Research Summary
After more than a decade of use, topical minoxidil solution has proven to be a safe and effective treatment for androgenetic alopecia. However, some patients report complaints of pruritus and scaling of the scalp. The most common causes of these symptoms include irritant contact dermatitis, allergic contact dermatitis, or an exacerbation of seborrheic dermatitis.
Patients suffering from allergic contact dermatitis may benefit from patch testing to identify the causative allergen. Among the patients we patch tested, propylene glycol was found to be the allergen in the majority of cases, rather than the minoxidil itself. Many of these patients may be suitable candidates for treatment with alternative formulations using other solvents, such as butylene glycol, polysorbate, or glycerol.
Although patch testing can be predictive, the results do not guarantee that compounded preparations will be well tolerated. Unfortunately, patients who are allergic to minoxidil are no longer candidates for topical treatment of their alopecia with any minoxidil-based preparations. (J Am Acad Dermatol 2002;46:309-12.)
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