TOPLINE:

In a randomized trial, low-dose oral minoxidil at 2.5 mg/d showed comparable hair density gains to 5 mg/d dosing in men with androgenetic alopecia (AGA), with fewer adverse events.

METHODOLOGY:

• Researchers conducted a double-blind, randomized clinical trial at a single center in Brazil of 100 men aged 25-55 years (mean age, 39.5 years) with Norwood-Hamilton stage 3V to 5V AGA; 92 men completed the study.
• Participants were randomly assigned 1:1 to receive either 2.5 mg or 5 mg oral minoxidil daily for 24 weeks.
• At baseline, non-vellus hair density was 144.7 hair/cm² in the 2.5-mg group and 146.1 hair/cm² in the 5-mg group. Total hair density was 214.7 and 194.4 hair/cm², respectively.
• The primary outcome was the change in non-vellus hair density at the vertex; secondary outcomes included total hair density changes, global photographic assessment, and adverse events.

TAKEAWAY:

• At 24 weeks, non-vellus hair density was not significantly different between 2.5- and 5-mg dosing groups (mean difference, 0.9 hair/cm²; P = .403).
• Total hair density was also similar between the groups (mean difference, 3.6 hair/cm²; P = .078).
• Dermatologist-blinded assessment of photographs revealed similar clinical improvement rates between groups (64% for 2.5 mg vs 62% for 5 mg; P = .386); self-reported improvement, however, was higher in the 5-mg group (92% vs 84%; P = .009).
• Adverse events, particularly pedal edema and dizziness, occurred more frequently in the 5-mg group (P = .024), but no significant differences were reported in heart rate or in systolic and diastolic blood pressure.

IN PRACTICE:

“Oral minoxidil 2.5 mg/d showed similar efficacy to 5 mg/d in the treatment of male AGA, with a more favorable safety profile,” the study authors concluded. These findings, they added, “support 2.5 mg/d as a reasonable starting dose in clinical practice.”

SOURCE:

The study was led by Larissa Pierri Carvalho Fonseca, MD, PhD, Department of Dermatology, Faculty of Medicine of Botucatu-Unesp, Botucatu, Brazil, and was published online on September 15 in the Journal of the American Academy of Dermatology.

LIMITATIONS:

Limitations included single-center design and a short follow-up period. 

DISCLOSURES:

The study did not receive any funding, and the authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.