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Efficacy and Safety of Oral Minoxidil in Comparison to Topical Form in Male Pattern Hair Loss Publisher



E Yousefi ELHAM ; Ms Ansari Mahshid SADAT ; S Shakoeinejad SAFOURA ; V Lajevardi VAHIDEH ; Sm Vahabi Seyed MOHAMMAD ; F Motavalli FARHAD ; Jch Donovan Jeff CH ; M Nasimi MARYAM
Authors

Source: Archives of Dermatological Research Published:2025


Abstract

Androgenetic alopecia (AGA) is the most common type of hair loss affecting both males and females, and the incidence increases with age. Currently approved treatment options include topical minoxidil in males and females and oral finasteride in males. Recent studies suggest oral minoxidil is a promising agent with an acceptable side effect profile. The objective of the study was to evaluate the efficacy and safety of oral minoxidil compared to topical minoxidil in patients with male pattern AGA. A randomized controlled trial was conducted from April 2022 to April 2023 at the Alopecia Clinic of a tertiary dermatology hospital. Men over 18 years of age, with AGA, were included. Patients were randomly assigned to receive oral minoxidil 2.5 mg once daily or topical minoxidil 5% solution once daily. Clinical and trichoscopic evaluations were conducted at baseline, and at 6 months. In this study with 42 participants, oral minoxidil significantly increased hair thickness, counts, and density in both frontal and vertex areas compared to topical minoxidil. Furthermore, anagen rates and density increased, and telogen and vellus rates significantly decreased in the oral minoxidil group. After 6 months, oral minoxidil showed higher effectiveness than topical minoxidil, with significant improvements in hair characteristics and density. The topical minoxidil group did not exhibit significant changes in mean thickness and hair counts. Oral minoxidil at 2.5 mg daily is more effective than topical minoxidil therapy for hair growth. With tolerable side effects and better compliance, oral minoxidil could become a first-line treatment for healthy males with AGA. © 2025 Elsevier B.V., All rights reserved.
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