Minoxidil: a final judgment or a hope?

Gadzhigoroeva A.G.

doi:https://doi.org/10.17116/klinderma201615496-101

Close metadata

Recommended articles:

Features of peroxide-antioxidant imbalance in patients with rosacea and approaches to comprehensive therapy. Russian Journal of Clinical Dermatology and Venereology. 2025;(4):439-444

Modern aspects of diagnostic and therapeutic approaches in the management of patients with recurrent anogenital warts. Russian Journal of Clinical Dermatology and Venereology. 2025;(5):658-665

Features of the clinical course of multiple sclerosis as a factor in persistent disability. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(7-2):39-44

Traumatic injuries of the rectum and anus in childhood. Pirogov Russian Journal of Surgery. 2025;(8):62-66

Course and outcomes of pregnancy in patients with multiple pregnancies with rhesus isoimmunization. Russian Bulletin of Obstetrician-Gynecologist. 2025;(4):59-65

Chronic traumatic encephalopathy. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(8):16-24

Burnout syndrome: prevention, treatment and rehabilitation. Regenerative Biotechnologies, Preventive, Digital and Predictive Medicine. 2025;(3):61-68

Evidence-based management of patients with acute viral sinusitis: a review of therapeutic strategies. Russian Rhinology. 2025;(3):242-249

Modern treatment of patients with cervical cancer. Russian Bulletin of Obstetrician-Gynecologist. 2025;(6):29-36

Features of arterial hypertension in individuals with anxiety disorders. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(11):44-51

Abstract:

Minoxidil is a basic drug for the topical treatment of androgenetic alopecia in males and females. Meanwhile, the attitude of both patients and medical professionals to minoxidil is controversial. Insufficient understanding of the etiology of various forms of hair loss, lack of clear understanding of the mechanisms of interaction between minoxidil and target cells, particularly the hair follicle cells, as well as specific reactions of the hair itself at the early stages of treatment, compromise drug effect on the hair and the entire human body, which results in limited therapeutic potential in treatment of hair loss and reduces patients’ compliance. This article provides an overview of the research of stimulatory mechanisms of minoxidil on hair growth, clinical efficacy and benefits of the use of foam-like dosage form of the drug in patients with androgenetic alopecia.

Keywords:

minoxidil

minoxidil foam

androgenetic alopecia

treatment

Authors:

Gadzhigoroeva A.G.

I.M. Sechenov Moscow Medical Academy

Close metadata

References:

