Skip to main content
Log in

Efficacy of 5% Minoxidil versus Combined 5% Minoxidil and 0.01% Tretinoin for Male Pattern Hair Loss

A Randomized, Double-Blind, Comparative Clinical Trial

  • Original Research Article
  • Published:
American Journal of Clinical Dermatology Aims and scope Submit manuscript

Abstract

Background: 5% topical minoxidil solution has been widely used to stimulate new hair growth and help stop hair loss in men with androgenetic alopecia (AGA). However, it is not convenient for patients to continue applying the solution twice daily on a regular basis. Tretinoin is known to increase the percutaneous absorption of minoxidil and, therefore, to enhance the response of AGA to minoxidil. For this reason, it was assumed that tretinoin would be helpful in alleviating the inconvenience associated with the recommended twice-daily application of minoxidil.

Objective: To compare the efficacy and safety of therapy using a combined solution of 5% minoxidil and 0.01% tretinoin once daily with those of the conventional 5% topical minoxidil therapy applied twice daily in the treatment of AGA.

Methods: A total of 31 male patients (aged 28–45 years, mean 39.7 ± 4.5) with AGA (Hamilton-Norwood classification type III–V) were randomly assigned into two groups, one in which 5% minoxidil was applied to the scalp twice daily and the other in which the combined agent was applied once daily at night together with a vehicle placebo in the morning. The efficacy parameters were: (i) changes in total hair count, non-vellus hair count, anagen hair ratio, linear hair growth rate, and mean hair diameter assessed by macrophotographic image analysis; and (ii) the patient’s and investigator’s subjective assessments.

Results: After therapy, increases in the macrophotographic variables of total hair count and non-vellus hair count were shown in both treatment groups. There were no statistically significant differences between the two treatment groups with respect to changes in macrophotographic variables or scores on subjective global assessments by patients and the investigator. The incidence of adverse effects such as pruritus or local irritation was similar in the 5% minoxidil group (4 of 14 subjects) and the combined agent group (5 of 15 subjects).

Conclusion: The efficacy and safety of combined 5% minoxidil and 0.01% tretinoin once-daily therapy appear to be equivalent to those of conventional 5% minoxidil twice-daily therapy for the treatment of AGA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Table I
Table II
Table III
Table IV
Table V
Table VI

Similar content being viewed by others

Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

References

  1. Brodland DG, Muller SA. Androgenetic alopecia (common baldness). Cutis 1991 Mar; 47 (3): 173–6

    PubMed  CAS  Google Scholar 

  2. Norwood OT. Male pattern baldness: classification and incidence. South Med J 1975 Nov; 68 (11): 1359–65

    Article  PubMed  CAS  Google Scholar 

  3. Bergfeld WF. Androgenetic alopecia: an overview: seventh symposium on alope In: Badin HP, editor. Dermatology capsule and comment. New York: HP Publishing, 1988: 1–10

    Google Scholar 

  4. Mori O, Uno H. The effect of topical minoxidil on hair follicular cycles of rats. J Dermatol 1990 May; 17 (5): 276–81

    PubMed  CAS  Google Scholar 

  5. Uno H, Cappas A, Brigham P. Action of topical minoxidil in the bald stump-tailed macaque. J Am Acad Dermatol 1987 Mar; 16 (3 Pt 2): 657–68

    Article  PubMed  CAS  Google Scholar 

  6. Messenger AG, Rundegren J. Minoxidil: mechanism of action on hair growth. Br J Dermatol 2004 Feb; 150 (2): 186–94

    Article  PubMed  CAS  Google Scholar 

  7. Olsen EA, DeLong ER, Weiner MS. Long-term follow-up of men with male pattern baldness treated with topical minoxidil. J Am Acad Dermatol 1987 Mar; 16 (3 Pt 2): 688–95

    Article  PubMed  CAS  Google Scholar 

  8. Olsen EA, Dunlap FE, Funicella T, et al. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol 2002 Sep; 47 (3): 377–85

