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Jul-ka
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Alopecia in Women
C. CAROLYN THIEDKE, M.D., Medical University of South Carolina, Charleston, South Carolina
Minoxidil (Rogaine). The currently preferred treatment for androgenetic alopecia is topically administered 2 percent minoxidil. Minoxidil appears to affect the hair follicle in three ways: it increases the length of time follicles spend in anagen, it "wakes up" follicles that are in catagen, and it enlarges the actual follicles. The mechanism by which minoxidil effects these changes is not known. Vellus hairs enlarge and are converted to terminal hairs. In addition, shedding is reduced.
In a randomized, controlled, double-blind clinical trial involving 550 women 18 to
45 years of age, treatment with 2 percent minoxidil solution resulted in a higher hair count compared with placebo. [Evidence label A, randomized controlled trial] In another study, 50 percent of women treated with 2 percent minoxidil had at least minimal hair regrowth, and 13 percent had moderate regrowth. No significantly increased benefit has been shown for the 5 percent minoxidil solution compared with the 2 percent solution.
The U.S. Food and Drug Administration (FDA) has labeled topically administered minoxidil for the treatment of androgenetic alopecia. A dropper is used to apply minoxidil solution directly onto dry scalp twice daily. After each use, hands should be washed thoroughly to avoid inadvertent application to other parts of the body. Minoxidil is listed as a pregnancy category C drug. It is not recommended for use in persons younger than 18 years.
The primary side effect of topical minoxidil therapy is hypertrichosis (excessive hair growth). The hair growth is most often noted above the eyebrows, in the malar region, and on the lateral cheeks. It occasionally occurs above the upper lip and on the chin. Facial hypertrichosis has been reported to affect 3 to 5 percent of women treated with the 2 percent solution and more than 5 percent of women treated with the 5 percent solution.
Hypertrichosis disappears after a year, even with continued use of minoxidil, and remits within one to six months if treatment is stopped.8 Bleaching of longer, darker hair is helpful cosmetically. Hair removal procedures are seldom necessary. Explanations for the occurrence of this side effect include local intravascular spread of minoxidil, inadvertent manual transfer of the drug to the face, and transmission of residual minoxidil from pillows.
Лит-ра:
Drake LA, Dinehart SM, Farmer ER, Goltz RW, Graham GF, Hordinsky MK, et al. Guidelines of care for androgenetic alopecia. American Academy of Dermatology. J Am Acad Dermatol 1996;35(3 pt 1): 465-9.
Dawber RP, Van Neste D. Alopecia areata. In: Dawber RP. Hair and scalp disorders: common presenting signs, differential diagnosis, and treatment. Philadelphia: Lippincott, 1995:41-138.
Price VH. Treatment of hair loss. N Engl J Med 1999;341:964-73.
Tosti A, Piraccini BM. Androgenetic alopecia. Int J Dermatol 1999;38(suppl 1):1-7.
Jacobs JP, Szpunar CA, Warner ML. Use of topical minoxidil therapy for androgenetic alopecia in women. Int J Dermatol 1993;32:758-62.
DeVillez RL, Jacobs JP, Szpunar CA, Warner ML. Androgenetic alopecia in the female. Treatment with 2% topical minoxidil solution. Arch Dermatol 1994;130:303-7.
C. CAROLYN THIEDKE, M.D., Medical University of South Carolina, Charleston, South Carolina
Minoxidil (Rogaine). The currently preferred treatment for androgenetic alopecia is topically administered 2 percent minoxidil. Minoxidil appears to affect the hair follicle in three ways: it increases the length of time follicles spend in anagen, it "wakes up" follicles that are in catagen, and it enlarges the actual follicles. The mechanism by which minoxidil effects these changes is not known. Vellus hairs enlarge and are converted to terminal hairs. In addition, shedding is reduced.
In a randomized, controlled, double-blind clinical trial involving 550 women 18 to
45 years of age, treatment with 2 percent minoxidil solution resulted in a higher hair count compared with placebo. [Evidence label A, randomized controlled trial] In another study, 50 percent of women treated with 2 percent minoxidil had at least minimal hair regrowth, and 13 percent had moderate regrowth. No significantly increased benefit has been shown for the 5 percent minoxidil solution compared with the 2 percent solution.
The U.S. Food and Drug Administration (FDA) has labeled topically administered minoxidil for the treatment of androgenetic alopecia. A dropper is used to apply minoxidil solution directly onto dry scalp twice daily. After each use, hands should be washed thoroughly to avoid inadvertent application to other parts of the body. Minoxidil is listed as a pregnancy category C drug. It is not recommended for use in persons younger than 18 years.
The primary side effect of topical minoxidil therapy is hypertrichosis (excessive hair growth). The hair growth is most often noted above the eyebrows, in the malar region, and on the lateral cheeks. It occasionally occurs above the upper lip and on the chin. Facial hypertrichosis has been reported to affect 3 to 5 percent of women treated with the 2 percent solution and more than 5 percent of women treated with the 5 percent solution.
Hypertrichosis disappears after a year, even with continued use of minoxidil, and remits within one to six months if treatment is stopped.8 Bleaching of longer, darker hair is helpful cosmetically. Hair removal procedures are seldom necessary. Explanations for the occurrence of this side effect include local intravascular spread of minoxidil, inadvertent manual transfer of the drug to the face, and transmission of residual minoxidil from pillows.
Лит-ра:
Drake LA, Dinehart SM, Farmer ER, Goltz RW, Graham GF, Hordinsky MK, et al. Guidelines of care for androgenetic alopecia. American Academy of Dermatology. J Am Acad Dermatol 1996;35(3 pt 1): 465-9.
Dawber RP, Van Neste D. Alopecia areata. In: Dawber RP. Hair and scalp disorders: common presenting signs, differential diagnosis, and treatment. Philadelphia: Lippincott, 1995:41-138.
Price VH. Treatment of hair loss. N Engl J Med 1999;341:964-73.
Tosti A, Piraccini BM. Androgenetic alopecia. Int J Dermatol 1999;38(suppl 1):1-7.
Jacobs JP, Szpunar CA, Warner ML. Use of topical minoxidil therapy for androgenetic alopecia in women. Int J Dermatol 1993;32:758-62.
DeVillez RL, Jacobs JP, Szpunar CA, Warner ML. Androgenetic alopecia in the female. Treatment with 2% topical minoxidil solution. Arch Dermatol 1994;130:303-7.
