A: Minoxidil has been prescribed (off-label) in combination with other medications, such as topical retinoic acid (Retin-A), to enhance its penetration into the skin and thus increase its effectiveness. This combination of medications, however, can significantly increase the absorption of minoxidil into the bloodstream and may increase the risk of potential side effects, including changes in blood pressure and severe scalp irritation that has, on occasion, led to scarring.

If person wants to add Retin-A to the minoxidil regime, the Retin-A should be applied only once a day, since the Retin-A will bind to the skin and will last for at least 24 hours.

Applying Retin-A more frequently will not increase its effectiveness (in facilitating the absorption of minoxidil); it will only increase the incidence of side effects. Retin-A can be applied to the scalp at the same time as Minoxidil, or by itself.

Retin-A should not be compounded with minoxidil (mixed together by your pharmacist or your doctor) for the following reasons:

1. Minoxidil works best when used twice a day. Retin-A is best used once a day.
2. Using Retin-A twice a day wastes money and increases the incidence of side effects
3. If you develop side effects from the Retin-A, it is best to stop only the Retin-A. If they are compounded, you would need to stop both and will lose the benefit of minoxidil.

Explore the pro’s and con’s of Minoxidil — also known by its over-the-counter product Rogaine — at the Rogaine/Minoxidil page on the Bernstein Medical – Center for Hair Restoration website or by viewing minoxidil-related posts on the Hair Transplant Blog.

A: It doesn’t matter what time of day you take Propecia and the time can very each day.

The absorption of Propecia (finasteride) is not affected by food, so it can be taken without regard to meals.

A: Rogaine can cause shedding at the beginning of treatment (i.e. in the first 3 months) but this is expected as it causes some hair to begin a new cycle of shedding and re-growth. This means the medication is working.

Another reason for your apparent shedding is that the less you wash your hair, the more will be lost each time. Go back to shampooing every day and see what happens.

A: Minoxidil does work on the front of the scalp to prevent the progression of hair loss and may thicken areas of early thinning, although it won’t re-grow hair in areas that are bald.

I would also consider using finasteride (the active ingredient in the hair loss medication Propecia) as this will also work on the front of the scalp to prevent further hair loss and to increase areas of thinning – and it is more effective than minoxidil.

A: Yes, you should.

You do not need finasteride (Propecia) for the hair transplant to work, or the transplanted hair to continue to grow, but finasteride can decrease further hair loss.