Topical treatment with minoxidil 2% and smoking intolerance

OBJECTIVE: To report smoking intolerance that occurred in two patients while they were treated with minoxidil. DATA SYNTHESIS: Minoxidil is a potent vasodilator useful in treating severe hypertension. Topical minoxidil was approved as a treatment for androgenital alopecia. Only few side effects have been reported during treatment with topical minoxidil, most of them localized skin reactions. Two of our patients developed smoking intolerance during treatment with topical minoxidil for androgenital alopecia. The relation between treatment with minoxidil and smoking intolerance was emphasized by stopping treatment and the disappearance of the smoking intolerance, and then by rechallenge in both patients. CONCLUSIONS: Topical minoxidil may cause smoking intolerance; further studies are needed to evaluation this side effect.