Should Oral Minoxidil Be Our First Choice for Treating Alopecia?

    September 2025 in “ International Journal of Trichology ”
    Ralph Michel Trüeb, Natalia Caballero Uribe, Juste Baksanskaite, Cristina Garcia Bielsa
    Studysummary This study discusses the use of low-dose oral minoxidil for hair loss, noting that while it is popular and considered safe, it can mimic Cantú syndrome effects such as hypertrichosis and pericardial effusion, necessitating careful monitoring and caution during prescription.
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    Research cited in this study 22

    1. Secondary Cutis Verticis Gyrata Induced by Long-Term Use of High-Dose Topical Minoxidil Skin Appendage Disorders · 2024
    2. Efficacy, Tolerability, and Superiority of Propylene Glycol-Free, North American Witch-Hazel-Based Solution of 5% Minoxidil Sulfate for the Treatment of Female Androgenetic Alopecia International Journal of Trichology · 2023
    3. Serious Complication of Low-Dose Oral Minoxidil for Hair Loss JAAD case reports · 2022
    4. Pericardial, Pleural Effusion and Anasarca: A Rare Complication of Low-Dose Oral Minoxidil for Hair Loss JAAD case reports · 2022
    5. Comment on Bicalutamide Improves Minoxidil-Induced Hypertrichosis in Female Pattern Hair Loss: A Retrospective Review of 35 Patients Journal of The American Academy of Dermatology · 2022
    6. Minoxidil-Induced Hypertrichosis in a Breastfed Infant Journal of The European Academy of Dermatology and Venereology · 2022
    7. Bicalutamide Improves Minoxidil-Induced Hypertrichosis in Female Pattern Hair Loss: A Retrospective Review of 35 Patients Journal of The American Academy of Dermatology · 2021
    8. Safety of Low-Dose Oral Minoxidil for Hair Loss: A Multicenter Study of 1404 Patients Journal of The American Academy of Dermatology · 2021
    9. Female Pattern Hair Loss: A Pilot Study Investigating Combination Therapy with Low-Dose Oral Minoxidil and Spironolactone International Journal of Dermatology · 2017
    10. Further Clinical Evidence for the Effect of IGF-1 on Hair Growth and Alopecia Skin appendage disorders · 2017
    11. Sulfotransferase Activity in Plucked Hair Follicles Predicts Response to Topical Minoxidil in the Treatment of Female Androgenetic Alopecia Dermatologic Therapy · 2014
    12. Cantú Syndrome Is Caused by Mutations in ABCC9 The American Journal of Human Genetics · 2012
    13. Perifollicular Fibrosis: Pathogenetic Role in Androgenetic Alopecia Biological & Pharmaceutical Bulletin · 2006
    14. Minoxidil: Mechanisms of Action on Hair Growth British Journal of Dermatology · 2004
    15. Pseudoacromegaly Induced by the Long-Term Use of Minoxidil Journal of The American Academy of Dermatology · 2003
    16. Fibrosing Alopecia in a Pattern Distribution Archives of dermatology · 2000
    17. In the Absence of Streptomycin, Minoxidil Potentiates the Mitogenic Effects of Fetal Calf Serum, Insulin-Like Growth Factor 1, and Platelet-Derived Growth Factor on NIH 3T3 Fibroblasts in a K+ Channel-Dependent Fashion Journal of Investigative Dermatology · 1996
    18. Stimulation of Elastin Expression by Minoxidil in Chick Skin Fibroblasts Archives of Dermatological Research · 1995
    19. Diagnostic and Predictive Value of Horizontal Sections of Scalp Biopsy Specimens in Male Pattern Androgenetic Alopecia Journal of The American Academy of Dermatology · 1993
    20. Sulfation of Minoxidil in Keratinocytes and Hair Follicles and the Stimulatory Effect of Minoxidil on the Biosynthesis of Glycosaminoglycans Annals of the New York Academy of Sciences · 1991
    21. Suppression of Fibroblast Proliferation and Lysyl Hydroxylase Activity by Minoxidil Journal of Biological Chemistry · 1987
    22. Minoxidil and Pericardial Effusion: An Idiosyncratic Reaction Clinical Pharmacology & Therapeutics · 1981