Is There Benefit in Treating Traction Alopecia With Minoxidil? A Systematic Review

ABSTRACT Background Traction alopecia (TA) is common condition. Although no treatment guidelines exist, minoxidil can be adjunctively added to behavioural modification strategies. Objectives This systematic review aimed to evaluate the impact of adjunctive minoxidil on the severity of TA. Methods A systematic review was conducted according to the PRISMA guidelines (PROSPERO ID: 1019088). PubMed, MEDLINE, CENTRAL and Mendeley were searched in May 2025 with an updated search on 2 September 2025. The inclusion criteria were studies in which patients diagnosed with TA were treated with oral or topical minoxidil and an outcome measure (subjective or objective) was reported. The risk of bias was assessed using the ROBINS‐E tool. Results Of the 85 initial results, 6 met the inclusion criteria. Topical and oral minoxidil improved TA severity from 3 months onwards. However, the number of studies is limited with predominantly case reports and retrospective case series. Conclusions There is very weak evidence supporting the use of minoxidil, as an adjunctive measure, in the treatment of TA. Clinicians should discuss the potential risks and benefits of therapy with patients to allow for joint decision‐making. Larger studies using objective measures of hair regrowth are required. Trial Registration: PROSPERO ID: 1019088.