Minoxidil is a piperidinopyrimidine derivative that was FDA approved for the treatment of androgenetic alopecia (AGA). Minoxidil is available for both oral and topical use. In a study of oral versus topical minoxidil for the treatment of AGA in men, oral minoxidil (5 mg once daily for 24 weeks) did not show superiority over topical minoxidil (5% twice daily). And with the higher risk of systemic side effects with oral medications, topical minoxidil is the first line of treatment for male pattern baldness, female pattern baldness, pemphigus, and many other hair loss conditions.

Topical Minoxidil is subdivided into Minoxidil Spray and Minoxidil Foam, both of which are known to slow hair loss and promote hair regrowth. However, Minoxidil Foam has fewer side effects due to the fact that Minoxidil Spray solutions usually contain propylene glycol, the compound responsible for many of Minoxidil's side effects.

Studies have shown that Minoxidil 5% Spray has a good therapeutic effect in about 85% of patients, and 62% of patients have a smaller area affected by hair loss. Side effects of Minoxidil Spray include: rash, itchy scalp, allergic contact dermatitis, excessive hair growth on the body or face (hirsutism) and hair loss. In order to reduce side effects, the clinical development of platelet rich plasma (PRP) and minoxidil combination therapy has become the new non-surgical treatment for AGA, which has minimal side effects, a good safety profile, and high patient satisfaction. In addition, the use of fractionated laser and 5% minoxidil combination therapy is also more effective than 5% minoxidil alone.

References:

[1] PENHA M A, MIOT H A, KASPRZAK M, et al. Oral Minoxidil vs Topical Minoxidil for Male Androgenetic Alopecia[J]. JAMA dermatology, 2024. DOI:10.1001/jamadermatol.2024.0284.

[2] ADARSH GOWDA  B. C S K  Sana Sankey. Comparative study of efficacy of minoxidil versus minoxidil with platelet rich plasma versus minoxidil with dermaroller in androgenetic alopecia[J]. International Journal of Research in Dermatology, 2021. DOI:10.18203/ISSN.2455-4529.INTJRESDERMATOL20210582.

[3] MAITHA RASHED  B. G  L Sharaf. Comparative Study of The Effect of Topical Minoxidil 5% Versus Combined Fractional CO2 Laser and Topical Minoxidil 5% in Treatment of Male Androgenetic Alopecia[J]. The Egyptian Journal of Hospital Medicine, 2022. DOI:10.21608/ejhm.2022.215574.