Is it more beneficial to start using topical Minoxidil later in life when Finasteride is no longer effective?

[alexmillne]

Is it more beneficial to start using topical Minoxidil later in life when Finasteride is no longer effective?

I am currently 37 years old with a Norwood 2/3 hair loss pattern. I have been taking Finasteride for 1.5 years and have plans to undergo a hair transplant in October. I have never used topical Minoxidil before. My belief is that once I have the hair transplant, I will be satisfied with the improved hair density and volume.

My question is whether I should begin using topical Minoxidil now to maximize further hair loss progress. I have come across conflicting information on the internet regarding the effectiveness of topical Minoxidil. Some sources claim that its effectiveness diminishes over time as the hair follicles become accustomed to the treatment, leading to reduced stimulation.

This makes me think that perhaps it is better not to use topical Minoxidil. Instead, I should get the hair transplant and continue taking Finasteride until many years later when I notice that I am losing more hair again. At that point, I can introduce topical Minoxidil. This way, I would have another stimulant "ready" for the future that will surely be effective.

Is my thinking wrong, or does it make sense?

Thanks in advance!

Edited June 3, 2023 by alexmillne

[BurnieBurns]

27 minutes ago, alexmillne said:

Is it more beneficial to start using topical Minoxidil later in life when Finasteride is no longer effective?

I am currently 37 years old with a Norwood 2/3 hair loss pattern. I have been taking Finasteride for 1.5 years and have plans to undergo a hair transplant in October. I have never used topical Minoxidil before. My belief is that once I have the hair transplant, I will be satisfied with the improved hair density and volume.

My question is whether I should begin using topical Minoxidil now to maximize further hair loss progress. I have come across conflicting information on the internet regarding the effectiveness of topical Minoxidil. Some sources claim that its effectiveness diminishes over time as the hair follicles become accustomed to the treatment, leading to reduced stimulation.

This makes me think that perhaps it is better not to use topical Minoxidil. Instead, I should get the hair transplant and continue taking Finasteride until many years later when I notice that I am losing more hair again. At that point, I can introduce topical Minoxidil. This way, I would have another stimulant "ready" for the future that will surely be effective.

Is my thinking wrong, or does it make sense?

Thanks in advance!

Minoxidil is a growth stimulant, pure and simple and it's benefit varies per individual.

It does not make your hair become 'addicted' in the sense you are saying. Any treatment only works so long as it's being continued just like finasteride. Hair loss, if aggressive enough can of course persist in spite of treatment.

Whether to use it now or later is a personal decision. It could delay you need for a second transplant but no guarantees. If I were you and I was stable on finasteride I'd just get the transplant and only add it down the line if losing ground.

Best to keep your regime as simple as you can get away with.  

[TheGreatPretender]

I would say take the switch to Dutasteride in that case since Minoxidil is mostly a stimulant. 

Still, its worth trying the combo (Finasteride + Minoxidil) before undergoing any surgery, this is because they both work synergetically. Minoxidil pushes the hairs to the anagen phase, while Finasteride shields them from further damage by the DHT.
So no, the hair doesn't grow "addicted" to the drug, people say that because there are many users that get on it without being on Finasteride and once they stop treatment they find themselves shocked to have lost ground. This isn't because of Minoxidil, rather because over time without a blocking therapy the hairs started to become "dependant" on the stimulation of the minoxidil itself without a 5ARI so your hair reverts to how it would have been without having started any sort of therapy if that makes sense.

Wouldn't worry too much if you are still stable on Finasteride, most people are able to maintain for ages (if not forever) while being in the drug.

[alexmillne]

16 minutes ago, BurnieBurns said:

Minoxidil is a growth stimulant, pure and simple and it's benefit varies per individual.

It does not make your hair become 'addicted' in the sense you are saying. Any treatment only works so long as it's being continued just like finasteride. Hair loss, if aggressive enough can of course persist in spite of treatment.

Whether to use it now or later is a personal decision. It could delay you need for a second transplant but no guarantees. If I were you and I was stable on finasteride I'd just get the transplant and only add it down the line if losing ground.

Best to keep your regime as simple as you can get away with.  

