Most prescribers favor oral minoxidil for androgenetic alopecia

Key takeaways:

• 81% of surveyed prescribers were in support of using oral minoxidil to treat androgenetic alopecia.
• Prescribers with more than 30 years of experience expressed the least amount of support.

Prescribers have expressed an overall positive opinion toward the off-label use of low-dose oral minoxidil for the treatment of androgenetic alopecia, though opinions varied based on years of experience, according to a study.

“Utilization of low-dose oral minoxidil has increased in recent years in association with several clinical studies that have shown its efficacy in treating [androgenetic alopecia (AGA)] and other hair loss conditions,” Eric Sanfilippo, BS, a student at The George Washington University School of Medicine and Health Sciences, and Adam Friedman, MD, FAAD, professor and chair of dermatology at The George Washington University School of Medicine and Health Sciences, wrote in the Journal of Drugs in Dermatology. “Given that oral minoxidil is not FDA-approved for the treatment of AGA, there is a lack of guidance in prescribing, as well as a lack of consensus regarding its role in treatment.”

Researchers distributed a survey to 2,200 providers to gage their attitudes and recommendation behaviors for prescribing oral minoxidil to treat AGA. The survey received 201 responses, 81% of which were in support of using oral minoxidil to treat hair loss.

The most significant factor that determined whether a practitioner supported the use of minoxidil for AGA was the number of years they have been in practice with more seasoned practitioners (those with more than 30 years of experience) expressing the least amount of support.

“Concerns about safety and side effects were the most cited reasons among those who did not prescribe oral minoxidil and likely played a role in the reticence among those who do not prescribe oral minoxidil,” the researchers wrote.

Also, 83% of respondents recommended patients use topical minoxidil before the oral formulation. Of the respondents that do prescribe oral minoxidil, 44% recommended the simultaneous use of 5% topical minoxidil once daily, whereas 29% of respondents urged against this practice.

The researchers found that 92% of respondents were comfortable prescribing oral minoxidil, 78% felt patients were satisfied with results and 89% believed oral minoxidil to be well tolerated. Additionally, 83% of respondents reported that low-dose oral minoxidil is better than topical minoxidil.

“Our results suggest that [low-dose oral minoxidil] is viewed favorably by most dermatology providers, even among those who do not prescribe it,” the researchers concluded.