Sensitization to saw palmetto and minoxidil in separate topical extemporaneous treatments for androgenetic alopecia

Abstract

We report a 24-year-old woman with androgenetic alopecia who became sensitized to topical minoxidil following use of an extemporaneous preparation of minoxidil 4% with retinoic acid in a propylene glycol base. She subsequently also became sensitized to saw palmetto (Serenoa repens), a topical herbal extract commonly promoted for the treatment of hair loss.

Alternative Medicine for Hair Loss

“…Side effects of S. repens are minimal. The most known side effects are related to gastric symptoms, although contact dermatitis, feeling of coldness, mild burning sensation, undesirable smell, itching, and acne are the reported adverse events after topical application [63,65,66].…”

“…Contact dermatitis was reported with onion juice in patients with AA, thus patients should be informed about skin irritation on the skin surface in contact with the onion juice (Figure 1) [53]. S. repens that can be used as both orally and topically may cause undesirable adverse effects such as mild stomach discomfort, contact dermatitis, feeling of coldness, mild burning sensation, undesirable smell, itching, and acne [63,65,66]. Vasovagal events, local infections, damage to internal organs, pneumothorax, spinal cord injury, and hepatitis B infection are some of the side effects that can be encountered after acupuncture therapy [116].…”

Saw Palmetto [Serenoa repens(Bartram) J.K. Small]

“…Case reports indicate that rarely an allergic contact dermatitis can develop following the chronic topical application of saw palmetto extract. 25 …”

Allergic contact dermatitis due to glycyrrhizic acid as an ingredient of a hair restorer

“…Treatments for androgenetic alopecia, range from non‐hormonal therapy with topical minoxidil to experimental use of anti‐androgens and various combinations of medical and surgical treatments (1). Both allergic and irritant contact dermatitis from minoxidil lotion have already been described (2), and its components as well allergic contact dermatitis from Serenoa repens and sensitization occurring after previous treatment with minoxidil (3). However, we could find no previous report from glycyrrhizic acid, as in this case, though there have been a few cases of contact allergy to enoxolone (18 β glycyrrhetinic acid) reported (4–6).…”