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

[Rahal Hair Transplant]

To be honest, I’m not an avid believer the efficacy of oral minoxidil. The truth is, even the most reputable doctors admit they don’t know exactly how minoxidil works. They know it’s a vasodilator and it “stimulates” hair growth - however, they don’t know the exact mechanism that makes it work.  But if minoxidil “stimulates growth“ by making contact with the follicle itself by absorbing into the skin, how exactly would oral minoxidil do anything?

Now please keep in mind that this is strictly my opinion and not necessarily the opinion of Dr. Rahal nor the clinic.  Personally, if topical minoxidil was working for you I think it would have been best to stick with that instead of switching.

However, If you switched to oral minoxidil because the topical wasn’t working then I agree it was worth a try.   And I also agree with others that if oral minoxidil is working for you, the hair loss you are experiencing could be the initial shed.

Hopefully I am wrong and I oral minoxidil can and does have some benefits for you. But personally I think it’s best that people stick with oral finasteride and topical minoxidil under the best case scenarios and only consider switching to topical finasteride and oral minoxidil if the others are not working or you’re experiencing extreme side effects.

best wishes,

Rahal Hair Transplant

Edited May 13, 2022 by Rahal Hair Transplant

[EvoXOhio]

I’m happy to report that for the last couple of weeks my hair fall has been reduced to 5-10 hairs a day like I was seeing before the switch. Hoping in the coming months I see new and/or thicker hair to replace the hairs that were shed. 

[GoliGoliGoli]

26 minutes ago, EvoXOhio said:

I’m happy to report that for the last couple of weeks my hair fall has been reduced to 5-10 hairs a day like I was seeing before the switch. Hoping in the coming months I see new and/or thicker hair to replace the hairs that were shed. 

Keep us posted in the coming months will be interesting to see the difference you notice

[EvoXOhio]

Just now, GoliGoliGoli said:

Keep us posted in the coming months will be interesting to see the difference you notice

Will do 

[ScottyHairs]

Hey Everyone,

Reviving this thread as I wanted to share my experience so far in switching from high strength topical minoxidil (30%) to oral minoxidil and also get some feedback.

I am a 45 y/o male that stated having MBR in late 20s (crown/vertex and front hair line loss).

Been on 2.5mg finasteride once daily for 15+ years (good efficacy, no side affects).  Started on 5% minoxidil OTC foam at same time and over past 15+ years have ramped up to compounded RX form of 30% minoxidil (based on the legendary Dr. Kleins' formula with Azelaic & Retinoic Acid).  Have been at 30 percent for past seven years.  Also have been applying 3% Acetyl Glutathione Liquid prior to the 30% minoxidil at bed time for the better part of the past 10 years.  Also periodically used a derma roller on scalp prior to application.

My results had been great on this regimen.  Full frontal hair line saved and good regrowth.  I had already had a bit of crown loss early on so it has maintained very thin crown cover with some regrowth.  I think I am one of those rare cases where my crown loss was much more significant than frontal hair line erosion.

About five months ago I decided to switch from the topical 30% minoxidil lotion and Acetyl Glutathione Liquid to oral minoxidil.  I have been taking 2.5 mg or oral minoxidil daily (1.25mg in morning at 1.25mg at night).  Despite switching the minoxidil I have maintained the 2.5mg daily finasteride.  The reason for the switch was really purely out of convenience (was trying to not have to mess around with lotions every night).

For the first 6 weeks I noticed no real change.  Since then I have noticed thinning and now significant loss of density in frontal hair line that seems to be ongoing.  And again this is at the 5 month mark.  I have NOT noticed any large/sudden amount of shedding.  Just slow thinning and gradual lost of density that continues.

I am leaning towards one of the two (or both) conclusions:

1.  I respond much better to Topical than Oral Minoxidil based on the previous 10+ years of maintenance and hair gains

AND/OR

2. The 2.5mg of daily oral minoxidil is not a strong enough replacement for the 30% topical minoxidil (FYI: I am not willing to try 5mg of oral minoxidil due to safety concerns)

So I am just about ready to throw in the towel on oral minoxidil and go back to the 30% topical.  Would like to hear your guys thoughts though?  Does anyone think five months is not long enough to wait (esp since the loss of frontal density has not stabilized and continues to get worse. 

 

 

 

 

[BaldDude]

8 minutes ago, ScottyHairs said:

Hey Everyone,

Reviving this thread as I wanted to share my experience so far in switching from high strength topical minoxidil (30%) to oral minoxidil and also get some feedback.

I am a 45 y/o male that stated having MBR in late 20s (crown/vertex and front hair line loss).

