Treatment of female pattern hair loss with low dose minoxidil.

Abstract

Background: The oral antihypertensive minoxidil stimulates hair growth, but its use in the treatment of female pattern hair loss (FPHL) is limited by the potential adverse events of postural hypotension, fluid retention and hypertrichosis, Spironolactone is another antihypertensive used to treat FPHL. Method: To investigate the safety and effectiveness of a single once daily oral capsule containing minoxidil 0.25mg and spironolactone 25mg in the treatment of FPHL, women with a Sinclair stage 2-5 FPHL were treated once daily for 12 months. Hair shedding was scored using a 6 point visual analogue scale. Patients were reviewed 3 monthly and blood pressure an side-effects documented. Full blood count, renal function, electrolytes and liver function were monitored at 3 monthly intervals. Results: 100 women were enrolled. mean age was 48.44 years (range 18-80). mean hair loss severity at baseline was Sinclair 2.79(range 1-5). mean hair shedding score at baseline was 4.82. mean reduction in hair loss severity score was 0.85 at 6 months and 1.3 at 12 months. Side effects were seen in 8 of women but were generally mild. No patients developed hyperkalaemia or any other blood test abnormality. Six of these women continued treatment and 2 women who developed urticaria discontinued treatment. Discussion: Once daily minoxidil / spironolactone appears to be safe and effective in the treatment of FPHL. Placebo controlled to investigate this further are warranted.