Minoxidil Finds Novel Indication In Hair Loss Prevention Following Rhytidectomy

By Pamela Harrison

NEW ORLEANS, LA -- February 24, 2002 --

Topical minoxidil appears to prevent temporary alopecia that can occur following facelift procedures, according to a Florida-based dermatologist.

Results from a retrospective review were presented during a poster session here yesterday at the 60^th annual meeting of the American Academy of Dermatology.

"Temporal hair loss that results from traumatized hair follicles following rhytidectomy is an unsightly complication that can distress patients and surgeons," observed lead author Dr. Cindy Li, who is in private practice in Boca Raton, Florida.

Noting that topical minoxidil has already been approved for the treatment of both androgenic alopecia and female senile alopecia, Dr. Li initiated prophylactic minoxidil 2% to 5% in 60 consecutive patients, one week prior to the rhytidectomy procedure, and then, following a five-day interval during which minoxidil was discontinued after the facelift, continuing its use for another four weeks.

Comparing their findings in these 60 patients to results from larger facelift series, in which minoxidil was not used prophylactically, the researchers concluded that "minoxidil plays a role in effectively preventing temporal hair loss that occurs following primary rhytidectomy," Dr. Li stated. Importantly, minoxidil does not appear to affect the risk of hematoma, skin necrosis or oedema, she added.

"To our knowledge, this is the first study to investigate the role of minoxidil in preventing post-rhytidectomy alopecia," Dr. Li indicated, "and we feel that minoxidil should be considered in all surgical procedures that may precipitate alopecia."

In another study presented during the poster session, topical minoxidil was shown to increase total hair counts relative to baseline by week 26 in a group of 50 men who were randomly assigned to 5% minoxidil plus placebo shampoo.

However, another 50 men who also had mild to moderate male pattern baldness achieved a modest but sustained improvement in hair growth with daily use of a commercially available shampoo containing 1% pyrithione zinc (PTZ). Specifically, at week 26, men treated with 5% minoxidil plus placebo shampoo had a 12.32 increase in total hair count/cm2 relative to baseline.

This compared with a 6.23 increase in total hair count/cm2 in men who used 5% minoxidil plus 1% PTZ shampoo daily. Men who used the shampoo containing only 1% PTZ had a comparable increase in total hair count at 5.69 count/cm compared with baseline, while men who used placebo shampoo experienced a 0.58 loss in total hair count/cm2 over the same 26-week study.

"These results suggest that daily use of a 1% PTZ shampoo could have a prophylactic benefit in slowing the progression of male pattern baldness," investigators state. As Dr. Kenneth Smiles, PhD, principle scientist for Procter and Gamble, in Cincinnati, Ohio, noted in an interview, previous work suggests that microbiologically driven inflammation contributes at least in part to male pattern baldness.

"Since PTZ is an excellent anti-fungal agent, these observations suggested that it, too, may have a benefit in androgenetic alopecia," he said, adding, "I think what we have shown is that by using a shampoo like this, people with male pattern baldness can get some modest benefit from it without having to apply something else."

The Procter and Gamble study was conducted with Head and Shoulders Dandruff shampoo (fine and oily hair version) which contains 1% PTZ.