INTRODUCTION
Androgenetic alopecia (AGA) results in progressive hair loss due to miniaturization of hair follicles secondary to androgen influence.1 AGA affects both men and women and is a common dermatologic complaint that causes significant patient distress. Minoxidil was initially developed as an anti-hypertensive medication and was incidentally found to increase hair density. While its use as an anti-hypertensive has fallen out of favor, it continues to be used in its topical formulation for various alopecic conditions and is one of only two Food and Drug Administration (FDA)-approved medications for AGA. Its mechanism of action for hair growth is not clearly defined; however, it is proposed to work by promoting increased regional scalp blood flow and stimulation of vascular endothelial growth factor.2 Attention has been drawn to oral minoxidil due to its superior efficacy compared to topical, as well as its cost and ease of use for patients.3,4 The side effect profile of oral minoxidil is more pronounced than its topical counterpart due to its systemic metabolism; these effects include hypertrichosis, pretibial edema, hypotension, and hypernatremia.5
Utilization of low-dose oral minoxidil (LDOM) has increased in recent years in association with several clinical studies that have shown its efficacy in treating AGA and other hair loss conditions.6-9 Given that oral minoxidil is not FDA-approved for the treatment of AGA, there is a lack of guidance in prescribing, as well as a lack of consensus regarding its role in treatment. We assessed dermatology providers' attitudes and recommendation behaviors of oral minoxidil for the treatment of AGA.
Utilization of low-dose oral minoxidil (LDOM) has increased in recent years in association with several clinical studies that have shown its efficacy in treating AGA and other hair loss conditions.6-9 Given that oral minoxidil is not FDA-approved for the treatment of AGA, there is a lack of guidance in prescribing, as well as a lack of consensus regarding its role in treatment. We assessed dermatology providers' attitudes and recommendation behaviors of oral minoxidil for the treatment of AGA.
MATERIALS AND METHODS
An online survey gauging the professional opinions, prescribing behaviors, and use of oral minoxidil was sent using the Orlando Dermatology Aesthetic and Clinical Conference email listserv which included multiple levels of dermatology practitioners including MD/DOs, NPs, and PAs across the United States. Data analyses were performed using SAS version 9.4 (SAS Institute, Cary, NC). This study was approved by the George Washington University Institutional Review Board #NCR224464.
RESULTS
Overall, the survey was sent to 2200 providers, and 201 responses were collected (9.1% response rate; Table 1). 81% were Board Certified Dermatologists, and most respondents practiced in a private setting, followed by an academic or VA
