A Retrospective Study on the Safety of Systemic Minoxidil for Hair Loss in the Older Population

<h3>ABSTRACT</h3> Oral or systemic minoxidil has been used off-label for decades to treat androgenetic alopecia (AGA) and other hair loss disorders. Its adverse effects have been reported in the literature to include facial and body hypertrichosis, palpitations, and fluid retention, among others. Most safety studies on low-dose systemic minoxidil for the indication of hair loss have been comprised of the younger population; however, for this retrospective study, we have chosen to look at adverse events in the older population (aged 60 years and above), taking into account the group’s possibly higher presence of comorbid conditions and/or intake of other medications. Among 42 patients, only 19% had experienced adverse events, with facial and body hypertrichosis being the most common. Adverse events were managed successfully by dose reduction, leg elevation, salt restriction, and diuretics, and only 2 had to discontinue minoxidil. No serious adverse events were found in the study. While no diagnostic evaluation is required for healthy patients in this age group, we highly recommend caution when prescribing systemic minoxidil for patients on multiple antihypertensives agents and for those at risk for cardiovascular events.