Drug-Induced Liver Failure Following Topical Minoxidil: A Case Report

This case report details a 21-year-old female who experienced severe drug-induced liver failure after using topical minoxidil for alopecia areata. Despite minoxidil's minimal systemic absorption, the patient developed elevated liver enzymes and jaundice three weeks into treatment. A liver biopsy confirmed drug-induced injury, and symptoms improved after discontinuing minoxidil, suggesting a causal link. The patient's autoimmune condition and oral contraceptive use may have increased her susceptibility. This case, the first of its kind, emphasizes the need to monitor liver function in patients using topical minoxidil and highlights the potential for rare, idiosyncratic drug reactions.