Given that over 85% of men [1] and 55% [2] of women experience hair loss in their lifetime, finding a hair growth treatment that works can be a great relief. Studies have shown Minoxidil to be very effective against androgenetic alopecia. But some say this medication can accentuate your hair loss, at least for a while. Is Minoxidil hair shedding real?
While more research is needed, it seems that taking oral Minoxidil may cause hair shedding in some people who use it. But the good news is that this side effect is only temporary, resolving in a few weeks. And after that, you should see significant improvement in your hair density. This article will tell you all you need to know about:
Anecdotic evidence of Minoxidil hair shedding is plentiful online. However, at this time, only a small number of the clinical trials that used Minoxidil reported temporary excessive hair thinning among the encountered side effects [3]. Most of those who found indications of this occurrence in some patients with androgenetic alopecia used oral Minoxidil:
One 2019 study [4] reported that out of 41 patients with male pattern baldness treated with oral Minoxidil, only one (who received a 2.5 mg dose) experienced hair shedding. A different clinical trial [5] revealed that 4 out of 25 male patients with androgenetic alopecia treated with a very low dose of oral Minoxidil (0.25 mg) experienced temporary hair loss.
Finally, a 2017 study [6] conducted on 100 women with female pattern baldness treated with 0.25mg oral Minoxidil and 25 mg Spironolactone showed a temporary increase in hair shedding in 22 participants. This began between 3 and 6 weeks after starting treatment. In most women (16 of them), this concerning phenomenon resolved itself in 4 weeks, but in a few cases, it lasted 6 weeks (4 women) or even over 12 weeks (2 women). However, no participant has experienced permanent hair loss due to Minoxidil use.
The studies involving men were performed on small samples with no control group, and the overall number of patients who experienced this side effect was low. Thus, more research is needed to determine whether the temporary increase in hair shedding was indeed caused by the oral Minoxidil, how dosage may have influenced this response, and what type of patient may be more predisposed to it.
While it may seem like women are more likely than men to develop Minoxidil hair shedding, it must be kept in mind that the female pattern baldness clinical trial mentioned above combined two different treatments. So, it is still being determined which of them (if any) produced this side effect and to what extent.
While there is anecdotal evidence that topical Minoxidil may also cause temporary hair thinning, only one clinical trial [11] conducted on women who used this medication reported increased hair shedding as a side effect. 9 of 50 women treated with a Minoxidil 2% solution and 6 of 50 women who received 5% Minoxidil foam reported some excessive hair loss However, no control group was used.
It must be remembered that it can be difficult for people who experience alopecia to accurately determine why their hair is falling out more than usual, as this can happen for multiple reasons.
Minoxidil hair shedding isn’t usually something you need to worry about. This temporary phenomenon is likely to be produced by the effect this medication has on the hair growth cycle.
There are four stages in the hair growth process, the anagen phase (growing), the catagen phase (transition), the telogen phase (resting), and the exogen phase (shedding). Out of these four stages, Minoxidil is believed to affect the anagen and telogen phases.
Using this medication will extend the length of the anagen (growing) phase and shorten the telogen (resting) phase. Doing this brings about the exogen phase much quicker, causing your already-about-to-shed hair to fall out.
However, although you may notice more loose strands than usual, Minoxidil hair shedding may be a good thing. After eliminating old hair, your follicles will soon start to grow new strands to replace what’s been lost. In addition, the growth phase will be extended to encourage more hair growth than usual.
If you’re thinking about taking this hair growth treatment, you needn’t worry about the Minoxidil shedding phase, as it’s only experienced by a very small percentage of patients and lasts for a short while.
In most cases, Minoxidil shedding will only last around 4-12 weeks [6][7]. After 4 months of consistent use, you should start to see noticeable hair growth and far fewer loose strands in your hairbrush and shower drain.
If, after 4 months, you’re still not seeing any results and your hair continues to fall out, it may not be caused by Minoxidil. In this case, it is a good idea to see a trichologist who can accurately diagnose your hair shedding and recommend the best solutions for your particular condition.
Unfortunately, it’s almost impossible to completely prevent the risk of experiencing hair shedding while taking Minoxidil. Because of how the treatment works, the hair growth cycle is altered which can speed up hair shedding to make room for new hair growth.
However, if you are particularly worried about potential hair loss, you might want to start with a lower concentration of Minoxidil (e.g. Minoxidil 2% instead of Minoxidil 5%). Just be sure to discuss this with your hair doctor first to check whether it is a good choice for your condition.
You can also try using some of the best essential oils for hair growth to keep your scalp moisturised and nourished and get frequent relaxing head massages to stimulate your hair follicles. While this will not prevent Minoxidil hair shedding from happening, it can keep your existing strands healthy, and some (e.g. rosemary oil for hair growth) make your locks grow back faster and denser.
It is known that some Minoxidil side effects, such as hypertrichosis, affect women to a greater extent than men. One study on female patients reported temporary hair shedding in almost one-quarter of the participants, a much higher rate than those reported by trials with male participants [6].
