JAMA Dermatol
Oral vs. topical minoxidil for male androgenetic alopecia: How do they compare?
April 16, 2024

In this double-blind, placebo-controlled, randomized trial, oral minoxidil, 5 mg, once per day for 24 weeks had similar efficacy to topical minoxidil, 5%, twice per day in men with androgenetic alopecia (AGA)—making it an option for patients who prefer oral therapy or are intolerant to topical treatment.
Study results:
- Participants were randomized 1:1 into 2 groups: oral minoxidil, 5 mg, daily and topical placebo solution; or 1 mL of topical minoxidil, 5%, twice daily and oral placebo for 24 weeks.
- Among 90 enrolled participants, 68 completed the study; mean age was 36.6 years; 33 participants were randomized to the oral minoxidil group and 35 to the topical treatment group.
- For the frontal area, the mean change from baseline to week 24 between groups was 3.1 hairs per cm^2 (95% CI, -18.2 to 21.5; P=0.27) for terminal hair density and 2.6 hairs per cm^2 (95% CI, -10.3 to 15.8; P=0.32) for total hair density.
- For the vertex area, the mean change from baseline to week 24 was 23.4 hairs per cm^2 (95% CI, -0.3 to 43.0; P=0.09) for terminal density and 5.5 hairs per cm^2 (95% CI, -12.5 to 23.5; P=0.32) for total hair density.
- According to the photographic analysis, oral minoxidil was superior to topical minoxidil on the vertex (24%; 95% CI, 0 to 48; P=0.04) but not on the frontal scalp (12%; 95% CI, -12 to 36; P=0.24).
- The most common adverse effects in the oral minoxidil group were hypertrichosis (49%) and headache (14%).
epocrates related resources:
Source:
Penha MA, et al. (2024, April 10). JAMA Dermatol. Oral Minoxidil vs Topical Minoxidil for Male Androgenetic Alopecia: A Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/38598226/
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