Been on 2.5mg finasteride once daily for 15+ years (good efficacy, no side affects).  Started on 5% minoxidil OTC foam at same time and over past 15+ years have ramped up to compounded RX form of 30% minoxidil (based on the legendary Dr. Kleins' formula with Azelaic & Retinoic Acid).  Have been at 30 percent for past seven years.  Also have been applying 3% Acetyl Glutathione Liquid prior to the 30% minoxidil at bed time for the better part of the past 10 years.  Also periodically used a derma roller on scalp prior to application.

My results had been great on this regimen.  Full frontal hair line saved and good regrowth.  I had already had a bit of crown loss early on so it has maintained very thin crown cover with some regrowth.  I think I am one of those rare cases where my crown loss was much more significant than frontal hair line erosion.

About five months ago I decided to switch from the topical 30% minoxidil lotion and Acetyl Glutathione Liquid to oral minoxidil.  I have been taking 2.5 mg or oral minoxidil daily (1.25mg in morning at 1.25mg at night).  Despite switching the minoxidil I have maintained the 2.5mg daily finasteride.  The reason for the switch was really purely out of convenience (was trying to not have to mess around with lotions every night).

For the first 6 weeks I noticed no real change.  Since then I have noticed thinning and now significant loss of density in frontal hair line that seems to be ongoing.  And again this is at the 5 month mark.  I have NOT noticed any large/sudden amount of shedding.  Just slow thinning and gradual lost of density that continues.

I am leaning towards one of the two (or both) conclusions:

1.  I respond much better to Topical than Oral Minoxidil based on the previous 10+ years of maintenance and hair gains

AND/OR

2. The 2.5mg of daily oral minoxidil is not a strong enough replacement for the 30% topical minoxidil (FYI: I am not willing to try 5mg of oral minoxidil due to safety concerns)

So I am just about ready to throw in the towel on oral minoxidil and go back to the 30% topical.  Would like to hear your guys thoughts though?  Does anyone think five months is not long enough to wait (esp since the loss of frontal density has not stabilized and continues to get worse. 

 

 

 

 

that's really sad to hear, I would expect better results at 5 months.  I've heard it can take up to a year or more tho.

[Judelaw]

30% minoxidil?? Why didn’t you mention that before bro, 1.25 mg twice a day probably isn’t enough to replace such a massive dose. 

[Melvin- Admin]

How much is 30% compounded? It’s probably more expensive than 5mg of oral minoxidil. 

[ScottyHairs]

56 minutes ago, Judelaw said:

30% minoxidil?? Why didn’t you mention that before bro, 1.25 mg twice a day probably isn’t enough to replace such a massive dose. 

So I did mention this to my prescribing doctor on the oral minoxidil.  He thought the oral going systemic 'should' be enough...  The problem tho is there's really not a lot of research on oral and certainly none on people using 30% topical.  

[ScottyHairs]

30 minutes ago, Melvin- Moderator said:

How much is 30% compounded? It’s probably more expensive than 5mg of oral minoxidil. 

It's not cheap.  About $80/month for the 30%.

[Melvin- Admin]

Just now, ScottyHairs said:

It's not cheap.  About $80/month for the 30%.

Yea, I don’t see that 30% being much more effective than 5mg of oral that costs $20 for 90 day supply. Unless you have severe sides on oral, it wouldn’t make sense to pay that much. 

[ScottyHairs]

30 minutes ago, Melvin- Moderator said:

Yea, I don’t see that 30% being much more effective than 5mg of oral that costs $20 for 90 day supply. Unless you have severe sides on oral, it wouldn’t make sense to pay that much. 

Cost was another reason I have tried the switch.  

Are people doing 5mg daily on oral?  My doc advised 5mg daily (or even 2.5mg morning & evening) was pushing the limits.  That said, I wonder with the 30% topical how much was going systemic?  I've had no side effects on the 2.5mg oral.

I think the decision I have to make at this point is do I switch back to topical or try a higher oral dosage.

[Melvin- Admin]

39 minutes ago, ScottyHairs said:

Cost was another reason I have tried the switch.  

Are people doing 5mg daily on oral?  My doc advised 5mg daily (or even 2.5mg morning & evening) was pushing the limits.  That said, I wonder with the 30% topical how much was going systemic?  I've had no side effects on the 2.5mg oral.

I think the decision I have to make at this point is do I switch back to topical or try a higher oral dosage.

I'm doing 5mg 3x per week and 2.5mg 4x per week. I was also on 15% minoxidil prior to switching to oral and I found that the oral was still more effective.

[thetdog666]

If 30% was working why did you want to change or oral?

[ScottyHairs]

52 minutes ago, Melvin- Moderator said:

I'm doing 5mg 3x per week and 2.5mg 4x per week. I was also on 15% minoxidil prior to switching to oral and I found that the oral was still more effective.

 

3 minutes ago, thetdog666 said:

If 30% was working why did you want to change or oral?