However, the clinical trial used a combination of Minoxidil and Spironolactone, so it is difficult to draw any conclusions regarding Minoxidil’s role in the patients’ hair thinning. More research is needed to determine whether and to what extent Minoxidil for women can cause more significant temporary hair shedding than in men.
Although side effects are very rare when taking Minoxidil, there are a few other things that you may experience while taking this treatment:
Most of these side effects will only affect a very small percentage of the men and women taking Minoxidil. However, if they don’t clear up after a few weeks, or if you notice that they are especially severe, it’s best to speak to your trichologist. You can also seek out Minoxidil alternatives with fewer side effects.
Since many hair growth treatments are available, ranging from natural home remedies to surgical hair restoration, it is difficult to say whether all hair loss treatments cause temporary hair shedding. They have different mechanisms of action, and there is often insufficient research to study the effect in many of them.
Some remedies, such as hair growth oils, may be less likely to cause this adverse reaction (but they are normally also less effective than hair loss medication).
There is anecdotal evidence that other hair loss treatments, such as Finasteride and Dutasteride, may cause some hair shedding as well, but it is usually reported to only last for a few weeks. Some hair loss is normal in the shower or while brushing one’s hair even for someone who is not experiencing alopecia.
So some concerned users may attribute any loose hairs to the treatment. Since most studies don’t mention such effects, any Finasteride and Dutasteride hair shedding is unlikely to be significant and long-lasting.
However, the hair loss treatment best known for temporary hair shedding is the hair transplant. This effect is well-documented, and patients are warned ahead of time that they are likely to experience shock loss after a hair transplant surgery, which normally lasts around 4 months before resolving.
However, when performed by an experienced surgeon at a reputable clinic, this surgical procedure also has a much higher success rate in restoring hair growth compared to other treatments (97-100%). So, the results are definitely worth the wait.
Hair loss is complex, and the best treatment is always the one that best suits your type of alopecia. If you are experiencing mild to moderate androgenetic alopecia, Minoxidil may be one of the first treatments that you may consider.
Minoxidil is an easy-to-use, accessible treatment with a fair amount of clinical studies that prove its effectiveness (see the results of using Minoxidil before and after treatment). While it’s not a universal cure for baldness, it can help treat many kinds of hair loss, such as chronic telogen effluvium, or advanced traction alopecia.
However, while it can increase treatment effectiveness as an adjuvant, it will be less helpful than steroid creams or steroid injections in curbing autoimmune conditions (e.g., alopecia areata).
Moreover, Minoxidil will only work for pattern baldness as long as you take the treatment. You’ll notice your hair thinning once more a few months after you stop using it.
If you are looking for a long-lasting solution for your hair woes, a natural-looking hair transplant may be your best chance. This procedure involves harvesting healthy hair follicles from the back of your head and implanting them in your thinning areas. After a few months of shock loss, they will grow new hair that is not sensitive to dihydrotestosterone (the male hormone responsible for androgenetic alopecia). And since a hair transplant is permanent, they will continue to do so for the rest of your life.
If you are a healthy person with moderate pattern hair loss (or another stable type of alopecia), you may be a good candidate for hair restoration surgery. However, only a hair specialist can say whether you are eligible and can benefit from this procedure.
Book a consultation at your earliest convenience with one of our world-class surgeons and they will answer all your questions about whether this procedure is the best option for you and how much you can expect a hair transplant to increase your hair density.
If you are a good candidate for surgical hair restoration, you are on your way to putting your balding behind you. Whether you opt for an FUE or FUT surgery, success rates are almost 100%. Then, going through a few months of shock loss will be worth the trouble, knowing your hair transplant will still look good after 10 years or more. Check out our before and after hair transplant gallery to see our results for yourself.
If you would like to find out more about Minoxidil hair shedding, you can do so by reading the answers to the following frequently asked questions:
There is presently no recorded case of Minoxidil hair shedding becoming permanent. Moreover, Minoxidil works by improving blood flow to the small blood vessels in your scalp so your hair follicles can get more oxygen and nutrients. It contains no active ingredient that can damage your hair follicles or prevent your hair from growing.
If your hair shedding continues after 12 weeks, it may have a different cause, or the Minoxidil may not be effective against your type of hair loss.
Oral Minoxidil is often stronger than topical varieties and has a systemic effect. That is why it has more side effects than those you apply to your scalp. When you take this medication, it enters your bloodstream and acts from the inside out, while the effect of using a Minoxidil spray or lotion is contained to the part of your scalp it is applied to and absorbed by.
There is some evidence that Minoxidil 2% and 5% solutions have a rather similar rate of reported hair shedding in female patients [11].
Minoxidil 10% can make your hair fall out more than both lower strength formulas, despite not being more effective than the 5% strength [9]. However, it is best always to follow your trichologist’s recommendation when choosing a specific hair growth treatment concentration, as they are experienced in weighing the benefits against the risks.
There is some evidence that prolonged use of both oral and topical Minoxidil can lead to some hair discolouration (greying, brown colour lightening), especially in people with a family history of premature greying [10] and in those with loose anagen syndrome [8].
While this discoloration is likely temporary, it hasn’t been studied sufficiently to say how long it may last.
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