Efficacy and Safety of Minoxidil Therapy: A Systematic Review and Meta-Analysis Weighing the Benefits Against the Risk of Hypertrichosis

This systematic review and meta-analysis evaluated the prevalence of hypertrichosis, a side effect of minoxidil therapy for androgenetic alopecia, across 27 studies with 4294 participants. Hypertrichosis was observed in 23% of patients, with higher rates in those using oral minoxidil (10% to 33%) compared to topical minoxidil (0% to 2%). Despite this, only 0.49% of patients discontinued treatment due to hypertrichosis. The study suggests that while hypertrichosis can be concerning, particularly for women, the benefits of minoxidil in treating alopecia generally outweigh the side effect, and clinicians should reassure patients accordingly. Limitations include variability in study designs and definitions of hypertrichosis.