Low-dose oral minoxidil (LDOM) and topical minoxidil: consensus recommendations for managing male and female pattern Hair loss in Hair transplant patients using a modified delphi process

This study provides consensus-based recommendations for the use of low-dose oral minoxidil (LDOM) and topical minoxidil in managing male and female pattern hair loss, particularly in hair transplant patients. An international panel of hair transplant surgeons used a modified Delphi process to reach consensus on 47 items related to assessment, dosing, monitoring, and safety. Key recommendations include starting LDOM at 1.25–2.5 mg/day for men and 0.625–1.25 mg/day for women, with maximum doses of 5 mg and 2.5 mg, respectively. Clinical improvement is expected within 4–6 months, and treatment can be continued long-term if effective. LDOM can be resumed 1–3 days post-surgery, while topical minoxidil can be applied 7–14 days after transplant. Side effects of LDOM include tachycardia, headache, peripheral edema, and hypertrichosis, which are dose-related and manageable. Topical minoxidil 5% is effective on the frontal scalp and vertex but should be avoided during pregnancy and breastfeeding.