Thanks! I could have sworn, though, that I saw some YouTube videos where someone explained in percentages how the effects of minoxidil decrease over time. But I don't want to spread false information here, and since I have no sources to verify this, I will take your word on it. If I ever find the link to the video or article, then I will post it here for you to see.

Yes, I kind of feel the same way about what you said. I wonder, do you think it would be sensible to stay on finasteride and have the hair transplant. Then, once per year, go to the dermatologist to get the trichoscopy (trichoscopy examines hair stems, hair follicle outlets, and surrounding skin) and see if there are any changes. If the doctor notice that I'm actually losing more ground visibly on the camera, should I then introduce minoxidil...?

[alexmillne]

6 minutes ago, TheGreatPretender said:

I would say take the switch to Dutasteride in that case since Minoxidil is mostly a stimulant. 

Still, its worth trying the combo (Finasteride + Minoxidil) before undergoing any surgery, this is because they both work synergetically. Minoxidil pushes the hairs to the anagen phase, while Finasteride shields them from further damage by the DHT.
So no, the hair doesn't grow "addicted" to the drug, people say that because there are many users that get on it without being on Finasteride and once they stop treatment they find themselves shocked to have lost ground. This isn't because of Minoxidil, rather because over time without a blocking therapy the hairs started to become "dependant" on the stimulation of the minoxidil itself without a 5ARI so your hair reverts to how it would have been without having started any sort of therapy if that makes sense.

Wouldn't worry too much if you are still stable on Finasteride, most people are able to maintain for ages (if not forever) while being in the drug.

I was contemplating this, but my issue is really that the hairline has receded a lot, and the temple area also lacks hair. I know for sure that Minoxidil won't be able to fill these empty gaps as there is no small hair miniaturization there. There are no hairs there. So yes, Minoxidil will surely fill up my hair more and perhaps make my hairline thicker, but it won't lower my hairline or fill the gaps where there is no hair at all. Therefore, I am going to go ahead with the hair transplant in October. Additionally, I'm not sure if I want to commit to applying Minoxidil every day on my head. I'm already having difficulties remembering to take Finasteride every day. Most weeks, I forget to take it 2-3 times.

[Mak Sergejev]

I can only say that for me Minoxidil resulted in quite a noticeable initial regrowth (started ca 5 years ago), but with years the progress reduced and I lost most of that hair. I know its anecdotal evidence, but fits into the narrative. I started topical finesteride alongside this year but not much noticable progress tbh.

[BurnieBurns]

12 minutes ago, alexmillne said:

Thanks! I could have sworn, though, that I saw some YouTube videos where someone explained in percentages how the effects of minoxidil decrease over time. But I don't want to spread false information here, and since I have no sources to verify this, I will take your word on it. If I ever find the link to the video or article, then I will post it here for you to see.

Yes, I kind of feel the same way about what you said. I wonder, do you think it would be sensible to stay on finasteride and have the hair transplant. Then, once per year, go to the dermatologist to get the trichoscopy (trichoscopy examines hair stems, hair follicle outlets, and surrounding skin) and see if there are any changes. If the doctor notice that I'm actually losing more ground visibly on the camera, should I then introduce minoxidil...?

Youtube if packed with people with no idea what they're talking about when it comes to hairloss. In that topic many don't understand the difference between a treatment and a cure. Or say I treatment works a while then loses effectiveness they think the they've 'built tolerance' or something when simply their genetics have caught up with them.

You might be better of staying monitored by your hair transplant doctors (if he/she is a good one) as their more specialised in hair than most dermatologists. Otherwise yes, keep a close eye on it. You don't even need a doctor to confirm it if you can see it with your own two eyes. In that case you could either switch to dutasteride or add minoxidil, topical or oral.

[BurnieBurns]

13 minutes ago, alexmillne said:

I was contemplating this, but my issue is really that the hairline has receded a lot, and the temple area also lacks hair. I know for sure that Minoxidil won't be able to fill these empty gaps as there is no small hair miniaturization there. There are no hairs there. So yes, Minoxidil will surely fill up my hair more and perhaps make my hairline thicker, but it won't lower my hairline or fill the gaps where there is no hair at all. Therefore, I am going to go ahead with the hair transplant in October. Additionally, I'm not sure if I want to commit to applying Minoxidil every day on my head. I'm already having difficulties remembering to take Finasteride every day. Most weeks, I forget to take it 2-3 times.

