I've been following a lot of Dr. Rahal's patient weblogs and I see he instructs his patients to apply minox to the recipient region after the operation is performed. Do you guys know of any other doctors who recommend this? I'm having my HT performed by Dr. Hasson in January and I don't see anywhere on the post-op instructions about using Minox on the recipient region. Any pros or cons in using Minox afer the operation?

I would quite like to know what other doctors think about this too.

I guess the pros are possibly faster regrowth of the grafts. I don't think we have enough patient results to say whether that is the case or not though (we'd really want to see hundreds of results to make a judgement).

Could graft survival be improved by minoxidil use? I assume not very much since minox use starts at 2 weeks post op, by which time the graft survival rate may already be set.

Cons are increased skin irritation to an area that is still healing and possible shedding of existing native hair. Both of these are quite big issues for patients trying to conceal their surgery.

Since other clinics post excellent results without the use of minox I'm not sure if it is really worth it (but I use it anyway since I am a Dr. Rahal patient).

Pros:

1. Minoxidil can decrease shedding of transplanted hair so that more of the transplanted hair grows sooner
2. Minoxidil can decrease shedding of existing hair in a transplanted area (i.e. reduce shock loss)

Cons:

1. The scalp is more sensitive after a hair transplant so about 10% of people have to stop it because of:
a. redness
b. itch
c. dry skin
d. possibly increased pimples

2. After stopping Minoxidil it can take 2 weeks or more for the side effects to disappear.

Minoxidil is more effective at preventing shedding if it is used before and after a hair transplant. If used, I ask patients to stop it a week before their hair transplant and start it 3 days later. Some patients want to wait until the scabs are off before starting it but it is most effective when used early. Patients can continue Minoxidil indefinitely if they want to maintain existing hair. If they want to just use it short-term, I recommend using it twice daily for 3 months, once daily for 2 weeks then once every other day for 2 weeks to avoid a second shedding by stopping it abruptly.

The transplanted hair will look the same a year later with or without Minoxidil but patients usually have more hair 4 months later if they use Minoxidil.

I discuss the pros and cons with my patients and they can choose to use it or not use it, as they wish.