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Health

Minoxidil shortage creates problems for some people with alopecia and hair loss

Nature

A popular medication used to regrow hair and thicken thinning locks in men and women may be hard to find at some drugstores, a new study suggests.

The pill, called minoxidil, must be taken daily for patients to maintain progress in restoring hair growth. An interruption could be devastating.

“You can go back and start losing hair again,” said Dr. Adam Friedman, professor and chairman of dermatology at George Washington University.

Minoxidil is often used to treat androgenetic alopecia, also known as male or female pattern hair loss. It’s a disease that affects nearly half of men and about a quarter of women before the age of 50, according to the American Osteopathic College of Dermatology.

In recent months, Friedman noticed that his patients were having difficulty obtaining a 30-day supply of medication from their pharmacies in the Washington, D.C., area.

Earlier this month, he and his colleagues called 277 pharmacies in the District of Columbia, Maryland and Virginia to ask about their minoxidil supplies. They found considerable shortages.

Only 40 percent of these pharmacies had the ability to immediately fill 30-day prescriptions of minoxidil at doses used to treat hair loss (2.5 milligrams). The research was published in the Journal of Drugs in Dermatology.

Friedman could not identify the reason for the shortage, but said the drug gained attention both in mainstream media and on social media, which could have triggered a surge in prescriptions.

Based on the survey, it is unclear how long patients should wait to receive their medications. The researchers did not ask how quickly these pharmacies could replenish their minoxidil supplies.

Friedman nevertheless expressed concern about the error.

“A significant number of our patients will not be able to access minoxidil due to these shortages,” Friedman said. “This is a significant issue.”

What is minoxidil and how does it work?

Minoxidil has been around for decades as a medication to treat high blood pressure by dilating blood vessels. When researchers first tested the drug in the 1960s, patients reported an interesting side effect: excessive hair growth.

Although no one knows for sure how minoxidil stimulates hair growth, doctors believe that this medication increases blood flow around hair follicles.

In the late 1980s, it was incorporated into topical hair loss treatments, such as Rogaine. Over time, it became clear that applying the treatment to the scalp daily was not only tedious; doctors found that it didn’t work as well as taking it orally.

However, when taken orally, minoxidil can stimulate hair growth anywhere on the body, including the chin and arms. This may not be desirable for many patients, especially women.

Still, Dr. Loren Krueger, assistant professor in the department of dermatology at Emory University School of Medicine, calls oral minoxidil a “game changer” in terms of hair loss, treatment and restoration.

“The drug is really low risk and very beneficial,” she said.

Addressing minoxidil shortages

The apparent problem with access to oral minoxidil — which is not approved by the Food and Drug Administration to treat hair loss — may be regional rather than national. The FDA does not list minoxidil as a drug in shortage, but occasional shortages have been reported anecdotally over the past year.

Michael Ganio, senior director of pharmacy practice and quality for the American Society of Health-System Pharmacists, an organization that represents pharmacies nationally, said he was not surprised that the points of sales do not always stock minoxidil stocks for 30 days.

Although the pill is intended to treat high blood pressure, it is not often used in health emergencies. Additionally, he added, wholesalers should be able to supply the drug to pharmacies within a few days.

“Why keep more than a week, maybe 10 days, on the shelves?” Ganio said.

But if the medication is needed urgently, patients may need to call different pharmacies to get their prescription filled.

“Hair loss is not life-threatening, but let’s not underestimate its impact on quality of life,” Friedman said. “When people lose their hair, it’s extremely debilitating.”

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