Enhanced Clinical Outcomes and Treatment Adherence in Patients Using Compounded Topical Minoxidil to Treat Androgenetic and Traction Alopecia.

INTRODUCTION

This study highlights the experiences and clinical outcomes of Black women treated with compounded topical minoxidil (CTM), containing a steroid and retinoid, compared to over the counter (OTC) minoxidil.

METHODS

A retrospective chart review included 66 Black women treated at Johns Hopkins Hospital between 2020 and 2024. Patients previously used OTC minoxidil and were currently using CTM. Data collected included patient demographics, formulation, side effects, follow-up visits, and patient-reported outcomes. Adherence was assessed at follow-up appointments based on self-reported CTM use.

RESULTS

Of the 66 patients, 33.3 percent had traction alopecia (TA), 37.9 percent had androgenetic alopecia (AGA), and 28.8 percent had combined AGA and TA. Side effects from OTC minoxidil were reported by 21.2 percent of patients, with scalp irritation being the most common. Only 10.6 percent of patients reported side effects while using CTM, with 4.5 percent reporting scalp irritation and four reporting hypertrichosis. After receiving treatment with CTM for at least six months, patients had an overall adherence rate of 84.7 percent, compared to only 44.7 percent of patients who adhered to OTC minoxidil (p<0.001). Clinical improvement was reported by 69.6 percent of patients using CTM, compared to 45.0 percent of patients using OTC minoxidil (p<0.001).

DISCUSSION: CTM was associated with higher adherence, fewer side effects, and clinical improvement in majority of patients treated with CTM compared to their previous OTC minoxidil use.

LIMITATIONS: This is a single institution study.

CONCLUSION

When treating AGA or TA in Black women, special consideration should be taken when selecting minoxidil formulation, as it may have an impact on adherence and efficacy.