01 ± 0.05) (-0.03 ± 0.08) in terms of change from baseline in total vertex and frontal hair mean count respectively. Pull test change to negative in minoxidil 5%: (37%) patients after 6 month treatment, Minoxidil 10% group (37.5%) patients changed and in placebo group all patients after 6 month were the same (0%) change. No reported sexual dysfunction in all three groups.
CONCLUSION
Five percent of topical minoxidil was moderately superior to 10% topical minoxidil and placebo in increasing hair regrowth opposite to the expected, the irritation was marked for 10% topical minoxidil. Psychosocial stress after 10% usage were worsen by the shedding, irritation compared to their high expectation in comparison to 5% usage.
Topics: Administration, Topical; Adult; Alopecia; Double-Blind Method; Hair; Humans; Male; Minoxidil; Patient Satisfaction; Placebo Effect; Treatment Outcome; Young Adult
PubMed: 31403367
DOI: 10.1080/09546634.2019.1654070 -
Journal of Cosmetic Dermatology Apr 2021Microneedling has shown to have positive therapeutic effects in treatment of androgenetic alopecia (AGA); however, the best microneedling protocol is still controversial.
BACKGROUND
Microneedling has shown to have positive therapeutic effects in treatment of androgenetic alopecia (AGA); however, the best microneedling protocol is still controversial.
AIMS
Investigating effect of microneedling with 2 different depths of penetration on promoting hair growth in patients with AGA.
METHODS
Sixty patients, in the age of 18-45 years old with moderate and severe AGA, were allocated into 3 groups of control: treatment with minoxidil 5% lotion; group A: treatment with minoxidil 5% lotion and biweekly microneedling with a depth of 1.2 mm and group B: treatment with minoxidil 5% lotion and biweekly microneedling with a depth of 0.6 mm during 12 weeks. Efficacy parameters including change of hair count and hair thickness from baseline and assessment of hair growth by patient and investigator were evaluated.
RESULTS
Compared with the baseline, a significant increase in hair count and hair thickness was observed in all three groups after completion of the treatment course (P < .05). The mean rise in hair count (P = .017) and hair thickness (P = .007) was significantly greater in group B compared with control group. Investigator's evaluation of hair regrowth was significantly greater in group A (P = .04) and group B (P = .007) compared with control group.
CONCLUSION
Microneedling with a depth of 0.6 mm in combination with minoxidil is more effective than minoxidil monotherapy in patients with AGA in terms of hair count and hair thickness. This depth of penetration tended to be more beneficial than depth of 1.2 mm.
Topics: Adolescent; Adult; Alopecia; Hair; Humans; Middle Aged; Minoxidil; Young Adult
PubMed: 32897622
DOI: 10.1111/jocd.13714 -
Journal of the European Academy of... Jul 2021Topical minoxidil has been used for many years as treatment for different hair disorders. Even though it is an effective therapy, many patients show poor compliance due... (Review)
Review
Topical minoxidil has been used for many years as treatment for different hair disorders. Even though it is an effective therapy, many patients show poor compliance due to the cosmesis, cost and side-effects. During the last few years, low-dose oral minoxidil has proven to be an alternative for patients with alopecia. We performed a literature search including all the articles that used oral minoxidil as a primary treatment in various hair diseases in order to evaluate the efficacy and safety of low-dose oral minoxidil as an alternative to topical minoxidil. Androgenetic alopecia was the most common studied condition, but others included telogen effluvium, tractional alopecia, postchemotherapy-induced alopecia, monilethrix, loose anagen hair syndrome, alopecia areata and scarring alopecias (frontal fibrosing alopecia and lichen planopilaris). Larger randomized comparative studies including standardized objective measurements should be done in order to clarify the best treatment protocol, including dosage and treatment duration. Oral minoxidil has proven to be a successful and well-tolerated alternative for patients with hair loss, including those with poor adherence to other therapies. Different dosing regimens have been utilized in scarring and non-scarring alopecia, varying from 0.25 to 5 mg daily. Higher doses have not been studied in men or women. Available literature suggests women require lower doses, from 0.25 to 2.5 mg daily, while men require higher doses for maximal efficacy, from 1.25 to 5 mg a day.
