Topical Minoxidil for Androgenetic Alopecia: When Blood Pressure Agents Make You Hairy

Topical minoxidil is effective in improving hair density for individuals with androgenetic alopecia, showing an increase of about 21 hairs/cm² compared to 5 to 9 hairs/cm² with placebo after 16 to 48 weeks. The study includes data from several randomized controlled trials with a total of 1,074 to 1,924 participants. Both oral and topical minoxidil are similarly effective, though they have different side effects. Finasteride may be more effective than topical minoxidil in men. Adverse effects of minoxidil include hypertrichosis, headaches, and scalp eczema, with oral minoxidil causing more severe side effects than topical. The clinical significance of the increase in hair density is unclear, and patient satisfaction is not well-studied. The study highlights the multifactorial nature of androgenetic alopecia and the importance of topical minoxidil as a mainstay treatment.