Treatment of Androgenetic Alopecia in Transgender People Receiving Testosterone Therapy With Sublingual Minoxidil: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

A recent randomized, double-blind, placebo-controlled clinical trial investigated the use of sublingual minoxidil for treating mild androgenetic alopecia (AGA) in transgender individuals undergoing testosterone therapy. Participants were assigned to receive either 1.35 mg of sublingual minoxidil or a placebo twice daily for 24 weeks, followed by an open-label phase where all received 2.5 mg of minoxidil. The study found that sublingual minoxidil significantly increased hair count in the midfrontal and vertex areas without affecting testosterone levels or causing serious adverse events. The treatment was well tolerated, suggesting that sublingual minoxidil is a safe and effective option for hair growth in this population. However, the mild baseline AGA may have limited the detection of changes in global photographs and quality-of-life scores.