WEDNESDAY, April 10, 2024  -- For male androgenetic alopecia (AGA) treatment, oral minoxidil is not superior to topical minoxidil, according to a study published online April 10 in JAMA Dermatology.

Mariana Alvares Penha, M.D., from São Paulo State University in Brazil, and colleagues randomly assigned eligible men with AGA aged 18 to 55 years to receive oral minoxidil 5 mg daily and topical placebo solution or 1 mL topical minoxidil 5 percent and oral placebo for 24 weeks. Sixty-eight men completed the study: 33 in the oral minoxidil group and 35 in the topical treatment group.

The researchers found that the mean change from baseline to week 24 between the groups was 3.1 and 2.6 hairs/cm2 for terminal hair density and total hair density, respectively, for the frontal area. For the vertex area, the mean change from baseline to week 24 was 23.4 and 5.5 hairs/cm2 for terminal density and total hair density, respectively. Oral minoxidil was superior to topical minoxidil on the vertex (24 percent) but not the frontal scalp (12 percent), according to the photographic analysis. Hypertrichosis and headache were the most common adverse effects reported in the oral minoxidil group (49 and 14 percent, respectively).

"Low-dose oral minoxidil has shown to be well tolerated and, therefore, is an option for patients who prefer oral therapy or are intolerant to topical treatment," the authors write.