Topics: Alopecia; Alopecia Areata; Female; Humans; Male; Minoxidil; Monilethrix
PubMed: 33660357
DOI: 10.1111/jdv.17216 -
Facial Plastic Surgery : FPS Apr 2024Androgenetic alopecia is a common type of hair loss, which is generally influenced by genetic factors and systemic androgens resulting in follicular miniaturization.1 It...
Androgenetic alopecia is a common type of hair loss, which is generally influenced by genetic factors and systemic androgens resulting in follicular miniaturization.1 It can cause cosmetic problems leading to psychological distress among affected men and women. Effective standard medical treatments available are topical minoxidil 2 to 5%, oral finasteride, oral dutasteride, and hair transplantation.1 However, some patients do not achieve favorable results with standard treatments. For these reasons, other novel treatments have been developed, including new medications, regenerative medicines (autologous platelet-rich plasma, adipose-derived stem cells, micrograft generation, and exosome), and low-level laser therapy.
Topics: Male; Humans; Female; Alopecia; Finasteride; Minoxidil; Low-Level Light Therapy; Platelet-Rich Plasma; Treatment Outcome
PubMed: 37871637
DOI: 10.1055/a-2196-4713 -
Journal of Cosmetic Dermatology Oct 2022Female pattern hair loss (FPHL) is the most common form of alopecia in women. FPHL may compromise body image and strongly affect self-esteem, negatively impacting... (Review)
Review
Female pattern hair loss (FPHL) is the most common form of alopecia in women. FPHL may compromise body image and strongly affect self-esteem, negatively impacting quality of life. Currently, the only Food and Drug Administration (FDA) approved drug for its treatment is topical minoxidil, with a variable response rate. Recently, a few studies in FPHL have pointed out bicalutamide as an emergent selective androgen receptor antagonist with a favorable safety and tolerability profile. This review aimed to summarize and discuss the key information on this new therapy for FPHL. Bicalutamide has no diuretic effect. It does not cross the blood-brain barrier, and it has little effect on serum luteinizing hormone. Additionally, bicalutamide was found to be effective on women presenting with other features of hyperandrogenism such as seborrhea, acne, and hirsutism with mild and well-tolerated adverse effects. Despite the high prevalence and psychosocial impairment, FPHL treatment remains challenging. Therefore, although future prospective, comparative, randomized clinical trials are essential to establish the ideal dose and efficacy of the drug, oral bicalutamide appears to be a promising option to expand the arsenal of FPHL treatment.
Topics: Female; Humans; Quality of Life; Dermatologists; Alopecia; Minoxidil
PubMed: 35032336
DOI: 10.1111/jocd.14773 -
Journal of the American Academy of... Oct 2023Androgenetic alopecia (AGA) management is a significant clinical and therapeutic challenge for transgender and gender-diverse (TGD) patients. Although gender-affirming... (Review)
Review
Androgenetic alopecia (AGA) management is a significant clinical and therapeutic challenge for transgender and gender-diverse (TGD) patients. Although gender-affirming hormone therapies affect hair growth, there is little research about AGA in TGD populations. After reviewing the literature on approved treatments, off-label medication usages, and procedures for treating AGA, we present treatment options for AGA in TGD patients. The first-line treatments for any TGD patient include topical minoxidil 5% applied to the scalp once or twice daily, finasteride 1 mg oral daily, and/or low-level laser light therapy. Spironolactone 200 mg daily is also first-line for transfeminine patients. Second-line options include daily oral minoxidil dosed at 1.25 or 2.5 mg for transfeminine and transmasculine patients, respectively. Topical finasteride 0.25% monotherapy or in combination with minoxidil 2% solution are second-line options for transmasculine and transfeminine patients, respectively. Other second-line treatments for any TGD patient include oral dutasteride 0.5 mg daily, platelet-rich plasma, or hair restoration procedures. After 6-12 months of treatment, AGA severity and treatment progress should be assessed via scales not based on sex; eg, the Basic and Specific Classification or the Bouhanna scales. Dermatologists should coordinate care with the patient's primary gender-affirming clinician(s) so that shared knowledge of all medications exists across the care team.
