Background: Chronic telogen efﬂuvium (CTE) may be primary or secondary to a variety of causes including drug reaction, nutritional deﬁciency and female pattern hair loss. Oral minoxidil stimulates hair growth, and topical minoxidil is used in the treatment of androgenetic alopecia. Neither oral nor topical minoxidil has been used to treat CTE.
Methods: Women with a diagnosis of CTE based on >6 month history of increased telogen hair shedding, no visible mid frontal scalp hair loss (Sinclair stage 1) and no hair follicle miniaturization on scalp biopsy were treated with once daily oral minoxidil. Hair shedding scores at baseline, 6 and 12 months were analysed using the Wilcoxon rank sum test for pair-wise comparisons.
Results: Thirty-six women were treated with oral minoxidil in doses ranging between 0.25 and 2.5 mg daily and for 6 months. Mean age was 46.9 years (range 20–83). Mean hair shedding score (HSS) at baseline was 5.64. The reduction in mean HSS scores from baseline to 6 months was 1.7 (p < 0.001) and the reduction in mean HSS scores from baseline to 12 months was 2.58 (p < 0.001). Five women who described trichodynia at baseline, noted resolution within 3 months. Two patients developed transient postural dizziness that resolved with continued treatment. Thirteen women developed mild to moderate facial hypertrichosis. No haematological abnormality was detected. Discussion: Once daily oral minoxidil appear to reduce hair shedding in CTE and may beneﬁt trichodynia in association with increased hair shedding. Placebo controlled studies are recommended to further assess this response.