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Low-Dose Oral Minoxidil Initiation for Patients With Hair Loss

Title: Low-Dose Oral Minoxidil Initiation for Patients With Hair Loss
Authors: Akiska, Yagiz Matthew; Mirmirani, Paradi; Roseborough, Ingrid; Mathes, Erin; Bhutani, Tina; Ambrosy, Andrew; Aguh, Crystal; Bergfeld, Wilma; Callender, Valerie D; Castelo-Soccio, Leslie; Cotsarelis, George; Craiglow, Brittany Gareth; Desai, Nisha S; Doche, Isabella; Duque-Estrada, Bruna; Elston, Dirk M; Goh, Carolyn; Goldberg, Lynne J; Grimalt, Ramon; Jabbari, Ali; Jolliffe, Victoria; King, Brett A; LaSenna, Charlotte; Lenzy, Yolanda; Lester, Jenna C; Lortkipanidze, Nino; Sicco, Kristen I Lo; McMichael, Amy; Meah, Nekma; Mesinkovska, Natasha; Miteva, Mariya; Mostaghimi, Arash; Ovcharenko, Yuliya; Piliang, Melissa; Piraccini, Bianca Maria; Rakowska, Adriana; Salkey, Kimberly S; Schmidt, Adriana; Shapiro, Jerry; Sibbald, Cathryn; Sinclair, Rodney; Suchonwanit, Poonkiat; Taylor, Susan; Tosti, Antonella; Vañó-Galván, Sergio; Wall, Dmitri Robert; Fu, Jennifer M
Source: JAMA Dermatology, vol 161, iss 1
Publisher Information: eScholarship, University of California
Publication Year: 2025
Collection: University of California: eScholarship
Subject Terms: 32 Biomedical and Clinical Sciences (for-2020); 3202 Clinical Sciences (for-2020); 42 Health Sciences (for-2020); Pediatric (rcdc); Patient Safety (rcdc); 6.1 Pharmaceuticals (hrcs-rac); Humans (mesh); Minoxidil (mesh); Alopecia (mesh); Delphi Technique (mesh); Administration; Oral (mesh); Off-Label Use (mesh); Consensus (mesh); Child (mesh); Adolescent (mesh); Adult (mesh); Vasodilator Agents (mesh); 1103 Clinical Sciences (for); 1112 Oncology and Carcinogenesis (for)
Subject Geographic: 87 - 95
Description: Importance: The results of small studies suggest that off-label use of low-dose oral minoxidil (LDOM) may be safe and effective for patients with hair loss, but larger trials and standardized guidelines are lacking. Objective: To create an expert consensus statement for LDOM prescribing for patients with hair loss. Evidence Review: The current literature on the pharmacological properties, adverse effect profile, and use of LDOM for patients with hair loss was reviewed. Topics of interest were identified, and a modified Delphi consensus process was created. A total of 43 hair loss specialist dermatologists from 12 countries participated in a modified Delphi process. Consensus was reached if at least 70% agreed or strongly agreed on a 5-point Likert scale. Findings: Over 4 survey rounds, 180 items in the first round, 121 items in the second round, 16 items in the third round, and 11 items in the fourth round were considered and revised. A total of 76 items achieved consensus including diagnoses for which LDOM may provide direct or supportive benefit, indications for LDOM compared to topical minoxidil, dosing for adults (18 years and older) and adolescents (aged 12 to 17 years), contraindications, precautions, baseline evaluation, monitoring, adjunctive therapy, and specialty consultation. Pediatric use and dosing items for children younger than 12 years, and LDOM titration protocols fell short of consensus. Conclusions and Relevance: This international expert consensus statement regarding the off-label prescribing of LDOM for patients with hair loss can help guide clinical practice until more data emerge. Hair loss experts with experience treating pediatric patients were underrepresented on this expert panel. Future research should investigate best practices for LDOM use in pediatric patients. Other critical topics for further investigation include the comparative efficacy of topical minoxidil vs oral minoxidil, the safety of oral minoxidil for patients with a history of allergic contact dermatitis to topical ...
Document Type: article in journal/newspaper
File Description: application/pdf
Language: unknown
Relation: qt2pp1b5gc; https://escholarship.org/uc/item/2pp1b5gc; https://escholarship.org/content/qt2pp1b5gc/qt2pp1b5gc.pdf
DOI: 10.1001/jamadermatol.2024.4593
Availability: https://escholarship.org/uc/item/2pp1b5gc; https://escholarship.org/content/qt2pp1b5gc/qt2pp1b5gc.pdf; https://doi.org/10.1001/jamadermatol.2024.4593
Rights: CC-BY
Accession Number: edsbas.D39DAB4E
Database: BASE