Characterization of follicular minoxidil sulfotransferase activity in a cohort of pattern hair loss patients from the Indian Subcontinent

Dermatol Ther. 2018 Nov;31(6):e12688. doi: 10.1111/dth.12688. Epub 2018 Oct 8.


Several studies have established that sulfotransferase enzyme activity in the outer root sheath of plucked hair follicles predicts response to topical minoxidil in the treatment of pattern hair loss. However, the prevalence of this enzyme activity among Indian patients has not been studied. Additionally, no reports in the literature characterize sulfotransferase activity based on sex, age, duration of hair loss, grade of hair loss, and family history. In this study we utilized a sulfotransferase activity assay first reported by Goren et al. We characterize the follicular sulfotransferase activity of 120 pattern hair loss patients visiting a dermatology outpatient clinic in India. Overall, 40.8% of patients with pattern hair loss had low levels of sulfotransferase. Surprisingly, 49.3% of men had low levels of sulfotransferase compared to 26.6% of women. No correlation was found between sulfotransferase activity and age, duration of hair loss, grade of hair loss, or family history. A sub-analysis of patient reported outcomes (PRO) validated previous findings that sulfotransferase enzyme activity is a predictive marker for minoxidil response in pattern hair loss patients.

Keywords: hair loss; minoxidil; sulfotransferase.

MeSH terms

  • Adolescent
  • Adult
  • Alopecia / diagnosis
  • Alopecia / drug therapy
  • Alopecia / enzymology*
  • Alopecia / physiopathology
  • Biomarkers / metabolism
  • Cross-Sectional Studies
  • Female
  • Hair / drug effects
  • Hair / enzymology*
  • Hair / growth & development
  • Humans
  • India
  • Male
  • Middle Aged
  • Minoxidil / metabolism
  • Minoxidil / therapeutic use
  • Patient Reported Outcome Measures
  • Sulfotransferases / metabolism*
  • Treatment Outcome
  • Young Adult


  • Biomarkers
  • Minoxidil
  • Sulfotransferases
  • minoxidil sulfotransferase