Heisenberg

"We also witnessed a young and previously healthy female patient who developed, within weeks of treatment, a pericardial effusion at a dosage of oral minoxidil 1.25 mg for the treatment of female androgenetic alopecia. The patient complained of shortness of breath, discomfort while breathing in the supine position, chest pain, lightheadedness, and swelling in the legs. The patient assessment revealed pitting edema involving the lower limbs, and the ultrasound scans showed fluid collections in the pericardium."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9678755/

She was on the lowest possible dose too.

On 7/1/2023 at 11:49 PM, TheDarkHour said:

I started off with 1.25mg on my first two months and experienced no side effects, not even hypertrichosis. Upped my dosage to 2.5mg over the last two months and once every couple of days I'll get very slight chest pain for a few seconds but aside from that I haven't experienced any other side effects. That being said I haven't experienced any regrowth either but will continue taking it at this dose along with using the topical version for maintenance. 

The chest pain may be a symptom of pericardial effusion:

https://patient.info/doctor/pericardial-effusion

5 minutes ago, LeveledUp said:

Yeah I definitely dont think its a gold standard.

Can it be very effective? Of course we've seen people with great results.
But its not 100% effective which I've seen some people claim.

I feel like we're getting more of a truer picture now.

Although not a representative sample, I'm seeing reports of experiences like mine on Reddit with people saying Oral Minoxidil hasn't done anything for them even after 12 months

Well I've been off topical since October last year, I was ready to switch back months ago but I was so aboard the oral hype I begrudgingly decided to hold out longer. 5MG is the last ditch attempt but yeah definitely I was a responder to topical and will likely be going back very soon after my vacation.

Shame as I thought I'd be enjoying decent density but I had better density last year before I quit. 

Moral of the story - If its not broken dont try fix it  

I'll just have to not be lazy and apply 1x per day and stay on top with washing my hair daily to deal with the flakes.

 

And I have switched btween Kirkland Minoxidil and Foligain Low Alcohol 5% Minoxidil.

I bought 3 Months of Kirkland a few months back as I was going to quit oral.

So I'll likely use that again then go to Foligain with reduced alcohol to help reduce any flaking or irritation.

I think clinicians tend to prescribe oral minoxidil because of the sulfotransferase enzyme issue. It seems, though, that oral minoxidil isn't necessarily going to resolve that problem.

Both those products you mention contain alcohol, so be careful of that.

1 minute ago, LeveledUp said:

Keep an eye on the chest pain mate not worth it if it causes you issues, but hopefully 2.5MG does the trick.

I think my plan by late August/September is to go back to topical if 5MG doesn't make any difference.

I think 9/10 months is more than enough time to know if its working or will be effective.

Just annoying as topical whilst inconvenient at times, gave me noticeable results within say 4 months.

Good video below with Dr. Bevin Bhoyrul of Sinclair Dermatology in Australia.
Not watched it in a few weeks, but recall he mentioned he has a patient on 7.25mg or something similar, with no issues.
Me personally? Im maxing out at 5mg.
 

 

Indeed.

What topical minoxidil product did you use, by the way?

17 minutes ago, TheDarkHour said:

I started off with 1.25mg on my first two months and experienced no side effects, not even hypertrichosis. Upped my dosage to 2.5mg over the last two months and once every couple of days I'll get very slight chest pain for a few seconds but aside from that I haven't experienced any other side effects. That being said I haven't experienced any regrowth either but will continue taking it at this dose along with using the topical version for maintenance. 

I would take the chest pain very seriously. The last thing you want is to end up with a damaged heart etc.

13 minutes ago, LeveledUp said:

I was on 2.5mg for 7 months now 5MG (2x 2.5mg in the AM) for last month or so.

I've had no sides at all...But I've also not had any results and lost everything I had grown on Topical🤷‍♂️

Even body hair cant say I've noticed a marked difference, maybe arms a bit hairier not sure but might just be me overanalyzing nothing noticeable anyway.
Funny how medication works differently for everybody, I feel like only way I'll get results is on a higher dose at this rate...Which obviously not going to do.

But will give 5mg another few weeks to see if there's any signs of growth or thickening.

I think in my case Topical is just a 100x more effective for me but im holding out hoping Oral does its thing, as I get lazy with topical and the flaking was annoying at times, especially if I didnt wash my hair daily.

