While minoxidil isn’t an essential treatment to use after a hair transplant, it is often recommended. It can reduce shock hair loss, accelerate growth, and limit native hair loss, so our hair transplant surgeons often recommend using topical minoxidil as an adjunct treatment to a hair transplant.
Minoxidil is a very popular complementary therapy for hair transplant patients. With minimal side effects and proven efficacy, it’s often recommended as a way of maintaining your hair transplant. Here, you’ll find out why minoxidil is useful, how to use it effectively, and how long you should use it to see continued benefits. Plus, find out when minoxidil isn’t recommended and the most popular alternatives to minoxidil for hair transplant patients.
Key takeaways
For this article, we’ve spoken to Wimpole Clinic hair transplant surgeon Dr Peter Thomas to provide expert clinical insight into the use of minoxidil before, during, and after hair transplant surgery.
Minoxidil is a drug that dilates the blood vessels, allowing the blood to flow more easily round the body. This process has been shown to reduce hair loss caused by many different types of alopecia, including pattern baldness, alopecia areata, and telogen effluvium [1].
Topical minoxidil is a licensed treatment for male pattern baldness in the UK, and is recommended for twice-daily application.
It’s not essential that you use minoxidil after a hair transplant, as it won’t make a difference to the success of your procedure.
However, hair transplants won’t stop future shedding. So to avoid new bald spots or a deteriorating hairline, preventative treatments like minoxidil are strongly recommended. There are a few proven benefits to using minoxidil after a hair transplant, so it’s definitely worth considering.
Dr Peter Thomas, one of the Wimpole Clinic’s senior surgeons, explains when minoxidil is the top choice of adjunct treatment for a hair transplant:
“I’d recommend minoxidil over finasteride if this is the patient’s preference, for example because they would rather avoid any effects on their hormones, or they want to avoid systemic medication. Older patients who have reached stability or have little native hair to work with wouldn’t benefit from finasteride so much.
“It’s also best to avoid finasteride for females, or male patients during family planning or those with a pregnant partner with whom they are sexually active. It would be sensible to avoid it if a patient has a strong family history of prostate cancer, or is concerned about monitoring their risk for prostate cancer more accurately, as finasteride can affect this.”
Studies repeatedly show that using minoxidil after a hair transplant can:
Let’s take a look at each of these benefits in greater detail.
Most patients experience a period of hair transplant shedding around 2-4 weeks after their procedure. This is a type of hair loss called telogen effluvium, and after a hair transplant it’s often known as shock hair loss. It’s common and temporary, but can still be alarming when it happens.
Studies have shown that topical minoxidil can reduce the amount of shock hair loss experienced post-transplant [1-3]. Limiting shock loss could also reduce stress associated with temporary hair loss in the early weeks after a hair transplant procedure.
One study examined the progression of 16 patients who began 2% minoxidil four weeks before hair transplant surgery and continued it for three months after [2]. 71% of the hair grafts continued to grow from implantation rather than shedding and regrowing.
Similarly, a study of 40 hair transplant patients compared the recovery with minoxidil versus normal shampooing [3]. While minoxidil did not affect the percentage of hair survival before and after transplantation, 60% of the grafts treated with topical minoxidil experienced no shock loss shedding.
Minoxidil can significantly speed up the regrowth of newly transplanted hair [4]. One small study found that some patients experienced hair regrowth within just 4 weeks of surgery, rather than the expected 3-5 months [5].
Minoxidil is said to shorten the resting phase of follicles in the hair growth cycle, and extend the growth phase [6]. This also affects transplanted hair, potentially resulting in faster hair growth post-procedure.
Native hair loss affects non-transplanted hair. Because male and female pattern hair loss are progressive conditions, your hair can continue to fall out around your transplanted hair, leading to unusual patterns of growth and loss if it’s not managed.
Minoxidil can limit native hair loss, preserving your hair transplant for longer [1]. This is really important for long-term hair transplant maintenance.
Minoxidil is generally well-tolerated and is safe for most adult hair loss patients [1]. However, it’s not a suitable treatment for everyone. Dr Thomas explains:
“I don’t recommend minoxidil to everyone. Patients with extensive hair loss would not see much benefit if there’s not much native hair to preserve and enhance. Other reasons to avoid include having a scalp condition that could be exacerbated, skin sensitivity, and contraindications like cardiac problems or hypotension (low blood pressure).
