In last month’s blog post, we provided an overview of various compounded solutions for hair loss. This month, we want to shift the focus to compounded bimatoprost for treating scalp alopecias. Bimatoprost was originally developed as an ocular hypotensive agent for glaucoma. It was observed to also promote hair growth and eventually received FDA-approval for treating eyelash hypotrichosis.
In addition to its FDA-approved indications, it has also shown promise as an off-label prescription for treating hair loss disorders such as scalp alopecia.1 For such off-label prescriptions, it may be necessary to enlist the services of a compounding pharmacy to ensure that the preparation is tailored to the specific needs of your patients, including an appropriate administration route.
Literature Evidence of Bimatoprost Efficacy for Scalp Alopecias
In alopecia areata and androgenetic alopecia, topical bimatoprost can trigger follicular activity, which can regrow or thicken hair shafts. A systematic review of prostaglandin analogs in hair loss showed significant improvements in hair density and length versus placebo, with no major differences in adverse effects compared to a control group. However, optimal dosing and frequency for scalp use remain under investigation.2
In a pilot trial, 0.03% bimatoprost applied to alopecia areata patches showed significantly greater hair regrowth than topical mometasone steroid after 12 weeks.3 Another small study in androgenetic alopecia compared 0.03% bimatoprost to 5% minoxidil, and though sample size was limited, the bimatoprost group showed increased terminal hair count and thickness at 3 months, with fewer reports of scalp irritation.4
These early studies suggest bimatoprost can be a useful compounded therapy for hair growth, particularly for patients who cannot tolerate standard treatments or even as an adjunct to enhance results from commercially available therapies such as minoxidil.
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Mechanism of Action of Bimatoprost for Scalp Alopecias
Hair growth is stimulated by prostaglandin E2 (PGE2), but the scalp of people with alopecias has low levels of PGE2.2 To stimulate hair growth, prostaglandin analogs like bimatoprost have been suggested to interact with prostanoid receptors in hair follicles, stimulating resting follicles in the telogen phase to transition into the anagen (growth) phase.5 Bimatoprost may lead to increased hair length and density by prolonging the anagen phase. This mechanism was first observed when using 0.03% bimatoprost to treat eyelash hypotrichosis and suggests its therapeutic potential for treating scalp hair loss.
Topical Compounding of Bimatoprost for Scalp Alopecias
The commercially available forms of many medications may not meet the needs of specific patients, especially when they are being prescribed for an off-label indication. This may require a re-formulation that is markedly different from the commercially available form of a drug when changing the administration route, such as switching from ophthalmic to topical administration.
A compounding pharmacy can also help remove irritating excipients. At VLS Pharmacy & New Drug Loft, we can formulate our preparations without propylene glycol, which is a known irritant and scalp offender that causes dryness and irritation in some patients.
Similarly, benzalkonium chloride is a preservative found in some commercially available bimatoprost solutions that may cause contact dermatitis.6 For treating scalp alopecias, bimatoprost can be re-formulated for topical administration without this preservative if a patient is experiencing contact dermatitis. Preservative-free formulations of bimatoprost can be prepared,7,8 but a compounding pharmacy will be necessary to ensure that the preservative is removed without affecting the effectiveness or stability of the formulation.
In addition to helping reduce adverse events such as skin irritation due to excipients, a compounding pharmacy can also help enhance penetration across the scalp to hair follicles by optimizing the formulation. Research on experimental formulations has shown that adding specific excipients increased bimatoprost skin absorption, with one specialized vehicle raising transdermal flux over 5-fold in a murine model, and even higher with further concentration increases.9
Why Choose VLS Pharmacy & New Drug Loft?
Men and women of all ages deserve to feel confident and comfortable with their appearance – and hair loss shouldn’t get in the way of this goal! If commercially-available hair loss medications are not meeting the needs of individual patients, prescribers may consider consulting a 503A pharmacy like VLS Pharmacy & New Drug Loft. By working with a trusted compounding pharmacy, you can develop a personalized hair loss treatment plan for your patients.
We will support you and your patients by creating individualized pharmaceutical therapies, including both sterile and non-sterile compounded preparations. All formulations are compounded with high-quality pharmaceutical-grade APIs sourced directly from PCCA, the leader in superior-quality APIs.
As part of our efforts to ensure patient safety, we compound all of our formulations using high-quality pharmaceutical-grade APIs sourced directly from PCCA, the leader of superior-quality APIs. Our pharmacists and technicians tailor each formulation to meet a patient’s specific needs, including the dose and administration route. As a 503A pharmacy specializing in sterile and non-sterile compounding, we will support you and your patients by creating individualized pharmaceutical therapies.
Please comment below with any thoughts or questions.
Reach out to our team to learn about best practices and to partner with our experts on custom compounded medications for your patients. All medications from VLS Pharmacy and New Drug Loft are prepared in a lab that follows safety and quality standards per our status as a 503A pharmacy.
References
- Zeppieri M, Gagliano C, Spadea L, et al. From Eye Care to Hair Growth: Bimatoprost. Pharmaceuticals. 2024;17(5):561. doi:10.3390/ph17050561
- Jiang S, Hao Z, Qi W, Wang Z, Zhou M, Guo N. The efficacy of topical prostaglandin analogs for hair loss: A systematic review and meta-analysis. Front Med. 2023;10. doi:10.3389/fmed.2023.1130623
- Zaher H, Gawdat HI, Hegazy RA, Hassan M. Bimatoprost versus Mometasone Furoate in the Treatment of Scalp Alopecia Areata: A Pilot Study. Dermatol Basel Switz. 2015;230(4):308-313. doi:10.1159/000371416
- Farida T, Irawan AA, Anni A, Dwi A. The Effectiveness of 0.03% Bimatoprost Solution Vs Minoxidil 5% in Androgenic Alopecia. Indian J Public Health Res Dev. 2018;9(12):1444-1448.
- Law SK. Bimatoprost in the treatment of eyelash hypotrichosis. Clin Ophthalmol Auckl NZ. 2010;4:349-358.
- Sodhi PK, Verma L, Ratan SK. Contact dermatitis from topical bimatoprost. Contact Dermatitis. 2004;50(1):50-50. doi:10.1111/j.0105-1873.2004.00271k.x
- Bimatoprost 0.03% preservative-free ophthalmic solution versus bimatoprost 0.03% ophthalmic solution (Lumigan) for glaucoma or ocular hypertension: a 12-week, randomised, double-masked trial | British Journal of Ophthalmology. Accessed April 9, 2025. https://bjo.bmj.com/content/97/8/989
- Muñoz-Negrete FJ, Topouzis F, Oddone F, et al. Preservative-Free Bimatoprost 0.01% Ophthalmic Gel for Glaucoma Therapy: A Phase III Randomized Controlled Trial. J Glaucoma. 2024;33(6):422. doi:10.1097/IJG.0000000000002371
- Full article: Preparation of topical bimatoprost with enhanced skin infiltration and in vivo hair regrowth efficacy in androgenic alopecia. Accessed April 1, 2025. https://www.tandfonline.com/doi/full/10.1080/10717544.2022.2027046
Read More…
- Learn more about our compounding capabilities for hair loss
- A deep dive into other hair loss prevention and regrowth treatment options
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