American Journal of Clinical Dermatology

, Volume 8, Issue 5, pp 285–290 | Cite as

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

A Randomized, Double-Blind, Comparative Clinical Trial
  • Hyo Seung Shin
  • Chong Hyun Won
  • Seung Ho Lee
  • Oh Sang Kwon
  • Kyu Han Kim
  • Hee Chul Eun
Original Research Article

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.

Keywords

Tretinoin Hair Growth Minoxidil Percutaneous Absorption Subjective Global Assessment 

Notes

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.

References

  1. 1.
    Brodland DG, Muller SA. Androgenetic alopecia (common baldness). Cutis 1991 Mar; 47 (3): 173–6PubMedGoogle Scholar
  2. 2.
    Norwood OT. Male pattern baldness: classification and incidence. South Med J 1975 Nov; 68 (11): 1359–65PubMedCrossRefGoogle Scholar
  3. 3.
    Bergfeld WF. Androgenetic alopecia: an overview: seventh symposium on alope In: Badin HP, editor. Dermatology capsule and comment. New York: HP Publishing, 1988: 1–10Google Scholar
  4. 4.
    Mori O, Uno H. The effect of topical minoxidil on hair follicular cycles of rats. J Dermatol 1990 May; 17 (5): 276–81PubMedGoogle Scholar
  5. 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): 657–68PubMedCrossRefGoogle Scholar
  6. 6.
    Messenger AG, Rundegren J. Minoxidil: mechanism of action on hair growth. Br J Dermatol 2004 Feb; 150 (2): 186–94PubMedCrossRefGoogle Scholar
  7. 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): 688–95PubMedCrossRefGoogle Scholar
  8. 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): 377–85PubMedCrossRefGoogle Scholar
  9. 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): 377–85PubMedCrossRefGoogle Scholar
  10. 10.
    Buhl AE, Waldron DJ, Kawabe TT, et al. Minoxidil stimulates mouse vibrissae follicles in organ culture. J Invest Dermatol 1989 Mar; 92 (3): 315–20PubMedCrossRefGoogle Scholar
  11. 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): 439–46PubMedCrossRefGoogle Scholar
  12. 12.
    Bazzano GS, Terezakis N, Galen W. G36 atTopical tretinoin for hair growth promotion. J Am Acad Dermatol 1986 Oct; 15 (4 Pt 2): 880–3PubMedCrossRefGoogle Scholar
  13. 13.
    Rushton DH. Chemical and morphological properties of scalp hair in normal and abnormal states. Aberystwyth: University of Wales, 1988Google Scholar
  14. 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): 123–9PubMedCrossRefGoogle Scholar
  15. 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): 751–60PubMedGoogle Scholar
  16. 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): 149–56PubMedGoogle Scholar
  17. 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): 317–20PubMedGoogle Scholar
  18. 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): 21–6PubMedCrossRefGoogle Scholar
  19. 19.
    Abell E. Histologic response to topically applied minoxidil in male pattern alopecia. Clin Dermatol 1988 Oct-Dec; 6 (4): 191–4PubMedCrossRefGoogle Scholar
  20. 20.
    Courtois M, Loussouarn G, Hourseau S, et al. Periodicity in the growth and shedding of hair. Br J Dermatol 1996 Jan; 134 (1): 47–54PubMedCrossRefGoogle Scholar
  21. 21.
    Osterberg L, Blaschke T. Adherence to medication. N Engl J Med 2005 Aug 4; 353 (5): 487–97PubMedCrossRefGoogle Scholar
  22. 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): 1296–310PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV. 2007

Authors and Affiliations

  • Hyo Seung Shin
    • 1
  • Chong Hyun Won
    • 2
  • Seung Ho Lee
    • 1
  • Oh Sang Kwon
    • 1
  • Kyu Han Kim
    • 1
  • Hee Chul Eun
    • 1
  1. 1.Department of DermatologySeoul National University College of MedicineSeoulKorea
  2. 2.Department of DermatologySeoul National University Boramae HospitalSeoulKorea

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