Off-Label Use of Topical Minoxidil in Alopecia: A Review

January 2019 in “ American Journal of Clinical Dermatology ”

Jenna R. Stoehr, Jennifer N. Choi, Maria L. Colavincenzo, Stefan Vanderweil

topical minoxidil alopecia alopecia areata scarring alopecia eyebrow hypotrichosis monilethrix telogen effluvium chemotherapy-induced alopecia Rogaine

From the encyclopedia

Alopecia Areata →

autoimmune disorder causing patchy hair loss

Minoxidil →

An essential vasodilator with some anti-androgenic effects

Studysummary This review discusses the use of topical minoxidil for various types of alopecia and reports mixed evidence on its efficacy, with stronger support noted for conditions like eyebrow hypotrichosis and chemotherapy-induced alopecia.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

This article is a review of the off-label use of topical minoxidil in treating various types of alopecia. While the evidence for its effectiveness in some conditions, such as alopecia areata and scarring alopecia, is inconclusive, there is evidence to support its use in treating eyebrow hypotrichosis, monilethrix, and early telogen effluvium, as well as shortening the duration of chemotherapy-induced alopecia. As research continues, further conclusions may be drawn about the role of minoxidil in the treatment of alopecia.

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research Minoxidil-Induced Hypertrichosis in a Child with Alopecia Areata

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research Infantile Generalized Hypertrichosis Caused by Topical Minoxidil

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research Monilethrix: A Typical Case Report with Microscopic and Dermatoscopic Findings

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research Frontal Fibrosing Alopecia: A Survey in 16 Patients

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research Chronic Telogen Effluvium: Incidence, Clinical and Biochemical Features, and Treatment

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research A Randomized Trial of Minoxidil in Chemotherapy-Induced Alopecia

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research Minoxidil as a Prophylaxis of Doxorubicin-Induced Alopecia

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research Postmenopausal Frontal Fibrosing Alopecia

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research Treatment of Chronic Severe Alopecia Areata with Topical Diphenylcyclopropenone and 5% Minoxidil: A Clinical and Immunopathologic Evaluation

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research Systemic Steroids With or Without 2% Topical Minoxidil in the Treatment of Alopecia Areata

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research Topical Minoxidil Therapy for Androgenetic Alopecia

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research Safety and Efficacy of Topical Minoxidil in the Management of Androgenetic Alopecia

67 citations , March 1987 in “Journal of The American Academy of Dermatology”

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research Topical Minoxidil (3%) in Extensive Alopecia Areata, Including Long-Term Efficacy

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research Minoxidil Stimulates Cutaneous Blood Flow in Human Balding Scalps: Pharmacodynamics Measured by Laser Doppler Velocimetry and Photopulse Plethysmography

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research Topical Minoxidil in the Treatment of Alopecia Areata

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