Safety and Tolerability of Low-Dose Oral Minoxidil in Adolescents: A Retrospective Review

This retrospective review evaluated the safety and tolerability of low-dose oral minoxidil (LDOM) in 192 adolescents aged 13-18 years treated for hair loss at a specialist clinic between January 2000 and March 2020. The study included patients with androgenetic alopecia (101) and alopecia areata or alopecia totalis (91). The mean treatment duration was 20.12 months, with a mean starting dose of 0.43 mg/day and a mean final dose of 0.99 mg/day. Adverse events were reported in 65 patients (34%), with hypertrichosis being the most common (22 cases). Other mild adverse events included postural hypotension, nausea, headaches, and palpitations/tachycardia. No serious adverse events were noted, and there were no significant differences in adverse event frequency between LDOM and sublingual minoxidil (SLM). The study concluded that LDOM and SLM have an acceptable safety and tolerability profile in adolescents, though larger placebo-controlled trials are needed to establish optimal dosing and safety in this population.