Sulfotransferase activity in plucked hair follicles predicts response to topical minoxidil in the treatment of female androgenetic alopecia

Dermatol Ther. Jul-Aug 2014;27(4):252-4. doi: 10.1111/dth.12130. Epub 2014 Apr 28.


Two percent topical minoxidil is the only US Food and Drug Administration-approved drug for the treatment of female androgenetic alopecia (AGA). Its success has been limited by the low percentage of responders. Meta-analysis of several studies reporting the number of responders to 2% minoxidil monotherapy indicates moderate hair regrowth in only 13-20% of female patients. Five percent minoxidil solution, when used off-label, may increase the percentage of responders to as much as 40%. As such, a biomarker for predicting treatment response would have significant clinical utility. In a previous study, Goren et al. reported an association between sulfotransferase activity in plucked hair follicles and minoxidil response in a mixed cohort of male and female patients. The aim of this study was to replicate these findings in a well-defined cohort of female patients with AGA treated with 5% minoxidil daily for a period of 6 months. Consistent with the prior study, we found that sulfotransferase activity in plucked hair follicles predicts treatment response with 93% sensitivity and 83% specificity. Our study further supports the importance of minoxidil sulfation in eliciting a therapeutic response and provides further insight into novel targets for increasing minoxidil efficacy.

Keywords: androgenetic alopecia; minoxidil; sulfotransferase.

Publication types

  • Clinical Trial

MeSH terms

  • Administration, Topical
  • Alopecia / drug therapy*
  • Cohort Studies
  • Female
  • Hair / growth & development
  • Hair Follicle / enzymology*
  • Humans
  • Minoxidil / administration & dosage
  • Minoxidil / metabolism
  • Minoxidil / therapeutic use*
  • Sensitivity and Specificity
  • Sulfotransferases / metabolism*
  • Treatment Outcome


  • Minoxidil
  • Sulfotransferases