OK BOYS, I EMAILED DR. LEE
... and he got back to me really quickly actually, here is what he said:
Minoxidil itself does not cause these symptoms. Your description suggests you may be having an untoward reaction to the propylene glycol in Rogaine. I now have many patients who complain of that problem.
Propylene glycol constitutes 50% of the liquid base in Rogaine Extra Strength and the generic 5% topical minoxidil solutions. Propylene glycol is used in minoxidil solutions because (1) it is an humectant, i.e. it helps to moisturize the skin and helps protect it from the drying effect of the alcohol; (2) it increases and stabilizes the solubility of minoxidil; and (3) it keeps a small quantity of minoxidil on the surface of the scalp to allow for a small amount of continued absorption after the alcohol has penetrated. Although it requires a more complicated process, our minoxidil solutions are formulated with only 30% propylene glycol in the base. Upjohn Pharmacia and generic manufacturers use a high concentration of propylene glycol (50%) principally because it extends the shelf life of the 5% minoxidil solution. Propylene Glycol does little to improve the effectiveness of the minoxidil formulas. It's the alcohol that allows for the penetration of minoxidil into the skin.
We have liquid minoxidil and Xandrox that doesn't have any propylene glycol in the base. Ask for either product 540 or 640 respectively. The prices are the same as regular minoxidil and regular Xandrox, $19.95 and $34.95.
Personally, I think that the minoxidil solutions which substitute glycerin for propylene glycol at the same concentration feel a bit more 'greasy' than the standard formulations. Paradoxically, we have patients who order the glycerin products because they feel that they feel less greasy. Regardless, if you find the propylene glycol free formula to be cosmetically unacceptable, then when you apply it in the morning, leave it on 1/2 hour to 1 1/2 hours and then shampoo your hair. In the evening, apply it before going to bed and leave it on all night.
Replace 5% minoxidil with either propylene glycol free 5% minoxidil or propylene glycol free 5% Xandrox.
Continue with Propecia or 1/4 Proscar pill per day. See comment below, and Nizoral.
Stop using Saw Palmetto, Green Tea and Grape Seed Extract, Tgel and Nioxin Shampoo.
Proscar and Propecia are the same medication, i.e. finasteride. The only difference is that Proscar is a 5 mg tablet of finasteride and Propecia is a 1 mg tablet of finasteride.
If you take quartered tablets of Proscar instead of Propecia, you will have the same beneficial results for treating male pattern baldness at less than 1/3 the price. In fact, your medical insurance might even pay for the Proscar, whereas the insurance companies almost never reimburse for the purchase of Propecia.
Use a pill cutter or any sharp blade and cut the hard, brittle, blue covered Proscar tablet into four pieces. You will undoubtedly also create some powder and many smaller fragments. It really makes no difference if the pieces are of unequal size. The range of effectiveness is very wide and has been shown to vary as much as from 0.2 mg to 5 mg of finasteride. Furthermore, there is such a tight bond created between the finasteride and the Type 2 5AR, that even if you discontinue taking finasteride altogether, it will require two weeks for your DHT level to return to your baseline levels. So, a variation in the daily dosage is really inconsequential.
So, take just one quarter of a tablet once / day. The time of day doesn't really matter. Nor does it matter if you take it with or without food.
When you are getting a physical examination or are having laboratory tests on your blood, inform your doctor that you are taking finasteride. Finasteride will decrease the PSA (Prostate Specific Antigen) level by approximately 50%.
Assessing the PSA level is a screening test for possible prostate cancer.
Richard Lee, M.D.
