Q: How do you best manage the irritation that comes with minoxidil? I have patients that report burning, and this causes them to stop treatment prematurely.

A: We start with minoxidil solution and if the patient gets irritated, switch to the foam (which doesn’t have the propylene glycol that is contained in the solution).

If he/she can’t tolerate the foam, then we consider oral minoxidil. We rarely use a topical steroid in conjunction with the minoxidil (a practice of many doctors).

As an aside, once a day use is all that is necessary and this seems to be less irritating than bid.