Journal article
Low-Dose Oral Minoxidil Initiation for Patients With Hair Loss: An International Modified Delphi Consensus Statement
JAMA dermatology (Chicago, Ill.), Vol.161(1), pp.87-95
01/01/2025
DOI: 10.1001/jamadermatol.2024.4593
PMID: 39565602
Abstract
The results of small studies suggest that off-label use of low-dose oral minoxidil (LDOM) may be safe and effective for patients with hair loss, but larger trials and standardized guidelines are lacking.
To create an expert consensus statement for LDOM prescribing for patients with hair loss.
The current literature on the pharmacological properties, adverse effect profile, and use of LDOM for patients with hair loss was reviewed. Topics of interest were identified, and a modified Delphi consensus process was created. A total of 43 hair loss specialist dermatologists from 12 countries participated in a modified Delphi process. Consensus was reached if at least 70% agreed or strongly agreed on a 5-point Likert scale.
Over 4 survey rounds, 180 items in the first round, 121 items in the second round, 16 items in the third round, and 11 items in the fourth round were considered and revised. A total of 76 items achieved consensus including diagnoses for which LDOM may provide direct or supportive benefit, indications for LDOM compared to topical minoxidil, dosing for adults (18 years and older) and adolescents (aged 12 to 17 years), contraindications, precautions, baseline evaluation, monitoring, adjunctive therapy, and specialty consultation. Pediatric use and dosing items for children younger than 12 years, and LDOM titration protocols fell short of consensus.
This international expert consensus statement regarding the off-label prescribing of LDOM for patients with hair loss can help guide clinical practice until more data emerge. Hair loss experts with experience treating pediatric patients were underrepresented on this expert panel. Future research should investigate best practices for LDOM use in pediatric patients. Other critical topics for further investigation include the comparative efficacy of topical minoxidil vs oral minoxidil, the safety of oral minoxidil for patients with a history of allergic contact dermatitis to topical minoxidil, the long-term safety of LDOM, and the use of other off-label forms of minoxidil, such as compounded formulations of oral minoxidil and sublingual minoxidil. As additional evidence-based data emerge, these recommendations should be updated.
Details
- Title: Subtitle
- Low-Dose Oral Minoxidil Initiation for Patients With Hair Loss: An International Modified Delphi Consensus Statement
- Creators
- Yagiz Matthew Akiska - George Washington UniversityParadi Mirmirani - Kaiser Permanente Vallejo Medical CenterIngrid Roseborough - University of California, San FranciscoErin Mathes - University of California, San FranciscoTina Bhutani - University of California, San FranciscoAndrew Ambrosy - Kaiser PermanenteCrystal Aguh - Johns Hopkins UniversityWilma Bergfeld - Cleveland ClinicValerie D Callender - Howard UniversityLeslie Castelo-Soccio - National Institute of Arthritis and Musculoskeletal and Skin DiseasesGeorge Cotsarelis - University of PennsylvaniaBrittany Gareth Craiglow - Yale UniversityNisha S DesaiIsabella Doche - Universidade de São PauloBruna Duque-Estrada - CASADirk M Elston - Medical University of South CarolinaCarolyn Goh - University of California, Los AngelesLynne J Goldberg - Boston UniversityRamon Grimalt - Universitat Internacional de CatalunyaAli Jabbari - University of IowaVictoria Jolliffe - Queen Mary University of LondonBrett A King - Yale UniversityCharlotte LaSenna - University of Wisconsin–MadisonYolanda Lenzy - University of ConnecticutJenna C Lester - University of California, San FranciscoNino Lortkipanidze - David Tvildiani Medical UniversityKristen I Lo Sicco - NYU Langone HealthAmy McMichael - Wake Forest UniversityNekma Meah - Mersey Care NHS TrustNatasha Mesinkovska - University of California, IrvineMariya Miteva - University of MiamiArash Mostaghimi - Brigham and Women's HospitalYuliya Ovcharenko - V. N. Karazin Kharkiv National UniversityMelissa Piliang - Cleveland ClinicBianca Maria Piraccini - Azienda USL di BolognaAdriana Rakowska - Medical University of WarsawKimberly S Salkey - Virginia Commonwealth UniversityAdriana Schmidt - Santa Monica Dermatology Group, Santa Monica, CaliforniaJerry Shapiro - New York UniversityCathryn Sibbald - University of TorontoRodney Sinclair - Sinclair DermatologyPoonkiat Suchonwanit - Ramathibodi HospitalSusan Taylor - University of PennsylvaniaAntonella Tosti - University of MiamiSergio Vañó-Galván - Universidad de AlcaláDmitri Robert Wall - University College DublinJennifer M Fu - University of California, San Francisco
- Resource Type
- Journal article
- Publication Details
- JAMA dermatology (Chicago, Ill.), Vol.161(1), pp.87-95
- DOI
- 10.1001/jamadermatol.2024.4593
- PMID
- 39565602
- NLM abbreviation
- JAMA Dermatol
- ISSN
- 2168-6068
- eISSN
- 2168-6084
- Publisher
- AMER MEDICAL ASSOC
- Grant note
- University of California, San Francisco, Department of Dermatology, Medical Student Summer Research Fellowship ProgramUniversity of California, San Francisco, Department of Dermatology, Medical Student Summer Research Fellowship Program
The University of California, San Francisco, Department of Dermatology, Medical Student Summer Research Fellowship Program provided funding for this work.
- Language
- English
- Electronic publication date
- 11/20/2024
- Date published
- 01/01/2025
- Academic Unit
- Dermatology
- Record Identifier
- 9984751759502771
Metrics
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