Minoxidil dose response study in female pattern hair loss patients determined to be non-responders to 5% topical minoxidil.

Topical minoxidil is the only US FDA approved drug for the treatment of female pattern hair loss (FPHL). 5% minoxidil foam is only effective at re-growing hair in a minority of women (approximately 40%). Thus, the majority of FPHL patients remain untreated. Previously, we demonstrated that nonresponders to 5% minoxidil have low metabolism of minoxidil in hair follicles. As such, we hypothesized that increasing the dosage of topical minoxidil to low metabolizers would increase the number of responders without increasing the incidence of adverse events. In this study, we recruited FPHL subjects that were identified as non-responders to 5% topical minoxidil utilizing the previously validated assay for minoxidil response. Subjects were treated for 12 weeks with a novel 15% topical minoxidil solution. At 12 weeks, 60% of subjects achieved a clinically significant response based on target area hair counts (>13.7% from baseline), as well as significant improvement in global photographic assessment. None of the subjects experienced significant hemodynamic changes or any other adverse events. To the best of our knowledge, this is the first study to demonstrate the potentially beneficial effect of a higher dosage of minoxidil in FPHL subjects who fail to respond to 5% minoxidil.

• Hair loss without scarring of the scalp is a very common condition and affects most people at some time in their lives.
• Medical professionals should distinguish hair loss from breakage of the hair shaft from hair loss due to decreased hair growth.
• Common balding (androgenetic alopecia) occurs in men and women and is due to the effect of testosterone metabolites in genetically susceptible hair follicles.
• Thyroid disease, anemia, protein deficiency, secondary syphilis, chemotherapy, and low vitamin levels may cause hair loss.
• Alopecia areata is a form of hair loss produced by the autoimmune destruction of hair follicles in localized areas of skin.
• Medications indicated for hair regrowth include minoxidil (Rogaine) and finasteride (Propecia).
• Prevention of hair loss includes good hair hygiene, regular shampooing, and good nutrition.
• Medical health screening for hair loss may include blood tests such as complete blood count (CBC), iron level, vitamin B, thyroid function tests (TFT), and a biopsy of the scalp.

Because there are many types of hair loss, finding the cause can be challenging. This review will cover the most common causes of hair loss occurring on normal unscarred scalp skin. The medical term for hair loss is alopecia.

Most hair loss is not associated with the systemic or internal disease, nor is poor diet a frequent factor. Hair may simply thin as a result of predetermined genetic factors and the overall aging process. Many men and women may notice mild physiologic thinning of hair starting in their 30s and 40s. Life vicissitudes, including illness, emotional trauma, protein deprivation (during strict dieting), and hormonal changes like those in pregnancy, puberty, and menopause may cause hair loss.

Several health conditions, including thyroid disease, iron deficiency anemia, and secondary syphilis, can cause hair loss. While thyroid blood tests and other lab tests, including a complete blood count (CBC), on people who have ordinary hair loss are usually normal, it is important to exclude treatable causes of hair loss.