Endocrine Abstracts

Introduction: Minoxidil is a vasodilator drug used as topical treatment of androgenetic alopecia; however, its efficacy for beard enhancement is reported in cisgender men and in a case-report of a transgender assigned female at birth (t-AFAB) adolescent. This study aims to evaluate the short- and long-term efficacy of topical minoxidil in a group of t-AFAB people on gender affirming hormone therapy (GAHT) with testosterone.

Materials and methods: Sixteen t-AFAB clients with an uncomplete beard development, on GAHT for at least for 6 months, were enrolled at CIDIGEM gender team, Turin. They used Minoxidil 2% 2 ml/day on the interested facial areas for at least 3 consecutive months. Before starting (T0), after 3 (T3) 6 (T6) and 12 months (T12) we evaluated facial hair growth using Ferriman-Gallwey modified score (FGm). Hair gowth pattern and side effects were subjectively reported.

Results: At T0, recruited clients were 26 (2.7) years old, and they were on GAHT for 18,5 [15-54] months; we observed a FGm of 2 [1-2] at the prolabium and 2 [1-2] at the chin. Compared to T0, we observed a statistically significant difference on the pair matched evaluation at T3 (median prolabium FGm 3 [2.25-4] and chin 3.5 [3-4]; P<0.05) and at T6 (FGm 3.5 [3-4] - prolabium and 4 [3.25-4] - chin; P≤0.002). No major side effects were reported. At T6 73% of the sample stopped minoxidil. At T12 we observed substantial stability of the obtained results (chin FGm 4 [3.75-4] and prolabium FGm 4 [3-4]; P>0.05), even if 2 people reported a slower hair growth since suspension. The other 27% kept using minoxidil due to unsatisfaction of the results or fear of regression.

Conclusion: The use of Minoxidil 2% in a group of t-AFAB people on GAHT showed at 3 and 6 months of use a significative beard growth enhancement. Stopping the therapy at 6 months seemed to maintain the obtained improvements during the subsequent months even if the beard speed growth may be impaired.