Should I give up on minoxidil for a hair transplant?

[jnx]

Brief background. 26 years old. Hair receded deeply between 15-16. High school teachers said I'd be bald before 20. Thinning didn't start until late 21 or 22. Been on Finasteride for 15 months without stoppage.

Started finasteride, minoxidil, ketoconazole, and RU58841 in April of 2019. Here are the results

https://i.imgur.com/as1LtvO.png (before, 1-4 months)

https://i.ibb.co/RC6Q0V2/AF23-CD27-3294-4473-B77-F-67-E4-F0-E8-C851.jpg (shortly before ending all topicals, around 6 month mark, no top shot unfortunately)

 

Stopped taking RU out of safety concerns, and decided to also stop Minoxidil due to it being so inconvenient. Oil 2x a day on your hair that takes 4 hours to dry and 8 hours for full absorption just isn't practicable or sustainable for a life long treatment. Well, that was a mistake, lost all gains as seen here in Jan 2020.

https://i.imgur.com/hn2nPX0.jpg

Got back on Minoxidil again and lasted until May. Ran out and was stuck overseas due to COVID travel restrictions, couldn't access more.

Now everything is starting to fall out again just like before. From my understanding, this is all temporary, just losing the minoxdil gains and experiencing telogen effluvium. I was planning on getting back on as soon as possible, which is now, but I'm having double thoughts.

Should I let every thing fall out, normalize without minoxidil, see what the finasteride alone has been able to keep/regrow, and then get a transplant? Before all this, I wasn't mentally ok with a transplant but I've overcome those mental obstacles. Still, applying minoxidil for life sounds very unappealing. 

Edited July 7, 2020 by jnx

[rob7331]

Hey jnx!

I don't chime in my opinions too much on this forum as there's a lot of experts, but I can speak to this topic a little bit. I'm about your age and had a similar experience with Minox. In addition to the "fragile nature" of the gains I did make, the skin on my face took on some weird water retention issues (increased dark circles under eyes, generally look aged, etc). Also like you said the daily routine of it was just annoying as it left your hair relatively oily for the majority of the day and didn't feel great on my scalp. The point of doing these things for our hair is that we want to enjoy having hair - not being afraid to run your hands through it.

My understanding of Minoxidil as a treatment is you apply it for life, and rigidly. In the end the minor gains I achieved after more than a year of consistent use just wasn't worth it. I stopped and sold the rest of my supply, a month or so later I felt the health of my face immediately improve.

There have been some amazing results of people who use Minox. What works for me is staying on Fin, eating healthy, taking Biotin and using Nizoral shampoo, with the occasional dermaroll. It's fairly low effort and easy to keep consistent, and best of all I don't feel any negative effects on my body.

[giegnosiganoe]

Wow, seems like minoxidil did a lot for you. I'm sure many of us wish we had such results. I don't think it has done anything for me, but I'm too afraid to get off of it in case it drops me below baseline.

Have you considered applying minoxidil only once a day to reduce the hassle? It has a half-life of 22 hours so that shouldn't affect the results too much. It's worth trying.

Also, I guess you are using liquid minoxidil? I agree with your general sentiments in that case. I was using it for about a year and hated how it took hours to dry, and even then my hair still felt gross. I've since switched to foam minoxidil which dries in 15 minutes and leaves your hair feeling normal.

[Melvin- Admin]

In order to keep gains you’ll have to take it for life, even finasteride. My advice stick with it if it’s working. Is being bald unappealing? If yes keep taking it.

[jnx]

12 hours ago, rob7331 said:

Hey jnx!

I don't chime in my opinions too much on this forum as there's a lot of experts, but I can speak to this topic a little bit. I'm about your age and had a similar experience with Minox. In addition to the "fragile nature" of the gains I did make, the skin on my face took on some weird water retention issues (increased dark circles under eyes, generally look aged, etc). Also like you said the daily routine of it was just annoying as it left your hair relatively oily for the majority of the day and didn't feel great on my scalp. The point of doing these things for our hair is that we want to enjoy having hair - not being afraid to run your hands through it.

