Regaine can cause scarring alopecia

[Heisenberg]

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!

Edited June 30, 2023 by Heisenberg

[thetdog666]

43 minutes ago, Heisenberg said:

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!

 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!

[Raphael84]

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.

[Heisenberg]

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.

[Heisenberg]

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? 

[Heisenberg]

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.

[Heisenberg]

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

[Raphael84]

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.

[Heisenberg]

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.

Edited June 30, 2023 by Heisenberg

[Heisenberg]

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