Season 7, Episode 3: Oral vs Topical Minoxidil for Androgenetic Alopecia

In this episode of the Evidence-Based Hair Podcast hair loss specialist Dr. Jeff Donovan breaks down the findings of a recent study comparing oral minoxidil and topical minoxidil in the treatment of male androgenetic alopecia. Published in JAMA Dermatology, the study challenged popular opinions by revealing similar performance between the two types of minoxidil, putting a spotlight on the importance of robust evidence from randomized controlled trials. Interestingly, Dr. Donovan examined the historical usage of oral minoxidil, once a blood pressure medication, in treating hair loss and the subsequent need for more rigorous studies to solidify its effectiveness. The episode also covers the surprising conclusion that oral minoxidil did not significantly outperform its topical counterpart, contrary to what the mainstream assumes. Diving deeper into the debate, Dr. Donovan explored differing perspectives derived from the Pantchprateep et al and Penha et al studies of oral minoxidil. Where the Panchaprateep et al study suggested that all patients saw some improvement, the Penha et al study showed that not all participants experienced the same positive results. In an in-depth examination of the 'Oral Minoxidil versus Topical Minoxidil for Male Androgenetic Alopecia: A Randomized Clinical Trial', the potential side effects, including minor adverse effects of both treatments were also discussed. While not definitive in recommending one treatment over the other, the episode sparks stimulating discussions around the efficacy of oral minoxidil, its comparison to topical minoxidil, and the potential of randomized controlled trials in determining the optimal treatment for male androgenetic hair loss.       STUDIES REVIEWED IN THIS EPISODE Penha MA et al. Oral Minoxidil vs Topical Minoxidil for Male Androgenetic Alopecia: A Randomized Clinical Trial. JAMA Dermatol . 2024 Apr 10:e240284. doi: 10.1001/jamadermatol.2024.0284. Online ahead of print     Panchaprateep et al. Efficacy and Safety of Oral Minoxidil 5 mg Once Daily in the Treatment of Male Patients with Androgenetic Alopecia: An Open-Label and Global Photographic Assessment. Dermatol Ther. 2020 Dec;10(6):1345-1357