Meisheri KD, Cipkus LA, Taylor CJ. Mechanism of action of minoxidil sulfateinduced vasodilation: a role for increased K+ permeability. J Pharmacol Exp Ther 1988; 245: 751-760.
Winquist RJ, Heaney LA, Wallace AA et all. Glyburide blocks the relaxation response to BRL 34915 (cromakalin), minoxidil sulfate and diazoxide in vascular smooth muscle. J Pharmacol Exp Ther 1989; 248: 149-156.
Yost CS. Potassium channels. Basic aspects, functional roles and medical significance. Anesthesiol 1999; 90: 1186-1203.
Yokoshiki H, Sunagawa M, Seki T et all. ATP-sensitive K+ channels in pancreatic, cardiac and vascular smooth muscle cells. Am J Physiol 1998; 274: C25-C37.
Schwanstecher M, Sieverding C, Dorschner H et all. Potassium chanel openers require ATP to bind to and act through sulfonylurea receptors. EMBO J 1998; 17: 5529-5535.
Li M, Marubayashi A, Nakaya Y et all. Minoxidil-induced hair growth is mediated by adenosine in cultured dermal papilla cells: possible involvement of sulfonylurea receptor 2B as a target of minoxidil. J Invest Dermatol 2001; 117: 1594-6000.
Ferrara N, Carver-Moore K, Chen H et al. Heterozygous embryonic lethality induced by targeted inactivation of the VEGF gene. Nature. 1996; 380: 439–442.
Yano K, Brown LF, Detmar M. Control of hair growth and follicle size by VEGF-mediated angiogenesis. J. Clin. Invest. 2001; 107 (4): 409–417.
Goldman CK, Tsai JC, Soroceanu L et al. Loss of vascular endothelial growth factor in human alopecia hair follicles. J. Invest. Dermatol. 1995; 104: 18–20.
Kozlowska R, Blume-Peytavi U, Kodelja V. Expression of vascular endothelial growth factor (VEGF) in various compartments of the human hair follicle. Arch. Dermatol. Res. 1998; 290: 661–668.
Lachgar S, Charveron M, Gall Y et al. Minoxidil upregulates the expression of vascular endothelial growth factor in human hair dermal papilla cells. Br. J. Dermatol. 1998; 138: 407–411.
Johnson GA, Barsuhn KJ, McCall JM. Sulfation of minoxidil by liver sulfotransferase. Biochem Pharmacol 1982; 31:2949-2954.
Falany CN, Kerl EA. Sulfation of minoxidil by human liver phenol sulfotransferase. Biochem Pharmacol 1990; 40: 1027-1032.
Johnson GA, Baker CA. Sulfation of minoxidil by human platelet sulfotransferase. Clin Chim Acta 1987; 169: 217-227.
Johnson GA, Baker CA, Knight KA. Minoxidil sulfotransferase, a marker of human keratinocyte differentiation. J Invest Dermatol 1992; 98: 730-733.
Buhl AE, Waldon DJ, Baker CA et all. Minoxidil sulfate is the active metabolite that stimulates hair follicles. J Invest Dermatol 1990; 95: 553-557.
Dooley TP, Walker CJ, Hirshey SJ et all. Localization of minoxidil sulfotransferase in rat liver and the outer root sheath of anagen pelage and vibrissa follicles. J Invest Dermatol 1991; 96: 65-70.
Hamamoto T, Mori Y. Sulfation of minoxidil in keratinocytes and hair follicles. Res Commun Chem Pathol Pharmacol 1989; 66: 33-44.
Baker CA, Uno H, Johnson GA. Minoxidil sulfation in the hair follicle. Skin Pharmacol 1994; 7: 335-339.
Dooley TP. Molecular biology of the human cytosolic sulferotransferase gene superfamily implicated in the bioactivation of minoxidil and cholesterol in skin. Exp Dermatol 1999; 8: 328-329.
Dooley TP. Molecular biology of the human cytosolic sulferotransferase gene superfamily implicated in the bioactivation of minoxidil and cholesterol in skin. Exp Dermatol 1999; 8: 328-329.
Buhl AE, Waldon DJ, Baker CA, Johnson GA. Minoxidil sulfate is the active metabolite that stimulates hair follicles. J Invest Dermatol 1990: 95 (5): 553–577. 23. Baker CA, Uno H, Johnson GA. Minoxidil sulfation in the hair follicle. Skin Pharmacol 1994: 7 (6): 335–339.
Anderson RJ, Kudlacek PE, Clemens DL. Sulfation of minoxidil by multiple human cytosolic sulfotransferases. Chem Biol Interact 1998: 109 (1–3): 53–67.
Buhl AE, Baker CA, Dietz AJ et all. Minoxidil sulfotransferase activity influence the efficacy of Rogaine topical solution (TS): enzyme studies using scalp and platelets. J Invest Dermatol 1994; 102: 534.
Anderson RJ, Kudlacek PE, Clemens DL. Sulfation of minoxidil by multiple human cytosolic sulfotransferases. Chem Biol Interact 1998; 109: 53-67.
Goren A, Castano JA, McCoy J, Bermudez F, Lotti T. Novel enzymatic assay predicts minoxidil response in the treatment of androgenetic alopecia. Dermatol Ther. 2014 May-Jun;27(3):171-173.
Roberts J, Desai N, McCoy J & Goren A. Sulfotransferase activity in plucked hair follicles predicts response to topical minoxidil in the treatment of female androgenetic alopecia Dermatologic Therapy, 2014; 27:252–254.
Blumeyer A1, Tosti A, Messenger A, Reygagne P, Del Marmol V, Spuls PI, Trakatelli M, Finner A, Kiesewetter F, Trüeb R, Rzany B, Blume-Peytavi U; European Dermatology Forum (EDF). Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men. J Dtsch Dermatol Ges. 2011 Oct;9 Suppl 6:S1-57.
Franz TJ. Percutaneous absorption of minoxidil in men. Arch Dermatol 1985 Feb;121(2):203-206.
Mahe YF, Michelet JF, Billoni N, Jarousse F, Buan B, Commo S, Seint-Leger D, Bernard BA (2000) Androgenetic alopecia and microinflammation. Int J Dermatol 39:576-584.
Piérard-Franchimont C, De Doncker P, Cauwenbergh G, Piérard GE. Ketoconazole shampoo: effect of long-term use in androgenic alopecia. Dermatology. 1998;196(4):474-477.
Warshaw EM, Botto NC, Maibach HI, Fowler JF Jr, Rietschel RL, Zug KA, et al. Positive patch-test reactions to propylene glycol: a retrospective cross-sectional analysis from the North American Contact Dermatitis Group, 1996 to 2006. Dermatitis 2009; 20:14-20.
Lessmann H, Schnuch A, Geier J, Uter W. Skin-sensitizing and irritant properties of propylene glycol. Contact Dermatitis 2005;53:247-259.
Olsen EA, Whiting D, Bergfeld W, Miller J, Hordinsky M, Wanser R, et al. A multicenter, randomized, placebo-controlled, doubleblind clinical trial of a novel formulation of 5% minoxidil topical foam versus placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol 2007; 57 (5):767-774.
Olsen EA, Dunlap FE, Funicella T, Koperski JA, Swinehart JM, Tschen EH, et al. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol 2002;47:377-385.
Ulrike Blume-Peytavi, Kathrin Hillmann, Ekkehart Dietz, Douglas Canfield, and Natalie Garcia Bartels. A randomized, single-blind trial of 5% minoxidil foam once daily versus 2% minoxidil solution twice daily in the treatment of androgenetic alopecia in women. J Am Acad Dermatol. 2011 Dec;65(6):1126-1134.
van Zuuren EJ, Fedorowicz Z, Carter B, Andriolo RB, Schoones J. Interventions for female pattern hair loss. Cochrane Database Syst Rev 2012: (5): CD007628.
DeVillez RL, Jacobs JP, Szpunar CA, Warner ML. Androgenetic alopecia in the female. Treatment with 2% topical minoxidil solution. Arch Dermatol 1994: 130 (3):303–307.
Jacobs JP, Szpunar CA,Warner ML. Use of topical minoxidil therapy for androgenetic alopecia in women. Int J Dermatol 1993: 32 (10): 758–762.
Olsen EA. Topical minoxidil in the treatment of androgenetic alopecia in women. Cutis 1991: 48 (3): 243–248.
Lucky AW, Piacquadio DJ, Ditre CM, et al. A randomized, placebo-controlled trial of 5% and 2% topical minoxidil solutions in the treatment of female pattern hair loss. J Am Acad Dermatol 2004: 50 (4): 541–553.