Coming full circle (almost): Low dose oral minoxidil for alopecia

Low-dose oral minoxidil (LDOM), at doses under 5 mg daily, has been explored as a treatment for various forms of alopecia. Randolph and Tosti reviewed 16 studies involving 622 patients and found LDOM to be an effective and well-tolerated alternative, particularly for those who have difficulty with topical formulations. No severe cardiopulmonary adverse reactions were reported, but caution is still advised with monitoring for blood pressure, heart rate, and fluid retention. Beach et al's retrospective study of 74 patients prescribed LDOM (1.25 mg daily for at least 3 months) showed increased scalp hair growth in 65% and decreased hair shedding in 27%, with facial hypertrichosis in 43% and hypotensive symptoms in 8%. LDOM was particularly effective in patients with nonscarring alopecia. The author, Warren R. Heymann, MD, acknowledges the potential of LDOM as a reasonable alternative for many alopecia patients.