Do Propecia and Minoxidil Operate in Cycles?
Hello Dr Rassman, thank you for this amazing blog of stable information.
I am a 23 year old male, thinning in a NW 3V pattern with diffuse hair loss on top of scalp with a NW 6 final pattern (had my miniaturization check). However, I look like I have dense NW 2 hair with proper styling (caught it very early). I have been using minoxidil and propecia for 7 and 9 months respectively, and had fantastic results since then. My shedding had almost completely stopped and I had a significant increase in density and regrowth.
However, since the beginning of last month, I have been experiencing a horrific process of shedding, almost more than 300 hairs everyday. Obviously this upset me after seeing such good results during the previous months, but I did notice the hairs I shed are very small (both in length and width) and miniaturized, and the general appearance of my hair has not altered so much during this intense period of shedding (have photographed my hair during the process, derived this result from comparisons; unfortunately bulk measurement is not available in where I reside).
So my question is as follows; does medicine like propecia and minoxidil (medicine with the potential of regrowing hair) operate in cycles? Are my small hairs shedding in order to make way to healthier, thicker hairs? Can some of the miniaturized hairs be effected after 8-9 months into the treatment? Or the first shedding period effects all the miniaturized hairs at the same time and the process of regrowing hair is a smooth transition which does not include a secondary shedding phase? This is the second shed that I am experiencing since beginning the medication, and I have been unable to find any other credible information similar to the matter.
I have been to my dermatologist (who specializes in hair loss), but he has only told me that shedding waves with types of medicines occur sometimes and I should not worry about it. Don’t get me wrong, I do understand that medical solutions are almost always temporary, and I accept the fact that I will go bald eventually. I am only curious about what I am experiencing, as these drugs are supposedly most effective after the 1 year mark. I wonder whether you have seen something similar in your practice throughout the years?
Thank you very much in advance.
I’ll break your questions out to make it easier to answer —
1- Does medicine like propecia and minoxidil (medicine with the potential of regrowing hair) operate in cycles?
- ANSWER: Probably not
2- Are my small hairs shedding in order to make way to healthier, thicker hairs?
- ANSWER: I doubt that is the case
3- Can some of the miniaturized hairs be effected after 8-9 months into the treatment? Or the first shedding period effects all the miniaturized hairs at the same time and the process of regrowing hair is a smooth transition which does not include a secondary shedding phase? This is the second shed that I am experiencing since beginning the medication, and I have been unable to find any other credible information similar to the matter.
- ANSWER: I rarely see shedding with either minoxidil or Propecia. Shedding this far into treatment might mean that your hair loss is now into a more aggressive phase, or you are developing a refractory state when it comes to one of these medications.
You will have to wait it out. Sorry, I can not help you.
I’ve been on Propecia for 7 years. I had great results after 14 months and then at the 15 month mark everything seemingly turned back to how it was pre-Propecia . However, by the 18th month mark it had all come back again thicker. I’ve had cycles like this the entire 7 years – every time I wonder if the drug is losing effectiveness, but it always somehow come back. It seems to be unusual though – most people are on a more consistent trajectory. I’ve only read online from two other people who had similar hair growth and loss cycles whilst on Propecia. Both have been on the drugs 10 plus years.
Do people actually sit and count the specific number of hairs they lose daily? It seems am unreliable system – given even people with perfect hair lose at least a hundred (and probably more) every day and hairs stuck from hair products etc can come out at random brushings etc.
I am pretty sure people have changes in hair quality, density and thickness based on weather, season, diet, stress, illness etc – I don’t think these things are directly related to actual real hair loss but it must appear very obvious to each individual.
I have been on pro and minoxidil and have experienced mini sheds throughout my time on it. Combining has worked for me. Not had much re growth but hair looks better and is thicker. Going through a mini shed now and worried that the drug doesn’t work anymore but we’ll see.
I seem to also observe cycles whilst using minox + finasteride.
I use it to try keep the frontal hairline think and have been using for about 2.5 years. In those years there have been countless moments where it seems like I’ve gone “past the point of no return” only for there to be a bounce back 2-3 weeks later.
I don’t think it’s as aggressive as described above, by we know that hair has cycles, so it’s not impossible that medication has an effect on those cycles. I think I read before that minoxidil tends to synchronize the hair growth, so that you get a period of thickness followed by a period of thinness.
That seems to be my experience, though of course it’s not something I’ve measured scientifically (and in any case it would be impractical to do so on a day to day basis)