“I suggest long-term use of finasteride for the best response, and remind patients these medications only work whilst taking them. However, there is some evidence that tolerance can build up with long-term use of minoxidil.”
It’s best to avoid topical minoxidil (or at least do a patch test first to check your reaction) if you’re hypersensitive or allergic to minoxidil and/or any other ingredients in the solution.
Minoxidil may also be less effective if you use it in the later stages of hair loss [7].
We advise patients to start using minoxidil around 2-4 weeks after your hair transplant. This gives your grafts plenty of time to heal and anchor into the scalp before you apply any potentially irritating substances. Dr Thomas gives his insight into these guidelines:
“Using minoxidil after the grafts are healed (2 weeks) is generally recommended but I remain cautious and say 3 weeks. This is because there may be open wounds, and the scalp might be sensitive soon after surgery. There’s a risk of dislodging grafts, causing infection, or irritating the skin if started too early. There’s no risk of starting late, but the downside would be that you’re delaying the benefit it can bring.”
Applying minoxidil too early can introduce bacteria into your incisions, possibly increasing the risk of hair transplant infection. The first few applications can also make your scalp itch, which puts you at risk of graft dislodgement if your hair transplant hasn’t fully healed.
If you start minoxidil too late (after a month, say), you can still see some benefits, but the treatment won’t have time to reduce shock hair loss or give you visible early growth.
Minoxidil is easy to add to your normal morning and evening routine. Patients are recommended to use 1 ml of minoxidil solution or half a capful of foam, twice a day. Here’s what to do:
For more detailed application instructions, find out how to apply minoxidil.
Continual, regular application is essential for effective results. Studies have indicated that lower dosages, such as only applying minoxidil once a day or only a few days a week, will have a direct, negative impact on results [8]. However, you might need to coordinate your minoxidil application with other aftercare activities, such as:
The main side effect of minoxidil is an itchy scalp. Skin irritation, itching, and redness are fairly common, and can affect you if you use minoxidil after a hair transplant. That’s why it’s important to give your hair grafts plenty of time to anchor into the scalp before you start applying minoxidil.
Minoxidil foam may be less likely to cause scalp irritation than other minoxidil solutions. The foam version doesn’t contain propylene glycol, which is the ingredient that commonly causes irritation.
Minoxidil-related hair shedding is another common side effect, although this is unlikely to be very noticeable post-hair transplant. A combination of shaving your head and hair transplant-induced shock loss may reduce the impact of this side effect.
Less commonly, you may experience skin flaking and changes in hair colour.
Men who have undergone a hair transplant are often recommended to take finasteride. Finasteride is an oral medication that limits production of dihydrotestosterone, the hormone that causes male pattern baldness.
Combining minoxidil and finasteride is a highly effective treatment for hair loss in men [9]. It’s generally safe to use both treatments before and after a hair transplant. However, unlike minoxidil, you won’t need to stop taking finasteride at any point; you can take it on the day of your surgery and throughout the recovery process.
Other minoxidil alternatives include platelet-rich plasma (PRP) therapy. Research shows that PRP may actually be a more effective treatment than minoxidil, though it isn’t officially licensed in the UK [10].
A study examining the effects of minoxidil vs PRP in 379 patients found that PRP increased the number of hairs in the growth phase by 6.9%, compared with 4.6% for minoxidil users [11]. Meanwhile, a small study of 30 patients found that 50% of PRP patients said they had moderate hair growth, while just 7.1% of minoxidil users said the same [10]. 87.5% of PRP patients said they were satisfied with their top of head results, compared with 35.7% of minoxidil users.
Dr Thomas explores some of the commonly recommended alternatives to minoxidil:
“Finasteride and dutasteride give strength to native hair and better preservation than minoxidil which reduces the risk of shock loss. PRP — platelet-rich plasma therapy — can be used intraoperatively or 1 month after transplant. This can encourage early regrowth which may mask some visibility of shock loss.
“Additionally, general measures taken in aftercare will help survival. This includes correct shampooing, limiting infection risk, and avoiding scalp contact.”
Your transplanted hair should continue to grow thick and full even if you stop using minoxidil. But the native hair around it could continue to fall out. To sustain your hair growth, you should use minoxidil indefinitely.
