Dr. Marc Avram

An article from the Journal of the American Academy of Dermatology (JAAD) Volume 65, Number 6:

 

A randomized, single-blind trial of 5% minoxidil foam

once daily versus 2% minoxidil solution twice daily in

the treatment of androgenetic alopecia in women

 

Ulrik Blume-Peytavi,MD, PHD, Kathrin Hillmann, MD, Ekkehart Dietz, PHD, Douglas Canfield,

and Natalie Garcia Bartels, MD

Berlin, Germany and Fairfield, New Jersey

 

Background: Although twice-daily application of propylene glycol- containing 2% minoxidil topical solution (MTS) stimulates new hair growth, higher concentrations of minoxidil in a once-daily, propylene glycol-free formulation may improve efficacy and reduce unpleasant side effects.

Objective: WE sought to compare the efficacy, safety and acceptability and to show noninferiority of once-daily 5% minoxidil topical foam (MTF) with twice-daily 2% MTS in woman with androgenetic alopecia.

Methods: A total of 113 women with androgenetic alopecia were randomized to 24 weeks of treatment with 5 % MTF and 2% MTS. The primary efficacy parameter was change from baseline in nonvellus target area hair count at week 24. Secondary end points included change in nonvellus target hair width, overall efficacy by global photographic review as assessed by treatment-blind evaluators and the subject herself, adverse events and participants’ assessment of product aesthetics.

Results: After 24 weeks, women randomized to 5 % MTF once-daily showed noninferior target area hair count and target area width and experienced great, but nonsignificant , improvements in target area hair count, target area hair width and overall efficacy by global photographic review than those randomized to 2% MTS used twice-daily. 5% MTF was significantly superior to 2% MTS in participants’ agreement with “the treatment doesn’t not interfere with styling my hair” (P=.002). Women randomized to 5% MTF experienced significantly lower rates of local intolerance (P=.046) especially in pruritus and dandruff with 2% MTS.

Limitation: Because of differences in the formulations tested, study participants were not blinded to treatment.

Conclusions: Once-daily 5% MTF is noninferior and as effective for stimulated hair growth as twice-daily 2% MTS in women with androgenetic alopecia and is associated with several aesthetic and practical advantages. (J Am Acad Dermatol 2011;65:1126-34.)

Key words: androgenetic alopecia; female pattern hair loss; hair preparations; hypertrichosis; minoxidil; topical administration; topical foam; topical solution. 

 

INTERNATIONAL SOCIETY OF HAIR RESTORATION SURGERY MAINTAINS SAFETY AND EFFICACY OF PROPECIA
(FINASTERIDE 1MG) FOR MALE HAIR LOSS IS BACKED BY PROVEN SCIENTIFIC DATA
Task force formed to study reports of sexual dysfunction in some men taking Propecia for hair loss
GENEVA, IL. – December 13, 2011. The International Society of Hair Restoration Surgery (ISHRS) – the world’s leading medical authority on hair loss and hair restoration – cautions that recent anecdotal reports of persistent sexual dysfunction by some men who have used finasteride 1mg (Propecia) to treat hair loss should not define the safety and effectiveness of this drug. Propecia is the only oral medication approved by the U.S. Food and Drug Administration (FDA) for the treatment of hair loss in men.
From a scientific standpoint, the ISHRS reports that there are no evidence-based data substantiating the link between finasteride and persistent sexual side effects after discontinued use of the drug in numerous, double blinded, placebo controlled studies conducted evaluating the use of Propecia 1mg for hair loss.

“The health and well being of our patients is the utmost concern of the 900 physician members of the ISHRS – whether prescribing medications like Propecia or performing hair restoration surgery,” said ISHRS President Dr. Jennifer Martinick. “ISHRS members devote an average of 72% of their practices to medically and surgically treating hair loss, and collectively they have treated millions of men around the world suffering from hair loss with finasteride 1mg with virtually no side effects.”
Since receiving FDA approval in December of 1997, 20.5 million and 6.7 million patient-years of exposure using Proscar (finasteride 5mg) and Propecia (finasteride 1mg) respectively are recorded with a low adverse event profile. The ISHRS believes that these are the most current and reliable data available until further studies are conducted.
Sexual dysfunction is a complex disorder, and Dr. Martinick noted that it often can be hard to pinpoint the exact cause – particularly when multiple factors such as nicotine, alcohol, prescription medications, stress, anxiety, fatigue and depression can contribute to erectile dysfunction (ED).
“The incidence of ED in the general population is known to be quite high – as high as 49% in middle-aged and older men according to one study published in 2006 in the Archives of Internal Medicine,” said Dr. Martinick. “That being said, we owe it to our patients to address valid concerns in a scientific manner and to clarify any misleading reports so that men can make informed choices regarding the use of this medication.”
Recently, the ISHRS formed a task force to more closely examine anecdotal reports of sexual dysfunction by some Propecia users who have used the drug to treat hair loss. In addition, the ISHRS has called on the medical communities of dermatologists, hair loss physicians, urologists, endocrinologists and sexual medicine specialists to join in a colloquium to share all data and experiences with finasteride in a fact-based manner.