Switched from topical to oral minoxidil and now losing significantly more hair

[EvoXOhio]

Background: I’ve been on finasteride and topical minoxidil for 3 years, and my hair loss has been stable. I’d never see more than 5 hairs when I washed or combed my hair. 
 

I got a HT almost 2 years ago, and I’ve been growing my hair long ever since. I’ve been concerned that topical min was not able to get to my scalp due to having so much hair. So a month ago I switched to oral min. In the past few days I’ve noticed significantly more hair loss. I didn’t count the hairs but it’s at least 10 times as much. 
 

So now the question is, is oral more effective and I’m shedding miniaturized hairs that will now grow in thicker and fuller, or is oral not doing its job and I’m losing hair because my scalp isn’t getting topical any more?

Any harm in reintroducing topical min while also doing oral? Best of both worlds?

[BaldDude]

33 minutes ago, EvoXOhio said:

Background: I’ve been on finasteride and topical minoxidil for 3 years, and my hair loss has been stable. I’d never see more than 5 hairs when I washed or combed my hair. 
 

I got a HT almost 2 years ago, and I’ve been growing my hair long ever since. I’ve been concerned that topical min was not able to get to my scalp due to having so much hair. So a month ago I switched to oral min. In the past few days I’ve noticed significantly more hair loss. I didn’t count the hairs but it’s at least 10 times as much. 
 

So now the question is, is oral more effective and I’m shedding miniaturized hairs that will now grow in thicker and fuller, or is oral not doing its job and I’m losing hair because my scalp isn’t getting topical any more?

Any harm in reintroducing topical min while also doing oral? Best of both worlds?

I'd talk to a doctor about it first, don't want to overdose on the stuff.

[Future Hair Doc]

Likely transient shedding from switching to oral minoxidil. Oral minoxidil is stronger than topical minoxidil and I've seen lots of people shed transiently when making the switch. No need to worry about it. It means the medicine will probably work well.

[uk005801]

I started on oral minox 5 weeks or so ago and noticing quite allot of shedding I am hoping that is a sign it’s going to work. Time will tell but I trust the recco of the doc in this case who recommended it ahead of my transplant in July 

[NARMAK]

Your likely going through a shedding phase and even if we take your value of 10x as much shedding, you said you only see 5 hairs a day. So 50 is still slap bang in the middle of the normal 50-150 hairs a day range people cite. 

Hopefully the hair will grow back thicker and longer. Definitely noticed that you can go through shedding phases normally too. 

[EvoXOhio]

I’m hoping it’s shedding but im nervous it’s real hair loss from discontinuing topical. I may experiment with doing both. 

[ciaus]

This should just be temporary. Did you shed much when starting the topical? gain much thickness or has it just helped you maintain? And what oral dosage are you taking?

 

[EvoXOhio]

2 minutes ago, ciaus said:

This should just be temporary. Did you shed much when starting the topical? gain much thickness or has it just helped you maintain? And what oral dosage are you taking?

 

It’s been so many years I don’t really recall. I don’t remember a shed and I don’t remember any regrowth. I just know it stabilized my loss. 
 

im taking 2.5mg daily. 

[ciaus]

2.5 is good, I do that too. 1.25 is the minimal effective and 5mg isn't worth the additional side effect risk, even though its still low. The topical relies on enzyme activity at the skin follicle level, where some guys don't have much or no capacity for so they only respond to the oral because it gets processed in the liver. I'd give it more time, this could be due to more of your hair follicles actually being exposed to the medication now that the liver is doing the work.

[ciaus]

And as long as you stay on the finasteride you're not actually losing any ground, you're just not getting the optimal thickening and growth cycle synchronization that the minoxidil does. Worse case you can just go back on the topical if your body isn't processing the oral effectively for whatever reason. 

[RTC]

I definitely wouldn't do both oral and topical min together

[EvoXOhio]

9 minutes ago, Aslitarcan sucks said:

I definitely wouldn't do both oral and topical min together

Why is that?

