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Riddhi Sable

 

Riddhi Sable

IMS and SUM hospitals, India

Abstract Title: Comparison of efficacy and safety of oral minoxidil 1.25mg vs topical minoxidil 5% in male Androgenetic alopecia: A randomised open-label pilot study

Biography:

Research Interest:

Background: Androgenetic alopecia (AGA) is a progressive miniaturisation of hair follicles leading to patterned hair loss. While topical 5% minoxidil is FDA-approved, low-dose oral minoxidil has emerged as a potential systemic alternative with improved compliance and efficacy.

Objective: To compare the efficacy and safety of once-daily oral minoxidil 1.25 mg with twice-daily topical 5% minoxidil in adult males with AGA over 24 weeks.

Methods: In this open-label, randomised, 24-week pilot study, 60 men with Norwood–Hamilton Grade II–IV AGA were allocated to either oral minoxidil 1.25 mg once daily (Group A) or topical 5% minoxidil twice daily (Group B). Efficacy was assessed at baseline and every 4 weeks for 24 weeks using parameters such as hair density (hair/cm²), hair diameter, interfollicular distance, terminal-to-vellus (T/V) hair ratio, patient satisfaction, and photographic documentation. Safety was monitored through clinical evaluation and patient-reported adverse events.

Results: Baseline characteristics were comparable between groups. At 24 weeks, the oral minoxidil group demonstrated significantly greater improvement in hair density (132.67 ± 5.62 vs 127.73 ± 4.50 hairs/cm²; mean difference 4.93; p < 0.001), with significant divergence from week 12 onward. The T/V hair ratio also improved significantly in the oral group (1.743 ± 0.165 vs 1.556 ± 0.106; p < 0.001). No statistically significant differences were observed in hair shaft diameter or interfollicular distance. Both groups showed significant intragroup improvement across all parameters. Mild adverse effects included transient hypotension and hypertrichosis in the oral group, and mild scalp irritation in the topical group.

Conclusion: Low-dose oral minoxidil (1.25 mg daily) demonstrated superior efficacy and comparable safety to topical 5% minoxidil in male AGA. Its ease of administration and tolerability make it a viable alternative for patients with poor adherence to topical therapy.