Awad et al 2023
In a brand new examine, Awad and colleagues got down to retrospectively reviewed the data of sufferers with TA age over 12 years who had been handled with low dose oral minoxidil LDOM for six months or extra. The severity of hair loss earlier than and after therapy was decided utilizing the marginal TA severity (M-TAS) rating. This scoring system combines the scores of the anterior (0-9) and posterior (0-9) margins to a most rating of 18.
58 sufferers had been included within the examine. Imply onset of TA was 32.7 years. The imply length of hair loss was 6.4 years. Most sufferers on this examine had been feminine though one was male. 75.9% had been White and 10.3 % had been Black, 8.6 % had been Center Jap, 3.4 % had been South Asian and 1.7% had been East and Southeast Asian
The reason for the traction alopecia was tight ponytails in 37.9%, tight buns in 12.1 %, hair extensions in 12.1%, braids in 8.6 %, hair clips in 6.9% and dreadlocks in 3.4 %
The imply beginning dose was 0.75 mg and the dose was titrated upwards if there was suboptimal progress and the imply remaining dose was 2.5 mg.
What had been the outcomes?
All in all, therapy with LDOM helped hair progress and the imply M-TAS rating decreased from 5.1 to three.6
Unwanted side effects included hypertrichosis in 22.% and light-weight headedness in 5.2 % and not one of the sufferers want to cut back or cease therapy.
Feedback
That is one other useful examine that highlights the advantages of oral minoxidil for treating traction alopecia. This examine was primarily a examine of traction alopecia in white ladies though 10 % had been black. This was additionally a examine of TA in longstanding illness with the imply length being 6.4 years.
The outcomes confirmed a gentle enchancment – reasonably than profound enchancment. The outcomes right here remind us that lengthy standing traction alopecia remains to be not straightforward to deal with.
We don’t have a way of affected person satisfaction and what quantity of the 58 sufferers felt this was a very good final result. That will be useful to know
Lastly, a key questions right here is “what occurs when oral minoxidil is stopped?” I don’t assume we actually perceive what occurs when oral minoxidil is stopped. The authors said that “it’s doubtless that enhancements can be maintained upon cessation of remedy offering tight hairstyles had been prevented.” I believe it is a huge leap in interpretation. First, we will’t make certain there is no such thing as a some extent of minoxidil dependence right here. Second, we count on 10% to fifteen % of ladies to have some extent of androgenetic alopecia, even whether it is subclinical. The cessation of oral minoxidil could serve to set off a telogen effluvium and doubtlessly worsen underlying androgenetic alopecia. For my part, the cessation of oral minoxidil is a giant deal however extra research are wanted.
REFERENCES
Awad A et al. Low-dose oral minoxidil improves hair density in traction alopecia. J Am Acad Dermatol. 2023 Feb 24;S0190-9622(23)00278-5.
Seashore RA. Case collection of oral minoxidil for androgenetic and traction alopecia: Tolerability & the 5 C’s of oral remedy. Dermatol Ther. 2018 Nov;31(6):e12707.
Kim and Craiglow. Remedy of traction alopecia with oral minoxidil. JAAD Case Rep. 2022 Apr 1;23:112-113.
