Value of Sulfotransferase Enzyme Assay in Predicting Minoxidil Response in Patients with Androgenetic Alopecia

Abstract Background Androgenetic Alopecia (AGA) is the most common type of progressive nonscarring hair loss in men and women. AGA features a progressive miniaturization of the hair follicle leading to transformation of terminal hair to vellus hair. These results from an alteration of hair cycle dynamic in which anagen phase duration gradually decreases and that of the telogen phase increases. Objective To compare Minoxidil result among patients with low versus high sulfotransferase activity in order to evaluate the validity of sulfotransferase enzyme testing before minoxidil use. Patients and Methods This was a prospective observational study that was conducted at Dermatology outpatient clinic, Ain Shams University Hospital on 60 male patients presenting with androgenetic alopecia grade II, III, IV. Results Vellus hair count/cm2 increased from baseline (17.4±9.2) to Month-4 (20.1±9.6), the differences (2.7±5.6) were statistically significant (p < 0.001). Terminal hair count/cm2 increased from baseline (6.1±3.3) to Month-4 (9.5±6.3), the differences (3.4±5.3) were statistically significant (p < 0.001). Terminal hair percent increased from baseline (25.7±3.6) to Month-4 (29.8±8.2), the differences (4.1±8.8) were statistically significant (p < 0.001). Total hair count/cm2 increased from baseline (23.5±12.4) to Month-4 (29.6±15.3), the differences (6.1±10.2) were statistically significant (p < 0.001). Mean hair width increased from baseline (0.04±0.02) to Month-4 (0.06±0.03), the differences (0.02±0.03) were statistically significant (p < 0.001). Less than half of the study cases showed increasing response (46.7%). Baseline Sulfotransferase enzyme was higher in responder cases (0.78±0.37) than in non-responder cases (0.31±0.16), the differences were statistically significant (<0.001). Conclusion The clinical response to 5% minoxidil commonly seen after 3-6 months and approximately 40% of patients will experience hair growth. considering the long time of treatment needed to produce a response by minoxidil in AGA, Sulfotransferase enzyme assay has a significant impact on minoxidil response in hair follicles and can be used as a diagnostic test perior the use of minoxidil to exclude the nonresponders.