To the Editor,
We commend the work of authors Desai et al in "The Potential Impact of Off-Label Medication Use on Patient Access: A Cross-Sectional Survey of Minoxidil Availability."1 This article highlights the shortage of low-dose oral minoxidil (LDOM) at pharmacies in the District of Columbia, Maryland, and Virginia (DMV) area following the rise in off-label use of LDOM for the treatment of androgenetic alopecia (AGA). The popularity of LDOM was further enhanced by the New York Times (NYT) publication on August 18, 2022, that discussed the use of LDOM for AGA with the general public.2
Beyond the DMV region, patients nationwide were impacted by pharmacy shortages of LDOM. To capture the increasing popularity of the medication that contributed to the national shortage, we performed a Google Search Trends analysis on the term oral minoxidil from 8/13/21 through 8/13/22 versus 8/22/22 through 8/22/23 (one year prior vs one year after the publication of the New York Times article excluding the week of publication). We compared relative search volume (RSV) on a scale from 0-100 which represents search interest relative to all searches for given regions and times.
There was a significant increase in RSV for oral minoxidil (P=0.035) in the year following publication (mean RSV:64.27) compared to the year prior (mean RSV:16.88), highlighting the increased popularity of this medication temporal to the publication of the NYT article. While there may be other contributing factors, the publication of the NYT article likely contributed to the rise in medication use and subsequent shortage of LDOM.
Scientific literature and clinical practices have well-established the reality that alopecia patients face significant psychosocial impacts due to their medical condition.3 These consequences range from higher rates of anxiety and depression to lower levels of self-esteem.3 Beyond these psychosocial consequences, the potential physical symptoms
We commend the work of authors Desai et al in "The Potential Impact of Off-Label Medication Use on Patient Access: A Cross-Sectional Survey of Minoxidil Availability."1 This article highlights the shortage of low-dose oral minoxidil (LDOM) at pharmacies in the District of Columbia, Maryland, and Virginia (DMV) area following the rise in off-label use of LDOM for the treatment of androgenetic alopecia (AGA). The popularity of LDOM was further enhanced by the New York Times (NYT) publication on August 18, 2022, that discussed the use of LDOM for AGA with the general public.2
Beyond the DMV region, patients nationwide were impacted by pharmacy shortages of LDOM. To capture the increasing popularity of the medication that contributed to the national shortage, we performed a Google Search Trends analysis on the term oral minoxidil from 8/13/21 through 8/13/22 versus 8/22/22 through 8/22/23 (one year prior vs one year after the publication of the New York Times article excluding the week of publication). We compared relative search volume (RSV) on a scale from 0-100 which represents search interest relative to all searches for given regions and times.
There was a significant increase in RSV for oral minoxidil (P=0.035) in the year following publication (mean RSV:64.27) compared to the year prior (mean RSV:16.88), highlighting the increased popularity of this medication temporal to the publication of the NYT article. While there may be other contributing factors, the publication of the NYT article likely contributed to the rise in medication use and subsequent shortage of LDOM.
Scientific literature and clinical practices have well-established the reality that alopecia patients face significant psychosocial impacts due to their medical condition.3 These consequences range from higher rates of anxiety and depression to lower levels of self-esteem.3 Beyond these psychosocial consequences, the potential physical symptoms
