American Journal of Clinical Dermatology

, Volume 20, Issue 2, pp 237–250 | Cite as

Off-Label Use of Topical Minoxidil in Alopecia: A Review

  • Jenna R. Stoehr
  • Jennifer N. Choi
  • Maria Colavincenzo
  • Stefan VanderweilEmail author
Review Article


Topical minoxidil is a well-known and often-utilized drug in dermatological practice for the treatment of alopecia. It was approved by the United States Food and Drug Administration for the treatment of androgenetic alopecia in 1988. Since its approval, minoxidil has been used off-label for the treatment of many other types of alopecia, with minimal formal evidence of efficacy. Conditions for which the use of topical minoxidil has been reported include telogen effluvium, alopecia areata (AA), scarring alopecia, eyebrow hypotrichosis, monilethrix, and chemotherapy-induced alopecia (CIA). The evidence for the use of minoxidil in each condition is derived from a variety of studies, including clinical trials, case series, and case reports. A comprehensive review of the literature indicates that while minoxidil is routinely used in the management of many alopecic conditions, there is mixed evidence for its efficacy. For certain conditions, including AA and most scarring alopecias, the evidence seems to be inconclusive. For others, such as eyebrow hypotrichosis, monilethrix, early traction alopecia, and CIA, there is more support for the efficacy of minoxidil. Although the favorable safety profile of minoxidil is established in adults, its use in the treatment of pediatric alopecia may require heightened monitoring and patient education.


Compliance with Ethical Standards

Conflict of interest

Jenna R. Stoehr, Jennifer N. Choi, Maria Colavincenzo, and Stefan Vanderweil have no conflicts of interest to declare.


No sources of funding were used for the preparation of this article.


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of DermatologyNorthwestern UniversityChicagoUSA

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