Bernstein Medical - Center for Hair Restoration - Allergic Reaction
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Q: Our dermatologist originally suggested our son use the 5% Rogaine and he developed an allergic reaction to it. Allergy tests confirmed it was the propylene glycol causing the reaction. I understand that Rogaine foam has 5% minoxidil in it but no propylene glycol. Is that correct? — B.M., Lower East Side, N.Y.

A: In addition to minoxidil 5%, Rogaine Foam contains: butane, butylated hydroxytoluene, cetyl alcohol, citric acid, fragrance, glycerin, isobutane, lactic acid, polysorbate 60, propane, purified water, SD alcohol 40-B, stearyl alcohol — but no propylene glycol.

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Q: I am a 48 year old woman. Since I have used a new hair dye, I seem to be going bald. Is this possible?

A: Dying hair is a very common practice and hair loss in women who are 48 years old is also very common. The fact that the two have occurred together does not necessarily imply that there is a cause and effect relationship.

Women who are already losing hair often go to a great deal of effort to disguise this fact with dying, bleaching, and perming. These procedures, particularly if too aggressive, or done too frequently, can cause weakening and increased fragility of the hair shaft and increased hair breakage may result. This is more common if the hair is already fine in texture. This breakage is frequently interpreted as “hair loss” and it certainly does result in a significant loss of hair bulk, although the follicle itself is not damaged.

When there is a relationship between hair dye and hair loss in women, it is usually an inflammatory/allergic or irritant reaction. If severe, there may be an actual burn. In these cases, there would be a history of redness and swelling. An inflammatory reaction could cause hair loss but it would be unusual to damage follicles enough to produce scarring – although this occasionally does occur. A scalp biopsy is often helpful to sort out these cases.

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Q: What is the difference between Rogaine for men and Rogaine for women? — G.K., Hawthorne, N.Y.

A: Rogaine, the brand name of generic minoxidil, comes in formulations for both men and women. The men’s versions come in a 5% solution and a 5% foam while women’s products are the 5% foam and 2% solution. Of these, the strongest and most effective is the 5% men’s solution. This is due to the inclusion of propylene glycol, which is a vehicle that helps the active ingredient, minoxidil, to more readily penetrate the scalp. As the other products do not contain propylene glycol, they may be slightly less effective.

Instructions for use also differ on the label between the men’s and women’s products. All products (5% men’s solution, 5% men’s foam, 2% women’s solution) recommend twice daily use, except for the 5% women’s foam which recommends once daily application. In reality, a thorough once daily application seems to be nearly as effective as twice daily for all version of topical minoxidil.

While the 5% solution may be stronger, it is more irritating to the scalp and more difficult for some to tolerate. Some people have a sensitivity to the added propylene glycol and will experience redness, burning, itching, and irritation. If this occurs, patients should switch to the 5% foam or 2% solution. We also recommend that patients use enough of the medication when they apply to adequately cover the treatment area of the scalp. Often, this means using 2 or 3 capfuls of foam or 2-3 droppers full of the solution (2-3mL).

It is important to understand, that contrary to the more restrictive package indications, it works in all areas of the scalp where there is thinning. It is not only for use in the crown. Many patients find that evening application allows the full 4-6 hours of contact time necessary for absorption and that the product will dry overnight and no longer look greasy in the morning. Results can appear as early as 3-6 months, but we often advise using minoxidil for a full year before judging its efficacy. As the hair is always cycling and growing, the product will need to be continued daily for ongoing benefit.

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