Is minoxidil safe to use on transplanted hair?

[tressful11]

I have heard several reports here that Dr Hasson and Wong advise against using minoxidil and also ask patients to stop minox 3 months before transplant.
I would like to know what's the consensus on long term minoxidil use?
Is it safe to apply? Does the solution have capability of affecting transplanted grafts over a long term?
Any long term users of minoxidil who have been using it successfully  even after a hair transplant?

[ITA]

minoxidil is a dilator vessel, they are advised to discontinue use before the procedure, to avoid excessive bleeding during the operation.  You will be able to start using it again from the fourth / fifth month onwards.

[ciaus]

Stopping months before a procedure or waiting months after to use minoxidil are both ridiculously long and have no medical basis.

Yes minoxidil dilates your blood vessels and that can cause excessive bleeding during the procedure and in the first week or so of healing. So you stop using it 7-10 days before the procedure and as long as you are healing normally you can start back up a week after, maybe wait 2 weeks if you want to be extra safe.

I take oral minoxidil now because the topical formula irritates skin conditions back on my crown area, but at the time of my first procedure on my hairline I was using it and started back up after the first week with my doctor's blessing, no issues.

[tressful11]

On 10/16/2020 at 6:34 PM, Egy said:

minoxidil is a dilator vessel, they are advised to discontinue use before the procedure, to avoid excessive bleeding during the operation.  You will be able to start using it again from the fourth / fifth month onwards.

But AFAIK, hasson and wong actively discourage patients from using minoxidil at all. According to them minoxidil affects the scalp laxity?
I am not sure though. I just remember reading it somewhere.

[DrTBarghouthi]

We usually stop it two weeks before to reduce potential heavier bleeding. We resume it 2 weeks after by the time the healing is well underway and shedding starts and the scrubbing of grafts is completed. 

[ITA]

@DrTBarghouthiresuming after just two weeks seems a little early, at least if you use the lotion version, it contains alcohol and the scalp is not completely healed, it is different if you use the foam version.   
@tressful11 as for compromising scalp laxity, I can't tell you, but if you have to undergo surgery with H&W and they advise so, I would.

Edited October 19, 2020 by Egy

[DrTBarghouthi]

Thanks @EgyCorrect. I only recommend the foam personally, at least for the initial phase. Nonetheless, I actually push for people to only use foam. 

[ciaus]

There's a study here where 12 patients were started on minoxidil 48-72 hrs after the transplant, not only did it do no harm but 2 of the patients never had the ugly duckling phase and another 2 started regrowth in less than 4 weeks instead of the usual several months.

But generally I wouldn't recommend that because unless you are in a controlled situation like this due to bleeding risk if you bump your head etc, and unless you are taking oral minoxidil some people will try to touch/rub the solution in and that could potentially end up dislodging the grafts.

 

https://pubmed.ncbi.nlm.nih.gov/3558912

 

[Westview]

Every clinic is different when it comes to this advice, but the general consensus is wait 2 weeks after your surgery before applying minoxidil when all the grafts are completely anchored.  Also like others have said make sure you use the alcohol-free foam for the first couple of months

[tressful11]

Thanks for your sharing your perspective everyone.
But my primary concern is whether using minox on transplanted hairs might affected them in the long term?
We do know that non transplanted hairs become dependant on minox and fall out when you stop using minox.
What about transplanted hairs? Will they be affected if we stop minox after a few years?

[DrTBarghouthi]

Transplanted hairs should not be affected by minoxidil or get sensitive to it on the longrun. Nonetheless, even if they do, it will only go back to it's normal cycling pattern without any fear of thinning etc as in the case of native hair. Remember that minoxidil keeps hairs in a growth stage rather than them entering into a resting stage, which is what we fear with thinning hairs. So even if minoxidil becomes ineffective on transplanted hairs on the longrun, it will just be a normal cycling pattern. 

[longjonsilver]

When to use it after a HT depends on each person. Most clinics say from two weeks onwards is ok. I couldn't use it for two months as the recipient area was too sensitive for the foam.

[Westview]

9 hours ago, tressful11 said:

Thanks for your sharing your perspective everyone.
But my primary concern is whether using minox on transplanted hairs might affected them in the long term?
We do know that non transplanted hairs become dependant on minox and fall out when you stop using minox.
What about transplanted hairs? Will they be affected if we stop minox after a few years?

They shouldnt, because transplanted hairs are not DHT sensitive