Oral Minoxidil in Pediatric Patients 10 years of Age and Older

How Safe is Oral minoxidil in Older Children ?

Oral minoxidil has not been extensively studied in children. However, there is a 2021 study reported 8 girls who used oral minoxidil for treating loose anagen hair syndrome. 7 patients experienced an improvement in density. Side effects were limited to hypertrichosis on the legs in one patient and no patient had tachycardia, dizziness, edema or other serious side effect. (see “Oral Minoxidil in Children 10 Years of Age and Younger”)

Nicolas-Ruanes et al, 2022

A new study set out to evaluate the safety and efficacy of oral minoxidil in pediatric patients 10-17 years of age. 87 % of patients were prescribed oral minoxidil for treatment of androgenetic alopecia and 13 % had telogen effluvium.

Low dose oral minoxidil was the only treatment in 31 % of patients (14 children). Oral minoxidil was combined with other treatments in 69 % of patients including topical treatments and oral treatments.

Oral minoxidil was used at a mean dose of 0.63 mg in girls and 2.35 mg in boys. The authors point out that most pediatric patients age 10 and older started with a dose of 0.5 mg and increased from that dose if additional improvement in the hair was needed.

80 % of children had an improvement and 20 % had stabilized. Follow up ranged from 3 to 24 months in this study.

25 % of Children Aged 10-17 Years Have Mild Side Effects with Oral Minoxidil

25 % of patients had some sort of side effect. This was mostly facial hypertrichosis (18%) followed by shedding (2 patients) and hypotension (1 patient). Fortunately, adverse side effects were mild in all patients, and none of the patients needed to stop oral minoxidil. 1 patient did require a dose adjustment.

Conclusion

This is a very nice study. The basic message of the study is that oral minoxidil appears to be well tolerated in children. Side effects are really the same range of side effects that we see in adults: hypertrichosis, shedding hypotension. Missing from the side effect list is edema and fluid retention. Whether this is all that common in children needs more study.

I think this study shared here and the Jergen et al study of 2021 are important for hair specialists to understand well.

REFERENCE

Nicolas-Ruanes et al. Low-dose oral minoxidil for treatment of androgenetic alopecia and telogen effluvium in a pediatric population: A descriptive study. J Am Acad Dermatol . 2022 Apr 26;S0190-9622(22)00696-X.

Jerjen R et al. Low-dose oral minoxidil improves global hair density and length in children with loose anagen hair syndrome. Br J Dermatol. 2021;184(5):977-978.