---

For Oral I think I guess the question is the long term outlook in terms of health and sides, but I think a lot of people will be okay as long as theyre sensible and listen to their body.

Definitely dont think Oral should be a 1st line treatment and people should use Topical/Foam Minoxidil first rather then jumping straight to oral.
Unless they are absolutely anti on committing to applying topical on their scalp daily or have severe allergies.

And in an ideal world should be under the supervision of a professional and have regular check ups.

 

That's interesting. Hair transplant surgeons seem to think that oral minoxidil is the gold standard (even though not approved by the FDA for hair loss), but it seems, in your case, it did next to nothing. Are you sure you are not having a shed? If you responded well to topical minoxidil, I would stick to that, as you are in the lucky group.

8 hours ago, Melvin- Moderator said:

I confirmed with Dr. Vaño that all side effects were included in the study, and that patients were monitored for 3 months, not given it 3 months prior. More studies are being conducted as we speak. It should be noted that there is no financial bias. They do not sell this drug, its compounded at pharmacies. There’s no reason to withhold truth or information.

How long have you been using the drug for, Melvin? Have you experienced no side effects at all? Are you having your cardiovascular system monitored by a clinician?

Anyone know of a good conditioner, which is gentle and alcohol free etc.?

Definitely stop taking the drug if you experience this:

48 minutes ago, hairman22 said:

Does Dr Bisanga advice any blood work or check your heart health?

I take OM no issues but it is best to take an individual approach and screen people before to see if suitable

He was accompanied by another clinician, who said that I should try taking it, but stop taking it if I sense any heart palpitations. He said that as I did not have any existing cardiovascular problems, it is unlikely that I will run into any serious problems, and said that even paracetamol etc. can cause side effects.

I'm not a big fan of topical solutions, as the ingredients/chemicals can cause inflammation, especially if they contain alcohol or propylene glycol. Also, I'm not sure rubbing the affected area constantly would be doing it any favours too, and that may indeed cause frictional alopecia. For those reasons, I am probably going to give oral minoxidil a go, but may only take it every other day.

Does anyone know of a topical minoxidil product that doesn't use alcohol as the delivery agent?

1 hour ago, Raphael84 said:

I dont believe that "Chronic" inflammation has been mentioned, and there has not been suggestion that inflammation from minoxidil is killing hair follicles?

As said, for specific details in relation to yourself and your case, then I would advise you to discuss all with your patient advisor.

Whilst inflammation may be due to topical minoxidil, it may also be that topical minoxidil is exacerbating symptoms of scarring alopecia.

Whilst Dr. Bisanga is extremely astute as evaluating scalp health and skin conditions, it is the speciality and entire career of scalp and hair related dermatologists and so whilst a consultation does incur a cost, it is not anywhere near the cost of surgery that may then produce a lesser yield, or potentially worse due to an undiagnosed scalp condition/status.

If your preference is to discontinue topical medication and see how you scalp may respond, then discuss this with your advisor and proceed as you are most comfortable.

My experience with patients would indicate that those with concerns, would prefer to rule this out and move forward as efficiently in regards to timeframe as possible.

For many, depending on location, waiting several months after discontinuing medication and then travelling, often internationally, for a further consultation/follow up with Dr. Bisanga may be more costly. So this is an example of where each individual has a completely unique set of circumstances and therefore should proceed in a way that makes most sense to them.

Please follow up with your advisor for any clarity and I wish you the very best.

I think the point I was trying to make is that the alcohol content in Regaine can lead to chronic inflammation, and that can lead to permanent hair loss. I'm not sure whether or not this has happened in my case, but that possibility nonetheless exists, if not for me, for other people who have an (undetected) adverse reaction to the alcohol, and who use Regaine for many years.

It gets worse because chronic inflammation can cause an increase in DHT production too.

Either way, if the alcohol within Regaine causes chronic inflammation in people who are sensitive to that, that, it would seem, is going to kill hair follicles over time, and one may not even know that that is happening until it is too late.

2 hours ago, Raphael84 said:

Thank you for attending your consultation today.

I respond to your thread to try and clarify any potential confusion.

I am not your advisor personally and so do not know the specifics of your case and your adviser will be best able to explain all that was discussed with you at consultation today.

