Stopping Minoxidil Shrinks Capillaries?

Dear Dr.

I have been taking Minoxidil 4% plus progesterone for 16 years and stopped 3 months ago because I was worried about the possible long term effects and I wanted to look at a more natural approach. Since then the shedding had increased dramatically (over 150 hairs during shampooing), my scalp can now be seen through my hair for the first time ever and the hairs that are falling out are thinner and in some cases shorter than before I stopped.

It was suggested by a trichologist that I am seeing that when you stop using Minoxidil the capillaries shrink to smaller than their original size, reducing the blood flow to the hair and causing them to fall out. He also suggested that they dont return to their normal size for up to 9 months and in some cases never as the damage is permanent.

However another trichologist told me that the hair loss could not be so sudden and it would take 6-12 months before I would notice any hair loss and even then it would only be the hair that was “saved” by the Minoxidil in the first place that would fall out. Can you tell me:

1. Do you know of any research to support either of these claims?
2. Is there anything I can do to stem the shedding if the cause is the fact I have stopped using Minoxidil?
3. Could blocked follicles (as the first trichologist suggests) also be a contributing factor?

Thank you for your time.

You are asking me to comment on what your trichologist told you and I don’t know what to say about blood vessels, shrinking capillaries, etc. What I do know is that for 16 years you used minoxidil and that you most likely have minoxidil-dependent hair that will not grow back unless you go back on the minoxidil and are not too late in doing so. So to answer your questions:

1. I’m not aware of any research, but I can’t say that it doesn’t exist.
2. Stopping minoxidil will result in losing benefits of the minoxidil — which would be any hair retained or regrown by the medication. You’ve been on the medication for 16 years, so you’ll have a difficult time guessing which hairs were saved by the minoxidil (meaning, the hairs that will be lost).
3. Isn’t this the same as question 1? I don’t have an answer for you, unfortunately.