As a general rule, you shouldn't expect a treatment to give regrowth. It's main rule is preventing or slowing further loss and any new hair is just a perk

[alexmillne]

2 minutes ago, BurnieBurns said:

Youtube if packed with people with no idea what they're talking about when it comes to hairloss. In that topic many don't understand the difference between a treatment and a cure. Or say I treatment works a while then loses effectiveness they think the they've 'built tolerance' or something when simply their genetics have caught up with them.

You might be better of staying monitored by your hair transplant doctors (if he/she is a good one) as their more specialised in hair than most dermatologists. Otherwise yes, keep a close eye on it. You don't even need a doctor to confirm it if you can see it with your own two eyes. In that case you could either switch to dutasteride or add minoxidil, topical or oral.

Regarding your first statement, I only rely on reliable YouTube sources such as Haircafe, The Hairloss Show, and Matt Dominance.

Regarding your second statement, I'm not entirely sure if self-monitoring is sufficient. It is well known that people often only notice hair loss when it reaches advanced stages. In my case, my hair loss gradually progressed to Norwood 3 over a decade, and I only truly noticed it towards the end.

[BurnieBurns]

2 minutes ago, alexmillne said:

Regarding your first statement, I only rely on reliable YouTube sources such as Haircafe, The Hairloss Show, and Matt Dominance.

Regarding your second statement, I'm not entirely sure if self-monitoring is sufficient. It is well known that people often only notice hair loss when it reaches advanced stages. In my case, my hair loss gradually progressed to Norwood 3 over a decade, and I only truly noticed it towards the end.

Interesting, I follow the first two quite regularly. Kevin Mann may have used the word 'addicted' before but there is more than one way to interpret that. Bottom line is it doesn't 'make the follicle itself take less nutrients because minoxidil is picking up the slack' or anything like that.

For monitoring loss, that totally fine in your case. Everyone's different. Personally I'm very vigilant, take regular photos and to and point I'm always a step ahead (Hope that doesn't sound like a brag haha)

[TheGreatPretender]

29 minutes ago, alexmillne said:

I was contemplating this, but my issue is really that the hairline has receded a lot, and the temple area also lacks hair. I know for sure that Minoxidil won't be able to fill these empty gaps as there is no small hair miniaturization there. There are no hairs there. So yes, Minoxidil will surely fill up my hair more and perhaps make my hairline thicker, but it won't lower my hairline or fill the gaps where there is no hair at all. Therefore, I am going to go ahead with the hair transplant in October. Additionally, I'm not sure if I want to commit to applying Minoxidil every day on my head. I'm already having difficulties remembering to take Finasteride every day. Most weeks, I forget to take it 2-3 times.

I get it but you never know. 

Some people are completly bald and reverse the hair loss completly in that area.

I can say that in my 2 years that I have used the drug I found some peach fuzz in that area, some of them seemed to started growing well enough but not that thick, while the rest of hairs stayed that way. Im not saying the same would happen to you but I think you have very little to lose by at least trying. 

You dont really need to apply it in your entire scalp and if you like to lazy around you can just apply it once a day since the half life is average of 21/22 hours, which is more then enough to make a difference.

[GoliGoliGoli]

11 hours ago, alexmillne said:

Thanks! I could have sworn, though, that I saw some YouTube videos where someone explained in percentages how the effects of minoxidil decrease over time. But I don't want to spread false information here, and since I have no sources to verify this, I will take your word on it. If I ever find the link to the video or article, then I will post it here for you to see.

You're referring to a study Matt Dominance mentions in one of his videos. What it says is commonly misinterpreted because he didn't explain it well.

It doesn't show that "the effects of minoxidil decrease over time". It shows that regrowth decreases over time. This is of course obvious since if it continued regrowing your hair forever you would just have hair all over your body  

Edited June 3, 2023 by GoliGoliGoli

[alexmillne]

1 minute ago, GoliGoliGoli said:

You're referring to a study Matt Dominance mentions in one of his videos. What it says is commonly misinterpreted because he didn't explain it well.

It doesn't show that "the effects of minoxidil decrease over time". It shows that regrowth decreases over time. This is of course obvious since if it continued regrowing your hair forever you would just have hair all over your body  

really?? I had no idea... are you sure about this? How can Matt Dominance make such a huge mistake...

