Pain in the heart, hair on the head: Pericarditis as an unanticipated risk of low-dose oral minoxidil

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Androgenetic alopecia (n=1). Intervention: Low-dose oral minoxidil. Primary outcome: Development of pericarditis.

Isabella Zappi; Archie J. Spindler; Derek Maas; Hooman Yaghoobzadeh; Kristen I. Lo Sicco; Jerry Shapiro

doi:10.1016/j.jdcr.2026.07.056

August 4, 2026JAAD Case ReportsOpen Access

Pain in the heart, hair on the head: Pericarditis as an unanticipated risk of low-dose oral minoxidil

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Key result

Low-dose oral minoxidil is linked to rapid onset of pericarditis in a case report.

n=1

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Key Points

To describe a case of pericarditis after reinitiating low-dose oral minoxidil for androgenetic alopecia and summarize previously reported cases in the medical literature.
Clinical, laboratory, electrocardiographic, and echocardiographic evaluation of a 33-year-old healthy man presenting with pleuritic chest pain after restarting low-dose oral minoxidil.
Scalp trichometry, trichoscopy, and a 4 mm punch biopsy were performed to assess hair loss progression.
A systematic literature search was conducted across PubMed, Google Scholar, and Scopus using the terms 'minoxidil pericarditis' and 'oral minoxidil pericarditis'.
A 33-year-old man developed diffuse ST elevations, elevated high-sensitivity C-reactive protein (peaking at 23.5 mg/L; reference 0.0-3.0 mg/L), and elevated erythrocyte sedimentation rate (peaking at 22 mm/h; reference 0.0-22.0 mm/h) 1 month after restarting minoxidil at 5 mg daily.
Pericarditis symptoms resolved within 10 days following minoxidil discontinuation and therapy with colchicine and non-steroidal anti-inflammatory drugs.
Literature review identified 2 additional cases of pericarditis associated with low-dose oral minoxidil (2.5 mg daily and 5 mg daily), both showing complete symptom resolution after drug cessation.

Study Design

Type

Case Report (n=1)

Structured PICO

P

Population

A 33-year-old otherwise healthy man with androgenetic alopecia who developed pericarditis after restarting low-dose oral minoxidil.

E

Exposure

Low-dose oral minoxidil 5 mg daily.

O

Outcome

Development of pericarditissafety

Limitations

Current studies may be underpowered to detect rare complications such as pericarditis
Direct-to-consumer telemedicine pharmacies may prescribe LDOM with limited monitoring and follow-up
Single case report
Current studies on low-dose oral minoxidil may be underpowered to detect rare complications such as pericarditis

Implication

Low-dose oral minoxidil used for alopecia can be associated with the development of acute pericarditis even in young, healthy individuals without prior cardiovascular disease.

Abstract

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Discussion

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Cite This Study

Zappi et al. (2026) conducted a case report in Androgenetic alopecia (n=1). Low-dose oral minoxidil was evaluated on Development of pericarditis. Low-dose oral minoxidil was associated with the rapid development of pericarditis in a healthy 33-year-old man, which resolved upon discontinuation and anti-inflammatory treatment.

synapsesocial.com/papers/6ad115af00741cc3fba7d7a5 https://doi.org/10.1016/j.jdcr.2026.07.056

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Pain in the heart, hair on the head: Pericarditis as an unanticipated risk of low-dose oral minoxidil

Figures

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Pain in the heart, hair on the head: Pericarditis as an unanticipated risk of low-dose oral minoxidil

Figures

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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