Dr. Diane M. Hoss, MD discusses Female Pattern Hair Loss Treatment. See more at www. dermnet. com PLEASE RATE AND COMMENT!!! Topical minoxidil is the treatment of choice for FPHL. Start therapy with 2 % minoxidil twice daily. It is important to counsel the patient as to the proper method for application. The solution needs to be applied to the scalp (not just the hair!) in the areas of thinning. This can be accomplished by parting the hair and using a dropper or applying the solution with a large Q-tip. Most women do not like using the rolling applicator currently attached to the brand name product (Rogaine). The hair should be dry or mainly dry to avoid diluting the medication. The second application of the day should be performed at least 2 hours before bedtime to avoid getting the minoxidil on the pillowcase with subsequent transfer to the face (and the risk of increased facial hair). Application just after dinnertime is often convenient for the patient and easy to remember. The main side effects with 2 % minoxidil are scalp irritation and increased facial hair, both of which occur in about 5% of patients. True contact allergy to minoxidil is uncommon and occurs in <1% of patients. If irritation occurs, a trial of a preparation of propylene glycol (PG)-free minoxidil can be beneficial. This can be obtained from a compounding pharmacy. An initial six month trial of topical 2% minoxidil is given. If there has been no improvement in the patient’s hair loss (determined by . . .