Topics: Humans; Minoxidil; Finasteride; Transgender Persons; Alopecia; Dutasteride; Treatment Outcome
PubMed: 34756934
DOI: 10.1016/j.jaad.2021.08.067 -
Aesthetic Plastic Surgery Jun 2020The combination of finasteride and topical minoxidil has been used for treating patients with androgenetic alopecia (AGA). However, whether combining these two... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The combination of finasteride and topical minoxidil has been used for treating patients with androgenetic alopecia (AGA). However, whether combining these two medications results in greater efficacy than monotherapy is a question worth exploring.
OBJECTIVE
This meta-analysis aims to determine the efficacy and safety of combined treatment of finasteride and topical minoxidil.
METHODS
A comprehensive search of the Embase, PubMed, and the Cochrane Library databases was performed. Data were extracted and analyzed according to predefined clinical endpoints.
RESULTS
Five randomized controlled trials (RCTs) were included in our meta-analysis. All studies compared combined therapy with minoxidil, but only 2 RCTs compared combined therapy with finasteride. Compared with minoxidil or finasteride alone, the combined group had a significantly higher global photographic evaluation score (P < 0.00001), more patients with marked improvement (P < 0.001), and fewer patients with deterioration or no change (P < 0.001). There was no significant difference between the combined group and minoxidil- or finasteride-only groups in the number of patients with moderate and mild improvements, hair density change, or adverse events.
CONCLUSIONS
In patients with AGA, the combination treatment of finasteride and topical minoxidil has better therapeutic efficacy than and similar safety as monotherapy. However, the best concentration of combination treatment requires further studies with sound methodological quality.
LEVEL OF EVIDENCE III
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Topics: Alopecia; Finasteride; Hair; Humans; Minoxidil; Photography; Treatment Outcome
PubMed: 32166351
DOI: 10.1007/s00266-020-01621-5 -
Dermatologic Therapy Jul 2020Androgenetic alopecia (AGA) is the most common type of baldness affecting both men and women. Studies investigating combination therapies for AGA reported greater... (Meta-Analysis)
Meta-Analysis Review
Androgenetic alopecia (AGA) is the most common type of baldness affecting both men and women. Studies investigating combination therapies for AGA reported greater efficacy than monotherapy but without rigorous examination. The authors performed a meta-analysis and systemic review to further verify the evidence. To evaluate the effectiveness of three common combination therapies of minoxidil with finasteride, low-level laser light therapy (LLLT) or microneedling versus minoxidil monotherapy. We conducted a systematic review of randomized controlled trials (RCTs) of combination therapies consisting of topical minoxidil for AGA through April 2020. Quality assessment and data analysis were performed by Review Manager 5.3. Fifteen studies met the inclusion criteria involving a total of 1172 AGA patients. We conducted meta-analysis for three groups of combined treatment separately, and all were superior to monotherapy in terms of global photographic assessment (P < .05). Combination of LLLT or microneedling with minoxidil also showed significant increase in hair count (P < .05) compared to monotherapy. The present study suggests that combination therapy could be an effective, safe and promising option for the treatment of AGA. However, more RCTs are needed to further investigate and confirm the efficacy of combined treatment.
Topics: Alopecia; Female; Finasteride; Hair; Humans; Male; Minoxidil; Treatment Outcome
PubMed: 32478968
DOI: 10.1111/dth.13741