The doctors have used topical minoxidil for almost 40 years to treat alopecia. There is growing evidence supporting off‐label use of low‐dose oral minoxidil. The researchers have taken the initiative to conduct a systematic review evaluating oral minoxidil use for all types of alopecia. They conducted a primary literature search using PubMed in May 2019, utilizing the search term ‘oral minoxidil AND hair loss OR alopecia OR baldness’. Reviews, non‐English studies, and articles concerning only topical minoxidil were excluded.
The researchers reviewed ten articles, including for review comprising a total of 19,218 patients with 215 women and 19,003 men. Oral minoxidil dose ranged from 0.25 to 5 mg daily to twice daily. The most substantial evidence existed for androgenetic alopecia and alopecia areata (AA), with 61–100% and 18–82.4% of patients demonstrating objective clinical improvement. They have also reported successful female pattern hair loss, chronic telogen effluvium, monilethrix, and permanent chemotherapy‐induced alopecia. The most common adverse effects with oral minoxidil included hypertrichosis and postural hypotension. Oral minoxidil is a safe and successful treatment of androgenic alopecia and AA. In addition to its therapeutic benefits, practical advantages over topical minoxidil stem from improved patient compliance.