My understanding of Minoxidil as a treatment is you apply it for life, and rigidly. In the end the minor gains I achieved after more than a year of consistent use just wasn't worth it. I stopped and sold the rest of my supply, a month or so later I felt the health of my face immediately improve.

There have been some amazing results of people who use Minox. What works for me is staying on Fin, eating healthy, taking Biotin and using Nizoral shampoo, with the occasional dermaroll. It's fairly low effort and easy to keep consistent, and best of all I don't feel any negative effects on my body.

Didn't personally experience those side effects you list, but I know they're a common concern. 

Did you have a huge shed like myself? I assume you lost whatever gains you had as well. The same exact process is happening for me again. Your hair stays in tact after stopping for 1.5-2 months, followed by hair EVERYWHERE as a result of the minoxidil halt shed. For how long have you been off? Ideally, I'd like to experiment, let all the hair fall out and see if finasteride alone has indeed kept baseline or improved at all. But this whole telogen effluvium process, from what I gather, will take about a year. And, if I don't like the result and need to start minoxidil again, that's another 4-6 months for solid results. We're talking about a year and a half of experimentation which is along time of your hair looking awful. 

12 hours ago, giegnosiganoe said:

Wow, seems like minoxidil did a lot for you. I'm sure many of us wish we had such results. I don't think it has done anything for me, but I'm too afraid to get off of it in case it drops me below baseline.

Have you considered applying minoxidil only once a day to reduce the hassle? It has a half-life of 22 hours so that shouldn't affect the results too much. It's worth trying.

Also, I guess you are using liquid minoxidil? I agree with your general sentiments in that case. I was using it for about a year and hated how it took hours to dry, and even then my hair still felt gross. I've since switched to foam minoxidil which dries in 15 minutes and leaves your hair feeling normal.

Appreciate the kind words on the results

Surely at minimum, minoxidil has switched and kept your existing follicles into the anagen phase even if it's not super apparent. I think your analysis about not wanting to stop is correct, as you'll experience a lot of switching of growth phases. 

Your recommendation might be the most solid move. Stick to the most non intrusive method possible, which would be the quick drying foam applied once in the morning. Just like brushing your teeth. If the same results are realized, great. If not, it can't make it any worse. 

Did you notice any difference or sheds months from switching to 1x a day foam application as opposed to 2x oil application? Maybe I'll do the 2x oil to kick start it again, until I get sick and have to switch to 1x morning foam. 

Edited July 7, 2020 by jnx

[giegnosiganoe]

46 minutes ago, jnx said:

Appreciate the kind words on the results

Surely at minimum, minoxidil has switched and kept your existing follicles into the anagen phase even if it's not super apparent. I think your analysis about not wanting to stop is correct, as you'll experience a lot of switching of growth phases. 

Your recommendation might be the most solid move. Stick to the most non intrusive method possible, which would be the quick drying foam applied once in the morning. Just like brushing your teeth. If the same results are realized, great. If not, it can't make it any worse. 

Did you notice any difference or sheds months from switching to 1x a day foam application as opposed to 2x oil application? Maybe I'll do the 2x oil to kick start it again, until I get sick and have to switch to 1x morning foam. 

Yeah I guess it has done something, but I'm a diffuse thinner and seem to be a weak responder so it's hard to tell. I didn't notice a shed when I first started using it, so I'm not worried about a shed from stopping it (especially not if it's temporary), but I don't want to risk permanently losing some hairs even if they are already weak. I'm going to soon add in microneedling to see if that improves the results.

I was only using the liquid once a day at night and am now using foam once a day at night for the past month, without noticing any difference. Had I been applying it twice a day to begin with, it's possible that I would have had better results. But honestly, a large percentage of users apply it once a day, and I've seen many before/after pictures of people who have had good results from doing so over on /r/tressless. Haven't seen many people claim that there's a big difference between the two methods.