What Is Minoxidil Hair Shedding and How Long Does It Last?
Treating hair loss and acne have at least one similarity: both conditions can get worse before they get better. Many people notice that their acne gets worse after they start acne treatment. The same is true with treating hair loss. When you take minoxidil in products such as Rogaine, you may notice some hair shedding before you notice hair regrowth.
Minoxidil is U.S. Food and Drug Administration (FDA)-approved to treat male-pattern and female-pattern hair loss. These conditions are also called androgenetic alopecia. Minoxidil is also used off-label to treat many other causes of hair loss.
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Can Minoxidil Cause Hair Loss?
Everyone sheds about 50 to 100 hairs each day. Hairs are shed when a hair follicle leaves the growth phase of its cycle and enters a resting phase. Telogen effluvium is the medical term for excessive hair shedding. Stressors on your body, such as emotional stress, infections, or changes in hormone levels, are some common causes of hair shedding.
When you start treatment with minoxidil, hairs may be pushed from the hair follicle as newer hairs develop. Starting minoxidil treatment can cause a temporary increase in hair shedding. This is not hair loss, as the follicles are still healthy and functioning. Hair loss occurs when something stops the hair in the hair follicle from growing.
What Is Minoxidil Shedding?
About 85% to 90% of the 100,000 hair follicles on your scalp are in the anagen growth phase. This phase lasts anywhere from two to six years.
About 1% to 3% are in the catagen transition phase. During this phase, the hair follicle stops growing, and it separates itself from its blood supply.
The other 5% to 10% of hair follicles are in the telogen resting phase. During this phase, the hair is sitting in the hair follicle, but it is no longer growing. It needs a blood supply to carry nutrients and oxygen for growth. Once new hair begins to grow, it pushes the old hair out of the follicle, and it is shed.
When you first start using minoxidil, you may notice hair shedding. Don’t be discouraged as this happens. It is an expected minoxidil side effect, but it can cause some people to quit using minoxidil.
Why Minoxidil Shedding Happens
Hair shedding when using minoxidil is common. In one study, about one out of every eight people using 5% minoxidil reported hair shedding and, interestingly, slightly more reported it with the 2% solution.1
Minoxidil pushes hair follicles into their growth phase. Increased shedding happens because each hair follicle must go through its entire cycle before returning to the anagen phase, and minoxidil makes this happen faster. This can result in noticeable shedding as more than the usual number of follicles enter the anagen phase at the same time.
Once in the anagen phase, it can take months for noticeable hair growth to occur. This makes shedding more noticeable.
How Long Does Minoxidil Shedding Last?
Minoxidil shedding typically occurs two to eight weeks after starting treatment. Minoxidil hair shedding is self-limited. If you continue taking minoxidil, you should notice decreased shedding and increased hair growth.2
Minoxidil Shedding Timeline
Using a typical hair growth cycle, researchers have developed a timeline for when to expect shedding.
- Weeks one to two: During this early phase, you are not likely to notice increased hair regrowth or hair shedding.
- Weeks two to four: During this phase, you may notice an increase in hair shedding.
- Weeks four to eight: Shedding increases and peaks during the second month after using minoxidil.
- After eight weeks: Minoxidil shedding decreases as more and more hair follicles are now in their anagen growth phase.
It takes several months for minoxidil to work. This is because scalp hair grows at a rate of about one centimeter per month. It takes about 4 to 6 months for enough hair growth to occur to be noticeable. Each minoxidil user may notice different results when using minoxidil and, therefore, a different timeline.
If you do not see hair regrowth or you have increased shedding after using minoxidil for 4 to 6 months, ask your doctor whether a new medication or dosage is needed. If you experience side effects from using minoxidil, contact your doctor.
How to Stop Minoxidil Shedding
Minoxidil shedding is a normal phenomenon that occurs as minoxidil changes your hair’s growth cycle. Because minoxidil shedding is to be expected, the most common error is to believe that it means minoxidil isn’t working and, as a result, to discontinue treatment.
While waiting for your thicker and longer hair, there are steps you can take to maximize your hair’s overall health.
Consuming a nutritious diet rich in antioxidants and vitamins that support hair and skin health is important for hair growth. Ensure you get plenty of folic acid, biotin, vitamin E, and omega-3 fatty acids in your diet. Learn more about how a healthier lifestyle focuses on proper nutrition.
Here are some tips for improving overall scalp health.
- Avoid harsh chemicals in shampoos and conditioners.
- Avoid hairstyles that pull or put traction on hair.
- Massage your scalp to increase blood flow.
- Allow hair to air dry when possible.
- Contact your doctor if you notice any scaling or reddened areas on your scalp.
Emotional and physical stressors can cause hair follicles to enter a resting phase more quickly. This is called telogen effluvium. If you think your stress is contributing to hair loss, it may be time to address your cognitive health.
Suppose your diet is low in nutrients. Maybe everyday stresses or the aging process are depleting the nutrients your body needs. In that case, supplements can help restore vitamins, minerals, and other nutrients, giving your hair follicles the support they need to grow. Many people incorporate supplements into their age management plan.
Other Treatments for Hair Loss
Other than minoxidil, there is only one other FDA-approved treatment for hair loss. Finasteride inhibits an enzyme that converts testosterone into dihydrotestosterone (DHT). People with increased androgen sensitivity at the hair follicle can benefit from finasteride, a medication designed to reverse male-pattern hair loss.
Rosemary oil is a natural option that some people may choose as an alternative to minoxidil. Rosemary oil is believed to increase blood supply to the hair follicle and reduce inflammation. It may also reduce DHT levels in the hair follicle.
Maintaining hair growth is a long-term commitment. Talk to your doctor about all your potential options and get personalized treatment recommendations.
- Suchonwanit P, Thammarucha S, Leerunyakul K. Minoxidil and its use in hair disorders: a review. Drug Des Devel Ther. 2019 Aug 9;13:2777-2786. doi: 10.2147/DDDT.S214907. Erratum in: Drug Des Devel Ther. 2020 Feb 10;14:575. PMID: 31496654; PMCID: PMC6691938.
- Olsen EA, Messenger AG, Shapiro J, Bergfeld WF, Hordinsky MK, Roberts JL, Stough D, Washenik K, Whiting DA. Evaluation and treatment of male and female pattern hair loss. J Am Acad Dermatol. 2005 Feb;52(2):301-11. doi: 10.1016/j.jaad.2004.04.008. PMID: 15692478.