EFFICACY OF LOW DOSE ORAL MINOXIDIL (1.25 MG) AS MONOTHERAPY IN MALE ANDROGENETIC ALOPECIA

Abstract

Androgenetic alopecia (AGA) is the most prevalent form of progressive hair loss in men, characterised by androgen-mediated follicular miniaturisation and significant psychosocial impact. Topical minoxidil, the established first-line therapy, is limited by scalp irritation, poor compliance, and variable absorption. Low-dose oral minoxidil (LDOM) has emerged as a promising alternative formulation, but evidence on the optimal dose and its short-term clinical profile in male AGA remains limited. A prospective, open-label, single-arm observational study was conducted at a tertiary care dermatology unit. Twenty-five adult male patients aged 20–50 years with AGA of Hamilton–Norwood grade ≥ III were enrolled by convenience sampling and treated with oral minoxidil 1.25 mg once daily for 24 weeks. Clinical assessments were performed at baseline, 12 weeks, and 24 weeks, and included global photographic assessment (GPA), trichoscopy, the Global Aesthetic Improvement Scale (GAIS), and a patient satisfaction questionnaire. Adverse events were recorded throughout the study period. At 24 weeks, 80% of patients demonstrated measurable improvement on GPA (mild: 30%, moderate: 40%, marked: 10%). Trichoscopic improvement was observed in 76% of patients, including increased hair density in 70%, reduced hair shaft diameter variability in 60%, and a decrease in the proportion of miniaturised hairs in 50%. On the GAIS, 70% of patients were rated as aesthetically improved. Overall patient satisfaction was 60% at 24 weeks. Adverse events were mild and transient; no cardiovascular or serious adverse effects were recorded. Oral minoxidil 1.25 mg once daily is an effective and well-tolerated monotherapy for male AGA, with progressive clinical and trichoscopic improvement extending through 24 weeks of treatment. These findings support the use of LDOM as a viable oral alternative, particularly for patients intolerant of or non-adherent to topical therapies.