Resumen

Objectives: Minoxidil is not a new invention, but arguable one of the most efficient hair growth stimulating treatments that exists. Lack of knowledge about this medication, and fear of side effects, are common reasons to why dermatologists hesitate in offering it to their patients. This presentation includes a step by step approach in how to succeed with both topical and oral minoxidil, and which checkpoints to go through if patients are not experiencing the desired results of minoxodil. Introduction: Hair loss is often perceived as cosmetic rather than medical, and a common complaint among dermatologists is that patients often turn to cosmetic clinics first for treatment. But even with a correct diagnosis at a dermatology clinic, many physicians are reluctant in treating hair loss patients with minoxidil. Common reasons to this hesitancy might be fear of side effects and lack of knowledge about dosing and follow ups. This presentation demonstrates the use of topical and oral minoxidil in different hair loss diseases and what to look for if patients are not experiencing results. Materials / method: Nine patiens with different hair loss conditions, diagnosed by the author clinically or by histology, received either topical or oral minoxidil as the only treatment or part of a combination therapy. Follow-up time was up to 18 months. The hair loss conditions were female pattern hair loss, alopecia areata, chronic telogen effluvium and frontal fibrosing alopecia. Evaluation of the results were based on the patients´ own and author´s examination, and pictures taken before and during the treatment. Blood tests and blood pressure were monitored in patients using oral minoxodil. Results: Visible improvent in hair density and reduction in hair shedding was accomplished. The dosage of oral minoxidil was 0.625 mg daily, and in those receiving topical treatment, the solution was 5% once daily. Two of the patients on oral minoxidil experienced mild hypertrichosis, in spite of that, they both continued with the treatment. Because of the use of low grade topical steroids, none of the patients receiving topical minoxidil experienced irritative dermatitis. No serious adverse reactions were reported. Conclusion: Minoxidil, whether it is oral or topical, is a safe and effective medication to stimulate hair growth, even in female patients. The hair stimulation part is unfortunately often not addressed when treating hair loss diseases, focusing only on hormonal or immunosuppressive options. An integrative part of succeeding with hair loss treatments, is combination therapy, where the reason to hair loss is addressed, as well as stimulating to imcreased hair growth.