The title of your thread prompted me to read your post. I think the title will cause alarm to many users and I believe it would be best to potentially consider changing that as it is not accurate.

Topical minoxidil does not cause scarring alopecia (LPP) and Dr. Bisanga did not suggest that it did. It is important to clear up confusion in that regard.

In some patients who use minoxidil, due to the sensitivity of the individual and the alcohol content of the medication, it can irritate the scalp and present itself as inflammation. This is not scarring alopecia, but would still require a change in scalp status and reduction in inflammation prior to surgery being able to be considered.

Scarring alopecia also presents itself as inflammation in the scalp and therefore if there is presence of any such inflammation, it is important to be able ascertain the reason behind any inflammation and rule out scarring alopecia before considering proceeding with surgery.

This is why consulting with a dermatologist who specialises in hair and scalp disease is in the best interests of any patient who may present such symptoms.

In terms of scarring alopecia, it is important to understand that this as a condition can not be cured. The condition will remain even if status becomes inactive due to treatment.

This means that any course of treatment that may be utilised is in an effort to reduce symptoms and to control status, however this would not "cure" the condition. 

Surgery itself can be a trigger to activate and progress the condition which means that not only would this likely influence and compromise growth and yield, but can also have a negative impact on existing hair and therefore individuals with scarring alopecia are generally not candidates for hair restoration surgery.

This is a prime example of the importance of in person consultation prior to scheduling hair restoration surgery.
Even individuals with very limited loss may still present some concern within their scalp that could potentially influence candidacy and result, and photo assessment would not present the opportunity for a thorough magnified assessment to check this.

Thanks for the post.

I am, however, still a bit confused. Why would I need to see a consultant dermatologist if stopping topical medications should resolve the problem, assuming the problem is caused by an alcohol sensitivity? 

2 hours ago, thetdog666 said:

 I have never heard of regaine causing scarring alopecia before. Does it look different one temple to the other side?

Doing a quick google looks like treatment would be anti-inflammatory medication. I would listen to an elite hair surgeon before some youtube wacko aswell!

Both temples look around the same.

Yes, hopefully it can be resolved with an anti-inflammatory medication, or by stopping topical treatments, but paying for a private dermatologist consultation etc. is pretty hefty.

Going to give 2.5 mg of oral minoxidil a go, but will start out taking it every other day to see how well I tolerate it.

I may try taking 2.5mg every other day, as that is probably safest, and better than nothing.

I've just consulted Dr Basinga and his colleague, and they seem to think you are more likely going to get serious sides with oral finasteride. I can't help but feel reluctant to take the stuff, though, not least because the side effects may be hard to spot, and there is always that risk. 

Hi all,

I have just got back from consulting Dr Basinga, and I'm told that I may have scarring alopecia around one of my temples. I'm told that this may be due to the alcohol contained in Regaine, which I have been using for years.

I am told that Dr Basinga's team is going to arrange for me to see a dermatologist to confirm if I suffer from scarring alopecia. Needless to say, this is the last thing I need.

Has anyone experienced anything like this, and how much does it generally cost to get this treated?

I'm going to be switching from Regaine to oral minoxidil I think, so I am hoping I won't experience serious side effects. Dr Basinga seems to think oral minoxidil is less risky than oral finasteride, but I know Kevin Mann (Haircafe) thinks the stuff can be fatal!

1 hour ago, mavigo said:

Go on... Green stain, as in stain your scalp green?

Yep, indeed:

https://www.quora.com/Toppik-hair-fibers-leave-a-stain-on-my-scalp-what-are-some-hair-fibers-that-do-not-leave-a-stain

It also leaves green marks over your bathroom sink etc.

The fact the Korean version of the FDA rejected approval is also a bit of a red flag.

I would be interested to know how many people are just using CosmeRNA, and not other anti-androgens concurrently. I suspect very few, so it would be largely impossible to pinpoint side effects. 

I think it has a dye in it, which is known to cause a green stain. For that reason alone, I am avoiding it.

On 6/9/2023 at 2:50 PM, New_Barnet_Please said:

Nice! Quite expensive for taxis in Brussels but you can just use Uber, maybe the app can tell you the price if you put in the journey.

Looks like around £30 using Uber in case anyone is interested.