Improvement in Androgenetic Alopecia (Stage V) Using Topical Minoxidil in a Retinoid Vehicle and Oral Finasteride

REPORT OF A CASE A 32-year-old healthy white man with androgenetic alopecia (AGA)(Hamilton-Norwood stage V) of 10 years' duration presented for therapy (Figure 1). The patient desired to pursue medical treatment only. THERAPEUTIC CHALLENGE To optimize the opportunity for hair regrowth in a patient with advanced, extensive AGA using nonsurgical intervention. SOLUTION Following informed consent, the patient agreed to a 6to f 2-month trial of topical minoxidil in an optimized retinoid vehicle applied twice per day and 5 mg of finasteride taken orally each day. The topical solution was prepared as follows: minoxidil tablets were dissolved in distilled water, polyethylene glycol, and absolute ethanol (volume ratio, 20:30:50, respectively) to a final minoxidil concentration of 3.75% (grams per deciliter). Following filtration, the 3.75% minoxidil solution was combined with 0.05% tretinoin (4:1 vol/vol) for final concentrations of 3% minoxidil and 0.01% tretinoin. The preparation was stored at room temperature and protected from