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The Pharmacovigilance Center of Navarra recently detected a case of a baby with hypertrichosisa pathology popularly known as werewolf syndrome. The particularity of this case is based on the fact that the baby’s father was undergoing treatment with a drug for alopecia known as Minoxidil. As a result of this finding, the bibliography of the disease was reviewed and up to eleven cases were documented throughout Europe of child patients who presented this process and who had been in contact with said medication, which had been being used by one or another progenitor.

What is hypertrichosis?

It is a very rare disease that consists of abundant existence of hair on the entire body surfacebut especially on the scalp, genital area, face, back and the external area of ​​the four extremities. Not all cases are the same, since intensity and extent can be highly variable. From minimal signs of hypertrichosis to very intense cases. The latter have been recognized since ancient times as cases of “werewolves.” It is suspected that this disease has a genetic origin and is due to a genetic mutation, which means that cases occur in the same family although with large generation gaps.

A variant of hypertrichosis is hirsutismwhich is defined as an increase in the amount of hair and hair distributed over the skin with a masculine pattern. When it affects girls and adolescents, it is characterized by an increase in hair in growth areas of the body, typical of children. This condition has a marked hormonal origin.

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What is minoxidil?

It is a medicine composed of tominexila substance derived from aminoxidine which has a direct action on the metabolism and good health of the hair follicle, producing a biostimulation in its growth and increasing the capillary density of the scalp and other parts of the body.

This medication, developed in the middle of the last century to treat high blood pressure, proved to be very effective by acting on the skin and hair follicles by direct contact, dilating the blood vessels of the scalp and improving the nutrition of the hair follicle and improving the growth and good health of the hair.

The continued and long-term use of minoxidil has been demonstrated as a effective treatment for notable improvements in hair quality and thickness in both sexes. The results become visible after six months of treatment and the effectiveness of its action is manifested earlier if the treatment begins at the beginning of the first symptoms of incipient baldness.

Although there are two forms of oral and topical presentation, the most used is the topical form of cutaneous application of the scalpin the form of lotion or foam. The oral form allows only lower doses as it has more side effects and is less effective.

Is it possible for a child to have hypertrichosis because a parent is using a baldness lotion?

Although we do not have enough information, the truth is that We think that such a conclusion is very unlikely.. We do not know the age of the babies studied, whether they were already born with hypertrichosis or it appeared after birth, what was the cutaneous distribution of the hair and the intensity of the process, if they had access to the lotion and in what way and its subsequent evolution.

If we take into account that the action of the drug requires direct contact with the hair follicle to be effective, its delay in appearing results and effects, which lasts up to six months of treatment, the location of the hypertrichosis and the intensity of the hygiene of the family group, we see that the possibilities that the medication used by the parents is in the origin of hypertrichosis in children are unlikely and rare.

Finally, without doubting the conclusions reached by the studies of local cases and the bibliographic compilation of other European cases, it is prudent to wait for new epidemiological studies to be sure that this association of hypertrichosis in children with the use of lotions with minoxidine by parents is harmful to their children and thus recommend that, if possible, such a situation be prevented and avoided.