Treatment of Monilethrix with Oral Minoxidil

Monilethrix is a hair shaft disorder characterized by hair fragility, keratosis pilaris, and pathognomonic beading of the hair shaft. There is no cure for monilethrix, but reduction in hairdressing trauma may diminish weathering and improve severely affected cases. Two women with monilethrix who responded to 6 months of treatment with low-dose oral minoxidil are described. Minoxidil is known to induce hypertrichosis, prolong anagen duration, and increase hair diameter. Oral minoxidil is a promising treatment for hair loss associated with monilethrix. When used in low doses it appears to be well tolerated. Based on observations in male and female pattern hair loss, it is likely that long-term maintenance treatment will be required to prevent relapse of hair loss. Patients receiving long-term treatment should have regular monitoring of their blood pressure and pulse rate, as oral minoxidil has been associated with postural hypotension and tachycardia. Facial hypertrichosis can occur with both oral and topical minoxidil. Further studies are required to document safety and efficacy.