Minoxidil is sometimes used to treat alopecia areata

Alopecia areata hair loss information for men and women
Alopecia Areata 
Alopecia Areata Biology
Alopecia Areata Treatments

  Minoxidil for the Treatment of Alopecia Areata

Alopecia areata is a hair loss disease that may affect men, women and children equally. It has been found to occur in 1% to 2% of the population. In this, there are nonscarring, inflammatory bald patches that may recur over a period of time. No specific cause has yet been identified for this disease and no regular treatment regime has been found. Management of this condition, therefore, remains a challenge

Alopecia areata is commonly believed to be an autoimmune disease, which is caused by a disorder of the immune system. Any course of treatment has so far therefore been immunomodulatory in nature. Drugs are administered to change the disorder of the immune system and have a corrective effect on it. Corticosteroids, which are immunosuppressive by nature, are mostly used in managing alopecia areata.

The approach to the treatment of this disease is to initiate direct action on the hair follicles, thereby hiding hair loss and promoting hair growth. Minoxidil is commonly used as an effective mode of therapy. Minoxidil falls under the class of agents called “Potassium channel openers”. These are generally used in the treatment of hypertension in humans. However, the exact action of minoxidil in averting hair loss has not yet been understood and the further refinement of the use of this drug is needed for successful stimulation of hair growth in alopecia areata.

How Minoxidil Works

Minoxidil has been seen to promote growth of hair fiber though how the drug works is still not very clear. Minoxidil is supposed to be working as an agent that promotes cell division rather than having an effect as an immunosuppressant or influencing the hormones. It has been observed that Minoxidil enhances the keratinocyte process thereby helping hair growth. Even vitro keratinocytes can be kept for a longer time with minoxidil. The drug has also been found to increase the number of hairs in monkeys and humans during anagen.

Minoxidil may also enhance hair growth by reducing the calcium influx in the cells. Calcium triggers off those epidermal growth factors that inhibit the growth of hair fibers. Minoxidil sulphate being a potassium channel opener induces the potassium ions to enter the cells and blocks the influx of calcium in the cells thereby facilitating hair growth.

Minoxidil being initially a drug for hypertension, was once thought to enhance hair growth by increasing the blood flow into the follicles but it has been found that dilation of blood vessels do not play a direct role in hair growth.

Success Rate of Minoxidil in Treating Alopecia Areata

Minoxidil has had limited success in the treatment of alopecia areata. Two percent concentration of minoxidil has shown mixed success rates in clinical trials. In individuals with patchy alopecia, 8 percent to 45 percent success was observed but there was no significant regrowth of hair in cases of extensive alopecia areata. A 5 percent concentration of the drug gives better results than a 2 percent concentration. Even dermatologists are divided over their recommendations of minoxidil for treatment of alopecia areata. On application of minoxidil, there is evidence of hair growth by about 12 weeks but considerable regrowth of hair to cover the patches only occurs with repeated applications.

Minoxidil, however, is more effective when used in combination with other drugs like corticosteroids or contact sensitizers. This approach to treatment is more effective than using one drug alone. Minoxidil can be used along with topical anthralin for better effect in cases of alopecia areata. O.5% anthralin cream is first applied to the patch for 5 to 10 minutes, daily. After application of anthralin, the scalp is thoroughly washed with soap and shampoo and 5% minoxidil is applied topically. As anthralin is an irritant, there may be mild irritation on its application. In some cases facial hypertrichosis is also seen to occur with this treatment. But the synergistic effect of both the drugs together provides a better cure for alopecia areata.

It must also be noted that minoxidil does not stop hair loss but only stimulates hair growth. The several advantages of minoxidil make it a popularly recommended course of treatment.

Minoxidil is well tolerated by most people and is safe to use in both men and women. Topical application of minoxidil is safe and does not have any systemic side effects.

Side Effects of Minoxidil

Side effects of minoxidil can occur when excess of the drug is absorbed by inflamed and abnormal scalps. Dosage should therefore be kept to the minimum level. The common side effects that are seen are itching, inflammation and redness at the site. In rare cases of topical minoxidil application, allergic contact dermatitis and photo allergic contact dermatitis have also been reported. There are also reported cases of facial hypertrichosis or abnormal growth of hair on the face. But this disappears once the application of the drug is stopped. Other side effects of minoxidil, especially oral use of minoxidil, are a drop in blood pressure, increase in heart rate and fluid retention leading to weight gain. Minoxidil is therefore not advised for patients with heart failure or coronary heart diseases.


Although minoxidil is a commonly used therapy for hair loss, it must be remembered that it is not a complete cure for alopecia. Minoxodil is not effective in cases of extensive hair loss like alopecia totalis and alopecia universalis. In the case of alopecia areata, it serves to temporarily promote hair growth till the normal hair starts growing again. For a significant effect, minoxidil should be applied continuously for a prolonged period of time. If the treatment is not sustained, there may be a relapse of alopecia areata as the hair follicles that are artificially kept in the growth phase enter telogen or the resting phase again.

Nevertheless, minoxidil is perhaps one of the best modes of treatment for cases of alopecia areata that are less extensive in nature. Generally an improvement in the condition is evident in four to six weeks. If there is no improvement with minoxidil, other lines of treatment should be considered.

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