Is there any reason people with MS shouldn't use Rogaine (or Minoxidil), since you are applying a molecule that's changing vascular permeability so close to the brain?
That is a very interesting question. Minoxidil is a vasodilator when given orally that will lower blood pressure. This can occur when given topically but is rare since a much smaller amount of the drug is absorbed through normal skin. It has also been studied as a drug to enhance delivery of chemotherapeutic and biologic agents to brain tumors by enhancing the permeability of the blood brain tumor barrier. This barrier is distinct from the normal blood brain barrier and over expresses ATP sensitive potassium channels, the target of minoxidil for this purpose. I can find no evidence that minoxidil has any significant effect on blood brain barrier permeability in healthy people or those with multiple sclerosis. Furthermore, it would likely have less of an effect when administered topically, since so little is absorbed and that which is absorbed would still go through first pass metabolism in the liver.
Rip Kinkel, MD
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