To see short-term benefits like reduced shock hair loss and accelerated growth, it’s best to use minoxidil prior to your hair transplant, stopping around a week before. (This is because minoxidil stimulates blood flow to the scalp, which isn’t ideal during surgery.) Resume minoxidil applications 2-4 weeks after your procedure, when your scalp has healed, and continue using it for at least 6 months.
The benefits of minoxidil only last as long as you use it, so you may see increased shedding of your native hair if you stop using minoxidil.
For best results, it’s recommended that you apply minoxidil twice a day every day. Reducing minoxidil application to 3 times a week or less is likely to limit its effectiveness.
However, if you struggle to manage the side effects of minoxidil, you can experiment with concentration or application frequency. For example, consider switching from a 5% minoxidil formula to 2% minoxidil. However, Dr Thomas doesn’t recommend using a formula higher than 5%:
“We can review minoxidil use at the usual post-transplant review periods at 6 and 12 months. Adjusting dose is not something I normally recommend. The response plateaus above 5% concentration, and would just irritate the skin more. If a patient has irritated skin, I recommend using the foam formulation instead. They can discontinue it if sensitivity or irritation occurs, or if they’re unable to keep up with regular use.”
Minoxidil is just one of the supportive aftercare treatments you can use to get the best results from a hair transplant. From finasteride to PRP to stem cell therapy, the Wimpole Clinic can offer several other effective therapies to support your current and future hair restoration goals. Additionally, we’ll provide you with all the aftercare essentials and instructions you need for safe, successful recovery.
With Wimpole Clinic locations across the UK, you can start your hair growth journey at a clinic near you. Book a consultation with a hair loss expert at our award-winning hair transplant clinic to get started.
Learn more about using minoxidil post-hair transplant in these frequently asked questions.
Yes, you’ll need to temporarily stop using minoxidil for 1-2 weeks before your hair transplant to allow your blood flow to return to normal prior to surgery.
Yes. Oral minoxidil for hair loss is also effective, though it has a greater risk of side effects. Oral minoxidil isn’t available over-the-counter, so you’ll need a prescription. Speak to your surgeon if you’re interested in trying oral minoxidil for hair loss, as it’s not suitable for everyone.
Yes. This is a highly effective combination for treating hair loss. Most eligible male hair transplant patients are advised to use both these medications to maximise and sustain their results.
Yes. If you apply minoxidil before your hair transplant wounds have fully healed, it increases the chance of introducing harmful bacteria that can lead to a hair transplant infection. If you’re unsure if it’s safe to apply minoxidil, check with your clinic.
No, your transplanted hair should be safe even if you stop using minoxidil. However, your native hair can continue to fall out, which can leave you with unnatural-looking results.
Wimpole Clinic Services:
Hair Transplants, Beard Transplants & Eyebrow Transplants.
Talk to a specialist
Dr Peter Thomas (GMC 7554440) specialises in FUE (Follicular Unit Extraction) hair transplants and has trained with our internationally recognised surgeons at the Wimpole and Mayfair Hair Clinic. His strong artistic background and breadth of surgical experience enable Dr Thomas to excel in combining a keen sense of aesthetics with meticulous attention to detail.
After graduating from St George’s University of London with a Bachelor of Medicine and Surgery, and also earning a Bachelor’s degree in Biological Sciences, Dr Thomas continued his career as a general practitioner. He is a member of the Royal College of General Practitioners, General Medical Council, and an associate member of the International Society of Hair Restoration Surgery (ISHRS). Dr Thomas gained valuable surgical experience in the NHS, working across general surgery and trauma and orthopaedics. His experience in general practice also provides expertise in women’s health and dermatology.
Focused on achieving natural results, Dr Thomas strives for harmonious designs that complement his patients’ facial features and age. He uses a sapphire blade to create closely packed and precise incisions, achieving high-density, and seamless hair direction and angulation. Additionally, he practices non-surgical hair restoration techniques including platelet-rich plasma (PRP) therapy.
Dr Thomas understands the significant impact of hair loss on an individual’s self-confidence and well-being, taking the time to listen to his patients’ concerns and aesthetic goals. He is one of the lead surgeons at our prestigious Birmingham clinic and contributes his expertise and experience to the benefit of Wimpole clientele.
