Does Minoxidil cause hair shedding?
Minoxidil is an FDA-approved medication for androgenic alopecia
A question that is often asked in my consultations with clients is:
“If I start using minoxidil, will my hair start shedding?”
Then there is the all too famous:
“When I stop minoxidil, will I lose all my hair again?”
The truth is, many people will experience some increased shedding when they begin using minoxidil.
This fact, alone, often dissuades people from trying one of the most powerful FDA-approved medications for hair loss.
I get it.
When we start to notice that we are losing our hair, the absolute LAST thing we would ever want is to introduce an item into our daily routine that could cause further loss.
In order to eliminate the fear of using minoxidil, we need to better understand the way that androgenic alopecia causes decreased follicle density.
Minoxidil can cause hair shedding when you begin using it
Hair Shedding Leads to New Growth
Androgenic alopecia is a progressive condition that continues to get worse without treatment. A major characteristic of this hair loss type is the miniaturization of the hair follicles leading to a cosmetic change in overall hair density.
Miniaturization is a key trait of androgenic alopecia (AGA) and the shedding cycle is the vehicle through which the miniaturization occurs.
In scalp tissue that is being affected by AGA, follicles will become smaller and smaller each time they shed and grow in anew. Allowing this cycle to continue leads to noticeable cosmetic changes in hair coverage.
The reversal of follicle miniaturization occurs during the same phase of the follicle’s life cycle - the shedding.
When an individual is responding to AGA treatments, their follicles are reversing the miniaturization by shedding and growing in again. This time, with the help of the treatments, the follicles will be marginally thicker than the previous hairs. Over time, this leads to a POSITIVE cosmetic change - an increase in overall density.
When a powerful growth factor, like minoxidil, is introduced to the scalp tissue - our follicles receive signals that there is an opportunity to synchronize, shed, and grow in thicker.
Does Minoxidil cause hair shedding when you start using it?
Yes!
For many individuals it will. In most cases, the shedding is a positive sign that you are responding to treatment and the hair that you shed will grow back slightly thicker than before.
Most of these ‘positive shedding events’ will occur 1-3 months into treatment and may last for a month or two before the client begins to notice improvement.
Positive improvements from minoxidil can be achieved in as little as 3-6 months.
But what about when you STOP using minoxidil?
Does Minoxidil cause hair shedding when you stop using it?
Yes!
In the lexicon of hair loss treatments, minoxidil is one of the most famous for causing a ‘dread shed’ once an individual has discontinued using it.
Why does this happen?
I’m not sure we fully know. However, my guess is that the answer is two-fold:
One. Androgenic alopecia is a progressive condition. It always gets worse without treatment. If you respond to a treatment and then remove it, the androgenic alopecia continues where it left off.
Two. Minoxidil likely doesn’t treat the root cause of AGA.
The first point is rather self explanatory, but I think the second requires some more digging.
How Does Minoxidil Work?
Would you believe it if I told you we don’t know?
It’s true. There are many theorized mechanisms of action through which minoxidil could be causing new hair growth. However, no one knows exactly how or why it grows hair. But it does.
To better understand this, look at the history of minoxidil.
Originally a blood pressure medication, users of minoxidil reported new hair growth (sometimes unwanted!) so consistently that the pharmaceutical industry changed course and began testing it for its hair growth potential.
Minoxidil continued to perform well in clinical trials aimed at unlocking the true nature of its hair growth prowess. Eventually, the drug was branded and offered topically as Rogaine.
There is a major problem with using minoxidil for combatting androgenic alopecia.
After the initial results from a positive response (usually ~3-6 months), most users report mild to no hair gains. At 12 months, many minoxidil users will quit the pharmaceutical because they feel that they have begun to lose ground again.
This experience is often repeated to me in consultations with clients. For this reason, I suspect that minoxidil, though great at growing hair, is limited in its ability to address the full spectrum of androgenic alopecia.
In other words, if minoxidil treated the root cause of androgenic alopecia, users should see a continued increase in density as opposed to the initial burst and then slow decline that typifies a minoxidil user’s experience.
Final Thoughts
Minoxidil is one of the ‘big 3’ pharmaceuticals approved by the FDA to combat androgenic alopecia. It can cause a shed when you begin using it and when you stop using it.
It’s a powerful medication and can help individuals achieve better cosmetic density and hair coverage. For the best results, minoxidil should be a component of a complete hair care regimen.
Do you have any questions about the blog post above? I would be delighted to hear from you. Use the button below to get in contact!
Matthew McCoy WTS certified Trichologist
