Minoxidil is a hair loss medication that works by providing increased blood flow to your hair follicles. To discuss how minoxidil works, we should look at the phases of the hair growth cycle and the mechanics of hair loss.
In a normal hair growth cycle, each follicle will begin producing a single hair strand, weaving together keratin and stacking it to add length to your hair. On average, a single hair follicle can grow hair for up to three years before entering a shedding phase.
During the shedding phase, the hair follicle releases the hair it has grown, before resting for a time to prepare for the next growth phase. However, in male pattern hair loss, this process is interrupted.
Testosterone has many functions throughout the body. One byproduct of testosterone is the hormone dihydrotestosterone (DHT). This hormone contributes to the growth of the prostate, body hair levels and other functions; however, it also causes the blood vessels in the scalp to shrink.
The lack of blood flow means the follicles do not get the nutrients they need to continue producing hair; the hairs they make might be thinner and weaker, and once they enter the resting phase, they will not be able to start a new growth phase (senescence). As DHT levels rise, narrowing and closing more blood vessels in the scalp, these static follicles will slowly die off, never to produce hair again.
However, by allowing greater blood flow to the scalp and promoting hair growth, minoxidil can allow hair follicles to grow thicker, healthier hair, and can even allow some senescent follicles to begin producing hair again.
Topical minoxidil (such as Regaine Foam or Regaine Solution) requires a twice-daily application, while oral minoxidil is a once-daily pill.
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Does Minoxidil Stop Working?
When you first start taking minoxidil, you might notice an increase in hair shedding over the first few weeks – this is perfectly normal. Your follicles are releasing the hairs they have been growing, so they can produce thicker, better ones in their place.
Some patients may find that, after a while, the results of minoxidil are less evident. This is referred to as a plateau – all the follicles which can be reactivated have been, and no new growth will be seen. However, minoxidil is still working at this point; it is keeping the blood flow steady to the existing follicles. This will keep your hair thicker and in better shape than without.
What Happens if You Stop Using Minoxidil?
Stopping minoxidil will normally lead to a reversion of your hair loss; as there is nothing to counteract the effects of the DHT your body naturally produces, the follicles will once again begin to shrink until they die off. This process may seem faster than before; the newer follicles will go first.
Minoxidil is considered safe for long-term use; there are few to no withdrawal effects, nor long-term side effects (aside from in very rare cases). Stopping minoxidil should not cause you any further issues aside from the return of your hair loss.
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How to Stop Minoxidil Without Losing Hair
Currently, your options are limited if you decide to stop taking minoxidil and wish to keep the head of hair you have saved.
You might consider a gradual weaning-off period; using less than the recommended amount, or using it less often, to allow you to gradually reduce the amount of hair loss you experience, while allowing some hair thinning. Eventually, however, you will lose the hair you have kept as the follicles once again enter stasis from lack of blood flow.
You may also wish to switch to another hair loss treatment. While oral minoxidil will give similar results to topical, and works the same way, a treatment like finasteride (or its branded equivalent, Propecia) works in a different way – rather than working against DHT, they actually prevent it from being created. This reduces the level of DHT in the body, allowing your follicles to recover. This also means that finasteride is only suitable to treat male pattern baldness, and isn’t effective for women.
Some patients may choose to use both minoxidil and finasteride in combination; these medications can work together well, and you may wish to simply switch over to finasteride.
Before trying any new medication, we would ask you to speak to your doctor or pharmacist for medical advice, and to check if these new treatments are suitable for you.
