Minoxidil (Mnx) is a topical drug indicated for the treatment of androgenic alopecia and female androgenic alopecia (AGA/ FAGA) both in men and women. Mnx can counteract the sex hormone-dependent miniaturization process of hair follicle which characterizes AGA physiopathology. The Mnx molecule could exert a vasodilation effect with a consequent positive action on the microcirculation of the scalp but at the same time favouring the cell cycle and cell proliferation, favouring at the hair follicle the anagen phase. The clinical efficacy of Mnx in AGA is maintained only if the treatment is continued. Therefore, long-term tolerability and safety are crucial aspects of AGA therapy with topical Mnx. Mnx 5% and 2% lotions commonly contain propylene glycol (PG), a solvent component able to enhance Mnx water solubility. PG is also a penetration enhancer of Mnx molecule, therefore contributing to the clinical efficacy. PG could have, especially in the long-term, a negative effect on the skin barrier function. Several adverse reactions due to PG have been documented, like allergic contact dermatitis (6% of treated subjects), scalp dryness, irritation, burning and redness in subjects treated with classical PG-containing Mnx lotions. The latter can be observed in up to 30% of Mnx-treated patients. Rossi et al. in a recent review have reported that scalp pruritus and scaling are the most common side effects of Mnx lotions treatments. A new propylene glycol (PG)-free 5% minoxidil (PG-Free-Mnx) lotion has been recently commercialized. Clinical efficacy and local tolerability have been, so far, documented in a limited number (n=30) of patients. The aim of this study was to evaluate the clinical efficacy, cosmetic acceptability, and local tolerability of the 6-month application of this new PG-Free Mnx lotion in a real-life situation in a large sample of subjects.

AGA and FAGA are common chronic dermatological conditions with a relevant impact on self-esteem and quality of life of the affected subjects. The only approved pharmacological treatments are topical minoxidil and finasteride. Both treatments should be used chronically to maintain the improvement in hair count. The NOMINAL trial has demonstrated that in real-life condition in a population of more than 190 subjects 6-month treatment with PG-free 5% Mnx lotion is effective, well-tolerated with a good cosmetic acceptability. Topical minoxidil is the mainstay pharmacological treatment for androgenic alopecia both in men and women. The specific mechanism of action of topical minoxidil remains however to be fully explained. Mnx can positively affect follicular cells, enhancing hair growth and at the same time reducing hair loss. Mnx solutions generally contain ethanol, water, and propylene glycol (PG). To read more about this article kindly go through this link https://www.longdom.org/archive/jcedr-volume-12-issue-5-year-2021.html

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Kathy Andrews
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Journal of Clinical & Experimental Dermatology Research

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