Sublingual Minoxidil Increases Fibre Diameter in Male Androgenetic Alopecia. - A proxy for Reversal of Hair Follicle Miniaturization

Rodney Sinclair, Justin Sicinska, Laita Bokhari, Michael Kasprzak

January 2025

While clinical trials with minoxidil topical solution in MAGA do not demonstrate increased fibre diameter, vellus-to-terminal reconversion is shown in a humanized mouse model treated with MXL.

The histological hallmark of male androgenetic alopecia (MAGA) is transformation of terminal follicles into miniaturized secondary-vellus follicles. As the volume of the dermal papilla determines the size of the hair bulb and hair fibre diameter, any treatment induced increase in fibre diameter could be used as a proxy for reversal of hair follicle miniaturization. 

While clinical trials with minoxidil topical solution in MAGA do not demonstrate increased fibre diameter, vellus-to-terminal reconversion is shown in a humanized mouse model treated with MXL.

The effect of SLM on mean fibre diameter was dose-dependent. SLM 1.35mg and 4.05mg, but not 0.45mg, significantly increased mean fibre diameter in MAGA. Diameter increased most in intermediate and thickest hairs. This increase in fibre diameter infers reversal of follicle miniaturization in MAGA and is consistent with the observation of vellus-to-terminal reconversion is shown in a humanized mouse model treated with minoxidil.

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