Can I stop my minoxidil for alopecia areata ... or is it lifelong?

Will I be able to stop my minoxidil?

I’ve selected this question below for this week’s question of the week. It allows us to review some concepts related to the use of minoxidil in alopecia areata.

Question

I am a 25 year old female and have alopecia areata. I have three patches and am getting steroid injections as well as using topical clobetasol and topical minoxidil. The protocol seems to be helping a lot and I’m happy with my progress so far. I know the steroid injections and clobetasol are not likley to be lifelong (if the hair can come back) but I’m confused if my Rogaine will be lifelong. Some say that once you start Rogaine that you can never stop?

Answer

In a patient with a few patches of alopecia areata who has no current evidence of androgenetic alopecia … topical or minoxidil can be started and stopped depending on how active the alopecia areata is. It’s simply an add on bonus. In other words, once the hairs grows back from treatment of the alopecia areata, the minoxidil can be stopped and the hair keeps growing (assuming the alopecia areata is still quiet and stays quiet).

However, if the patient also has some degree of androgenetic alopecia, the rules might be a bit different. In a patient with alopecia areata who also has any degree of androgenetic alopecia … any decision to add on minoxidil must be done with the understanding that the minoxidil use will be forever IF IT IS USED IN THE AREA OF ANDROGENETIC ALOPECIA - and stopping minoxidil at any time in the future will likely trigger shedding and possibly irreversible worsening of the AGA.