Role of Systemic Minoxidil in the Treatment of Alopecia Areata: A Scoping Review to Direct Future Research

The review discusses traditional hair loss treatments like minoxidil and finasteride, and newer options like Low-Level Laser Therapy, microneedling, and platelet-rich plasma for androgenetic alopecia. It highlights the need for more high-quality trials to assess these treatments' effectiveness and standardized protocols for emerging therapies.

Minoxidil may inhibit androgen receptors and affect hormonal pathways, potentially explaining its effectiveness in treating androgenetic alopecia (AGA). Users discuss its varying effectiveness on scalp versus facial hair and note fewer side effects with topical use compared to oral.

Minoxidil's effectiveness varies due to differences in sulfotransferase enzyme levels in the scalp, affecting people with conditions like ASD, liver disease, and androgenic alopecia. Treatments like topical tretinoin, microneedling, and using minoxidil sulfate instead of regular minoxidil can improve results for those with low enzyme levels.

Oral dutasteride is the most effective for hair regrowth, followed by oral finasteride and minoxidil. Topical finasteride combined with minoxidil is recommended for those avoiding systemic DHT reduction.

Oral minoxidil, finasteride, and dutasteride are being used to treat hair loss, but results are limited, leading to consideration of a hair transplant. The user plans to continue medication for another year before deciding on further action.

Minoxidil should be applied directly to the scalp for effectiveness, as applying it elsewhere may not work and could cause systemic effects. Alternatives like oral minoxidil are not suitable for everyone due to potential side effects like severe water retention.