    Article  PubMed  Google Scholar 

  9. Olsen EA, Messenger AG, Shapiro J, et al. Evaluation and treatment of male and female pattern hair loss. J Am Acad Dermatol 2002 Sep; 47 (3): 377–85

    Article  PubMed  Google Scholar 

  10. Buhl AE, Waldron DJ, Kawabe TT, et al. Minoxidil stimulates mouse vibrissae follicles in organ culture. J Invest Dermatol 1989 Mar; 92 (3): 315–20

    Article  PubMed  CAS  Google Scholar 

  11. Ferry JJ, Forbes KK, VanderLugt JT, et al. Influence of tretinoin on the percutaneous absorption of minoxidil from an aqueous topical solution. Clin Pharmacol Ther 1990 Apr; 47 (4): 439–46

    Article  PubMed  CAS  Google Scholar 

  12. Bazzano GS, Terezakis N, Galen W. G36 atTopical tretinoin for hair growth promotion. J Am Acad Dermatol 1986 Oct; 15 (4 Pt 2): 880–3

    Article  PubMed  CAS  Google Scholar 

  13. Rushton DH. Chemical and morphological properties of scalp hair in normal and abnormal states. Aberystwyth: University of Wales, 1988

    Google Scholar 

  14. Hayashi S, Miyamoto I, Takeda K. Measurement of human hair growth by optical microscopy and image analysis. Br J Dermatol 1991 Aug; 125 (2): 123–9

    Article  PubMed  CAS  Google Scholar 

  15. Meisheri KD, Cipkus LA, Taylor CJ. Mechanism of action of minoxidil sulfate- induced vasodilation: a role for increased K+ permeability. J Pharmacol Exp Ther 1988 Jun; 245 (3): 751–60

    PubMed  CAS  Google Scholar 

  16. Winquist RJ, Heaney LA, Wallace AA, et al. Glyburide blocks the relaxation response to BRL 34915 (cromakalim), minoxidil sulfate and diazoxide in vascular smooth muscle. J Pharmacol Exp Ther 1989 Jan; 248 (1): 149–56

    PubMed  CAS  Google Scholar 

  17. Madani KA, Bazzano GS, Chou AC. Effects of vitamin A status on cellular retinoic acid-binding protein in rat skin and testes. Eur J Clin Chem Clin Biochem 1991 May; 29 (5): 317–20

    PubMed  CAS  Google Scholar 

  18. Yoo HG, Chang IY, Pyo HK, et al. The additive effects of minoxidil and retinol on human hair growth in vitro. Biol Pharm Bull 2007 Jan; 30 (1): 21–6

    Article  PubMed  CAS  Google Scholar 

  19. Abell E. Histologic response to topically applied minoxidil in male pattern alopecia. Clin Dermatol 1988 Oct-Dec; 6 (4): 191–4

    Article  PubMed  CAS  Google Scholar 

  20. Courtois M, Loussouarn G, Hourseau S, et al. Periodicity in the growth and shedding of hair. Br J Dermatol 1996 Jan; 134 (1): 47–54

    Article  PubMed  CAS  Google Scholar 

  21. Osterberg L, Blaschke T. Adherence to medication. N Engl J Med 2005 Aug 4; 353 (5): 487–97

    Article  PubMed  CAS  Google Scholar 

  22. Claxton AJ, Cramer J, Pierce C. A systemic review of the associations between dose regimens and medication compliance. Clin Ther 2001 Aug; 23 (8): 1296–310

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This study was financially sponsored by AmorePacific R&D Center, Gyeonggi-do, Korea. The authors have no conflicts of interest that are directly relevant to the content of this study.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hee Chul Eun.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shin, H.S., Won, C.H., Lee, S.H. et al. Efficacy of 5% Minoxidil versus Combined 5% Minoxidil and 0.01% Tretinoin for Male Pattern Hair Loss. AM J Clin Dermatol 8, 285–290 (2007). https://doi.org/10.2165/00128071-200708050-00003

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00128071-200708050-00003

Keywords

Navigation