Frequently Asked Questions About Retinoic Acid

• What is Retinoic acid?
• Why is Retinoic Acid combined with Minoxidil and how does it help hair loss?
• What are the side effects of Retinoic Acid? Can I use anything to decrease the side effects of Rinoxidil and Retinoic acid?
• Is it true that Retinoic acid makes my skin more sensitive to the sun?
• Will I see an initial increase in hair loss when starting Retinoic acid? What is Retinoic acid?

Retinoic Acid was first FDA approved for acne under the trade name Retin-A®. Since then it has been discovered that Retinoic acid can be used for several medical conditions, one is hair loss. Retinoic Acid is available only by prescription from a doctor in the United States.

Retinoic acid is believed to be advantageous for two reasons:

Retinoic acid is known to increase the absorption of other medications through the skin, therefore it is apparently increasing the amount of minoxidil reaching the hair follicles.

There is experimental evidence that indicates that retinoic acid may play a significant role in hair growth by presently unknown mechanisms. There have been case reports where the use of retinoic acid alone induced a significant amount of hair growth.

The side effects my patients have experienced are "itchiness" and "flaking" of the scalp (i.e. - it can make your dandruff worse). However there are numerous medications that can resolve these side effects.

Yes, actually in Dr. McAndrews formulation he adds a low potency topical steroid, similar to hydrocortisone. This is the same medication we use to treat dandruff (seborrheic dermatitis).

Other ways to decrease the irritation of the scalp are:

When first starting the formulation, start using it every other night for one week, then increase to ever night for one week, and finally increase to twice a day.

Consider using some anti-dandruff shampoo (ie- Head & Shoulders Zinc shampoo or DHS Zinc shampoo).

If your scalp is still itchy and/or flaky, then consider getting a prescription for an anti-dandruff shampoo or a stronger topical steroid solution for the scalp.

Retinoic acid may increase your sensitivity to the sun. Therefore if you apply any solution that contains Retinoic acid in the morning avoid direct sun exposure to the scalp or apply a sunscreen. The activity of Retinoic acid can also be affected by direct sunlight. Therefore, if you are constantly out in the sun, it would be prudent if you used the solution with Retinoic acid only at night and in the morning use solely the 5% Minoxidil.

Similar to the use of Minoxidil, a small percentage of patients may experience an initial increase of hair loss at the onset of treatment. However, this resolves with time.