Oral minoxidil bio‐activation by hair follicle outer root sheath cell sulfotransferase enzymes predicts clinical efficacy in female pattern hair loss

patent 10226462 detection and treatment of excessive hair shedding Miot HA: no conflict of interest Topical minoxidil (TM) is the only FDA-approved medication for the treatment of female pattern hair loss (FPHL). 1 Minoxidil is a pro-drug.TM efficacy in FPHL requires bio-activation into minoxidil sulfate by sulfotransferase enzymes. 2 Sulfotransferases are xenobiotic metabolizing enzymes expressed in many tissues with the highest expression found in the human liver. 36] The clinical response to TM is variable.Several strategies have been previously explored to overcome lack of response to 5% TM secondary to low ORS sulfotransferases activity. 7Use of higher concentrations of TM is effective in up to 60% of non-responders. 8