First and foremost, convenience.  Taking a pill once or twice a day is far easier than applying the lotions/creams.  Secondly, cost.  Oral is probably 80-90 percent cheaper.

[ScottyHairs]

1 hour ago, Melvin- Moderator said:

I'm doing 5mg 3x per week and 2.5mg 4x per week. I was also on 15% minoxidil prior to switching to oral and I found that the oral was still more effective.

This is very interesting especially because I think there's likely not much difference between 15% and 30% topical (point of diminishing returns).  You are likely one of the few other people that I have ever encountered to switch from high concentration topical to oral.  I have a few more questions for you:

1.  Can you tell me what type of 15% you were using (lotion, cream, liquid?).  Also, do you mind sharing from what compounding pharmacy?

2.  Are you taking the daily amount all at once daily or on the three days are you taking 2.5mg twice a day?

3.  Can you give a time line of how your transition went...was there any overlap?  shedding? thinning?  how long to see more effective results after the switch?

Many thanks!  

[ThePerseverantWarrior]

On 5/13/2022 at 12:55 AM, 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?

Hey! 

 

Any update? When did your hair shed stop, and have you seen improvements from oral minoxidil? 

 

I switched from topical to oral minoxidil a month back and I've been seeing some good shedding for 2 weeks now. Most of the falling hairs seem small and thin though. 

[EvoXOhio]

21 minutes ago, ThePerseverantWarrior said:

Hey! 

 

Any update? When did your hair shed stop, and have you seen improvements from oral minoxidil? 

 

I switched from topical to oral minoxidil a month back and I've been seeing some good shedding for 2 weeks now. Most of the falling hairs seem small and thin though. 

The shed lasted maybe 4-6 weeks, I can’t remember exactly. It’s really hard for me to track improvement because I’ve had an HT and SMP. My hair loss daily is still extremely minimal, like maybe 10-20 hairs. And most of that is from combing my hair because it’s long down to my shoulders and gets knotted up in the shower. The best part about switching is I no longer have greasy hair from the topical. 

[ThePerseverantWarrior]

On 5/13/2022 at 2:05 AM, uk005801 said:

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 

Any update?

[Cory]

Fellow oral Minox users,

I'm experiencing severe shedding since I switched from topical to oral minoxidil, about a month ago.
Did many of you regain those hairs after continuing the minoxidil tablets for the months afterwards?

@EvoXOhio @uk005801 @ScottyHairs @ThePerseverantWarrior or someone else on the forum?
Like to hear your experience!

[uk005801]

2 hours ago, Cory said:

Fellow oral Minox users,

I'm experiencing severe shedding since I switched from topical to oral minoxidil, about a month ago.
Did many of you regain those hairs after continuing the minoxidil tablets for the months afterwards?

@EvoXOhio @uk005801 @ScottyHairs @ThePerseverantWarrior or someone else on the forum?
Like to hear your experience!

I had same but everything came back stronger in my view mate so hang in there touch wood no sides bar more hair in other areas but nothing major, I also think I get in grow hairs on chest but maybe due to me shaving the growth I don’t want from minox but small price to pay 

[Cory]

5 minutes ago, uk005801 said:

I had same but everything came back stronger in my view mate so hang in there touch wood no sides bar more hair in other areas but nothing major, I also think I get in grow hairs on chest but maybe due to me shaving the growth I don’t want from minox but small price to pay 

Appreciate it! 🫶
Let's hope for the best..

[uk005801]

3 hours ago, Cory said:

Appreciate it! 🫶
Let's hope for the best..

Trust in the process mate loss is a part of it but it does work trust me 

[ThePerseverantWarrior]

On 4/21/2023 at 4:28 PM, Cory said:

Fellow oral Minox users,

I'm experiencing severe shedding since I switched from topical to oral minoxidil, about a month ago.
Did many of you regain those hairs after continuing the minoxidil tablets for the months afterwards?

@EvoXOhio @uk005801 @ScottyHairs @ThePerseverantWarrior or someone else on the forum?
Like to hear your experience!

2.5 months on oral minoxidil. I don't think my shedding has stopped. Nor do I see any improvement whatsoever in my situation yet. Maybe it's too early. Or maybe, it's not working for me. No excessive body hair growth either. 

I'm going to give it at least another 3 months before taking a call. 

I don't think you should worry though. Shedding on switching medication is usually a positive sign. 1 month is too short a time to lose hairs due to stopping topical minoxidil, so it may be oral minoxidil induced shedding. Those hairs are likely to come back stronger

[ThePerseverantWarrior]

23 hours ago, uk005801 said:

I had same but everything came back stronger in my view mate so hang in there touch wood no sides bar more hair in other areas but nothing major, I also think I get in grow hairs on chest but maybe due to me shaving the growth I don’t want from minox but small price to pay 

After how long on oral minoxidil did you see results?