Can I Use Minoxidil During LPP?

 

The best hair transplant surgeon in India is often asked if any patient can use Minoxidil who has active Scarring Alopecia. But it cannot be said easily as it depends upon the patient and more over the specific details. Before we tackle the question, we need to know what active scarring alopecia is.

What is Active Scarring Alopecia?

Active scarring alopecia refers to hair loss caused by an overactive immune system process. The patient may have scalp itching, have increased scalp burning and may be shedding more and more hair. All of these things point to active scarring alopecia. What do we do when scarring alopecia is deemed active? Well, we increased the amount of immunosuppressive and immunomodulatory treatments we are using.

 

Here are just some of the examples of how we change treatment is we feel LPP is active.

Example 1: Instead of using steroid injections, they might use steroid injections and topical steroids.

Example 2: Instead of using topical steroids, we might add oral doxycycline.

Example 3: Instead of using oral doxycycline and topical steroids, a patient might take oral doxycycline plus oral hydroxychloroquine, suggested by the best hair transplant surgeon in Kolkata.

 

In other words, once the LPP is determined to be active (or still active) we are going to make some pretty important decisions about increasing treatment. These are indeed big decisions because treatments have potential side effects, cost money.

 

What are the potential side effects of minoxidil?

Now, let’s focus on minoxidil and the potential side effects. In addition to side effects like headaches, dizziness and heart palpitations and hair growth on the face, minoxidil can cause two important side effects for patients with scarring alopecia: 1) Minoxidil can cause increased hair shedding and 2) Minoxidil can cause scalp itching for some people.  These two side effects can make it difficult to figure out if the itching and shedding are coming from the active LPP or coming from the minoxidil.

So can anyone use minoxidil if they have LPP or not?

They always advise that patients review use of any medication with their dermatologist. In general, if a patient was using minoxidil for a very long time (without any problem) before the LPP even started, it’s usually fine to continue.

 

In these situations, it’s unlikely any increased shedding or scalp symptoms the patient experiences is going to be attributable to the minoxidil. But starting up or initiating the use of minoxidil when one has active LPP is active is not usually a good idea. If the patient gets more shedding or more scalp symptoms, it will be impossible to tell if they are coming from active LPP or coming from the minoxidil.

 

In the worst case scenario, one can imagine a situation where the doctor increases the dose of medications thinking that the change in clinical symptoms or signs was due to increased activity of the LPP when really it was just the minoxidil.

 

Imagine if the patient developed a side effect of the new medication - and it never needed to be started in the first place said by the best hair transplant surgeon in India.