[EvoXOhio]

11 minutes ago, ciaus said:

And as long as you stay on the finasteride you're not actually losing any ground, you're just not getting the optimal thickening and growth cycle synchronization that the minoxidil does. Worse case you can just go back on the topical if your body isn't processing the oral effectively for whatever reason. 

That’s what I’m hoping, I’m just so scared I’ll lose hair and then never get it back. I also forgot to mention I’m on topical dutasteride too. 

[RTC]

7 minutes ago, EvoXOhio said:

Why is that?

Minoxidil can affect your heart. You don't play around with stuff like that.

[RTC]

7 minutes ago, EvoXOhio said:

That’s what I’m hoping, I’m just so scared I’ll lose hair and then never get it back. I also forgot to mention I’m on topical dutasteride too. 

What strength, how often, where do you get it from? And you have noticed benefits?

[ciaus]

10 minutes ago, EvoXOhio said:

That’s what I’m hoping, I’m just so scared I’ll lose hair and then never get it back. I also forgot to mention I’m on topical dutasteride too. 

That's understandable, just keep remembering its the finasteride and dutasteride that's doing all the heavy lifting in terms of keeping your hair follicles working enough to produce the visible hair that the minoxidil is just enhancing. Minoxidil doesn't actually address the underlying causes of hair loss, without blocking DHT its just a way to make your hair look its best until the DHT completely wipes it out. 

Edited May 12, 2022 by ciaus

[EvoXOhio]

7 minutes ago, Aslitarcan sucks said:

What strength, how often, where do you get it from? And you have noticed benefits?

Haven’t noticed anything good or bad. I get it from Strut. 

[EvoXOhio]

13 minutes ago, ciaus said:

That's understandable, just keep remembering its the finasteride and dutasteride that's doing all the heavy lifting in terms of keeping your hair follicles working enough to produce the visible hair that the minoxidil is just enhancing. Minoxidil doesn't actually address the underlying causes of hair loss, without blocking DHT its just a way to make your hair look its best until the DHT completely wipes it out. 

I hope that’s the case. But I’m so paranoid because I have a full head of super long hair and I just don’t want to lose any of it. 

[SLA]

Take a look at what is said about temporary shedding in the following link.

Perhaps the oral minoxidil is more effective than topical prompting the shed.

I would give it a couple of more weeks to see if shedding subsides.

 

https://www.midlandskin.co.uk/conditions/minoxidil/#:~:text=Temporary shedding is very common,will stop after 4 weeks.

[EvoXOhio]

1 minute ago, SLA said:

Take a look at what is said about temporary shedding in the following link.

Perhaps the oral minoxidil is more effective than topical prompting the shed.

I would give it a couple of more weeks to see if shedding subsides.

 

https://www.midlandskin.co.uk/conditions/minoxidil/#:~:text=Temporary shedding is very common,will stop after 4 weeks.

Yeah I’ve read similar things, just paranoid I guess. I’ll definitely give it a couple more weeks then reassess. 

[Melvin- Admin]

It could be the minoxdil shed. I remember when I first tried minoxdil my hair was falling by the clumps. I believe it's shedding weaker hairs, and then when they grow back they're stronger and thicker. 

[EvoXOhio]

11 minutes ago, Melvin- Moderator said:

It could be the minoxdil shed. I remember when I first tried minoxdil my hair was falling by the clumps. I believe it's shedding weaker hairs, and then when they grow back they're stronger and thicker. 

Really hoping so. Some of the hairs definitely seem thin but I’ve also shed some that are thick. But the thick ones could be normal ones shedding based on the cycle or just from tension from hair washing and brushing. 

[Melvin- Admin]

In my experience, hair shedding is a sign the medication is working.

[EvoXOhio]

1 minute ago, Melvin- Moderator said:

In my experience, hair shedding is a sign the medication is working.

Which is great, but also terrible if I lose a ton of hair since I’ve been growing it for 19 months now. Having to start over from scratch would be awful. Hopefully I don’t lose enough to create a thin/bald spot anywhere. 

[BaldDude]

35 minutes ago, Melvin- Moderator said:

In my experience, hair shedding is a sign the medication is working.

even for Keto shampoo too?  I've noticed shedding since I started it.