[Gatsby]

I would recommend seeing an excellent dermatologist and start Finasteride and minoxidil (or what they believe is best) asap. I would have ongoing follow up appointments to track what is happening. All the best. 👍

[Coldblade7]

4 hours ago, Gatsby said:

I would recommend seeing an excellent dermatologist and start Finasteride and minoxidil (or what they believe is best) asap. I would have ongoing follow up appointments to track what is happening. All the best. 👍

Hey Gatsby, I'm new here is there a way to DM people? I apologize if writing this here was wrong. Idk where else to post this. I can't DM anyone, is there way around this? 

Will appreciate your reply 

[Coldblade7]

18 hours ago, alexmillne said:

I was contemplating this, but my issue is really that the hairline has receded a lot, and the temple area also lacks hair. I know for sure that Minoxidil won't be able to fill these empty gaps as there is no small hair miniaturization there. There are no hairs there. So yes, Minoxidil will surely fill up my hair more and perhaps make my hairline thicker, but it won't lower my hairline or fill the gaps where there is no hair at all. Therefore, I am going to go ahead with the hair transplant in October. Additionally, I'm not sure if I want to commit to applying Minoxidil every day on my head. I'm already having difficulties remembering to take Finasteride every day. Most weeks, I forget to take it 2-3 times.

I don't want to give my advice as a matter of fact. I'll just share my experience, minoxidil might work or help in thickening of your existing hairs/keep them. But the areas you have marked on the hairline for regrowth, I doubt Minoxidil will give you long healthy terminal hairs there. You are considering a transplant on the hairline, which means your ideal expectation out of all this hair restoration is getting your hairline back. Minoxidil most probably will only grow small peach fuzz hairs there, again this is not fact. You may be a hyper responder, it's a matter of personal decision. Are you willing to give at least another 6 months to a year to minoxidil and see if it works on the hairline? And will you be okay if all it does is grow peach fuzz there?

For me, I was like a norwood 1ish receding when I used minoxidil, i used it strictly on the hairline. It shed my hairline and temples like crazy and even after 6 months it didn't have any noticeable regrowth. I'm now like a norwood 1.5 or 2.

Again, might work brilliantly for you, my experience was different. The kind of result you're probably expecting on the hairline only a transplant will give, you can use it for rest of hairs tho

[alexmillne]

3 hours ago, Coldblade7 said:

I don't want to give my advice as a matter of fact. I'll just share my experience, minoxidil might work or help in thickening of your existing hairs/keep them. But the areas you have marked on the hairline for regrowth, I doubt Minoxidil will give you long healthy terminal hairs there. You are considering a transplant on the hairline, which means your ideal expectation out of all this hair restoration is getting your hairline back. Minoxidil most probably will only grow small peach fuzz hairs there, again this is not fact. You may be a hyper responder, it's a matter of personal decision. Are you willing to give at least another 6 months to a year to minoxidil and see if it works on the hairline? And will you be okay if all it does is grow peach fuzz there?

For me, I was like a norwood 1ish receding when I used minoxidil, i used it strictly on the hairline. It shed my hairline and temples like crazy and even after 6 months it didn't have any noticeable regrowth. I'm now like a norwood 1.5 or 2.

Again, might work brilliantly for you, my experience was different. The kind of result you're probably expecting on the hairline only a transplant will give, you can use it for rest of hairs tho

Thank you very much for sharing your valuable experience! I truly appreciate it. I am extremely confident about proceeding with my hair transplant in October and intend to keep Minoxidil as a backup option for the future. Additionally, I plan to have annual consultations with my dermatologist to monitor the progression of my hair loss. If I observe further signs of baldness, I will then consider starting the use of minoxidil.

[Coldblade7]

26 minutes ago, alexmillne said:

Thank you very much for sharing your valuable experience! I truly appreciate it. I am extremely confident about proceeding with my hair transplant in October and intend to keep Minoxidil as a backup option for the future. Additionally, I plan to have annual consultations with my dermatologist to monitor the progression of my hair loss. If I observe further signs of baldness, I will then consider starting the use of minoxidil.

Which clinic and doctor are you getting the transplant from? How many grafts have they told you? And what's your family history of hairloss like? 

Best wishes man