Real-life Long-term Efficacy of 5% Topical Minoxidil in Female Androgenetic Alopecia

ABSTRACT

Based on the highest level of clinical evidence, topical minoxidil (MX) has established itself as the first-line treatment for female androgenetic alopecia (FAGA). So far, the longest study on the long-term efficacy of topical MX in AGA has been for 24 months. Global photographic assessment has successfully been established as a standard method for objectively monitoring hair growth in the course of the finasteride trials in men since 1998. Since its introduction, the technique in combination with epiluminescence photography and digital imaging has proven to be essential for follow-up of hair loss patients undergoing long-term treatment in daily clinical practice. Since 15 years, we perform global photographic assessment in tandem with epiluminescence photography as a standard operating procedure and have followed up our respective patients treated for hair loss, typically after 3, 6, 12, 18, and 24 months and yearly thereafter. In women with FAGA treated with topical MX, we observed over the observation period of 15 years amelioration of global photographs and/or diversity of hair shaft diameters starting at 3 months of therapy and continuing up to between 2 and 7 years. Thereafter, the results remained constant for the duration of continued treatment. This observation underscores the importance of long-term treatment and compliance for maximum treatment effect.