Considering dropping Minoxidil after HT, been on 2 years along with finasteride. Good/bad idea?

[Savemyhairline]

I just had 4k FUE grafts placed in my frontal third. Prior to this, I’ve been on finasteride 1mg/day and topical foam 5% minoxidil/rogaine once a day for 2 years. Dr. Hasson, my doctor, said he doesn’t think the minoxidil will have much effect if I just continue the finasteride, which I always will. I wouldn’t mind dropping topical minoxidil because it’s a pain, and want to say *im not interested in oral minoxidil* at all. I have diffuse thinning but it was mostly bad in the frontal third that I just addressed, the crown/midscalp while thinner than original, weren’t bad when grown out a bit. Even my barber never noticed the thinning in my crown, can really only be seen when sweaty+super harsh lighting+ parted in an unflattering way etc. the thinning is only along the scalp, my donor is above average. I started finasteride June 2021 and minoxidil July 2021, I did notice I lost hair/shed after staring fin & before starting min, leading me to believe the finasteride did regrow/thicken and not only maintained. I did notice significant improvement 6-12 months after starting both, but it’s impossible to say how much improvement can be attributed to each. The way I see it, I have 3 options (all while staying on finasteride 100%):

 

1) be safe and stay on topical minoxidil. Might just waste money and continue the inconvenience. I haven’t noticed any sides but always nice to be safe with facial aging, heart health, etc.

 

2) Drop min and just stay on only fin. This would be very convenient and imo less drugs put into your body the better, as long as they aren’t necessary. The risk of course is I lose minoxidil gains. Theoretically if I stopped, then 6 months later my crown/midscalp appears thinner, I could restart minoxidil but I have heard of people stopping and never getting back what they had originally gained on minoxidil 

 

3) continue Min for a couple more years, then drop and see what the situation is. Being that my frontal third is now mostly transplanted hair from my thick donor, I’m pretty secure with the front so long as I stay on fin. Would there be any weird impact if introduced minoxidil to my strong donor hair in my front, then a couple years later stopped? Idk if that would mess with the good hairs or not.

Pre and post op:

Thank you

[Turkhair]

You would lose the gains you made with minoxidil and the overall thickness brought on by Minoxidil. Even if it’s not visible to you, minoxidil does regrow and thicken hair if you’re a responder.

There’s no damage to hairs maintained by Finasteride.

Also stopping Minoxidil causes a massive shed whereby you some hairs that will come back few months later. 

[Savemyhairline]

2 hours ago, Turkhair said:

You would lose the gains you made with minoxidil and the overall thickness brought on by Minoxidil. Even if it’s not visible to you, minoxidil does regrow and thicken hair if you’re a responder.

There’s no damage to hairs maintained by Finasteride.

Also stopping Minoxidil causes a massive shed whereby you some hairs that will come back few months later. 

Right. I wish I started them at different times so I could assess if I did actually respond to minoxidil or if it was as all finasteride. The shed part doesn’t matter I’m about to shed anyway from the transplant. I’m thinking I might want to just be as safe as possible and continue minoxidil, then maybe in a couple years if I’m feeling like the risk is worth it, stop and then re-assess. Minoxidil is pretty cheap at least. Dr. Hasson seemed pretty confident minoxidil doesn’t do much compared to finasteride, I know many other doctors have varying opinions on the long term effectiveness of minoxidil.

[Turkhair]

3 hours ago, Savemyhairline said:

Right. I wish I started them at different times so I could assess if I did actually respond to minoxidil or if it was as all finasteride. The shed part doesn’t matter I’m about to shed anyway from the transplant. I’m thinking I might want to just be as safe as possible and continue minoxidil, then maybe in a couple years if I’m feeling like the risk is worth it, stop and then re-assess. Minoxidil is pretty cheap at least. Dr. Hasson seemed pretty confident minoxidil doesn’t do much compared to finasteride, I know many other doctors have varying opinions on the long term effectiveness of minoxidil.

Yeah that’s the best option. It would help with getting results fast from your hair transplant too. 

 

[TorontoMan]

Personally I would continue using it, and just stop buying into the idea that its a hassle to use. For me its no different than putting on moisturizer my face before bed, both will take 2 minutes and it will potentially help thicken up your crown while keeping a fairly low side profile. If you miss a few days in between you won't be charged either, just be more relaxed about it, thats my take

[LaserCaps]

The medication is now available in pill form which is less labor intensive.  

Most consider the combo of Fin/Min to be the most beneficial when it comes to hair retention, particularly towards the crown.  The problem, in my view, is one of expectations.  Most people expect.  If I do something, I expect something in return.  I think we can agree most people retain and see no visual change.  A small percentage will experience enhancement, and a very small percentage don't respond to the regimen.  I'd encourage you, if you been on the meds for years, to continue and don't stop, particularly if you look the same as you always did.  If, on the other hand, you're losing hair despite the use of the meds, get off of them because they're doing nothing for you.  Just let nature take its course. 

You remind me of a patient I visited with some 15 years ago.  He'd been a long time user of Fin.  Decided to get off of it just to check what would happen.  Within a year he lost all his hair.  And, once gone, it will not return.  These are very inexpensive meds - why play with fire? 

[Savemyhairline]

22 minutes ago, LaserCaps said:

The medication is now available in pill form which is less labor intensive.  

Most consider the combo of Fin/Min to be the most beneficial when it comes to hair retention, particularly towards the crown.  The problem, in my view, is one of expectations.  Most people expect.  If I do something, I expect something in return.  I think we can agree most people retain and see no visual change.  A small percentage will experience enhancement, and a very small percentage don't respond to the regimen.  I'd encourage you, if you been on the meds for years, to continue and don't stop, particularly if you look the same as you always did.  If, on the other hand, you're losing hair despite the use of the meds, get off of them because they're doing nothing for you.  Just let nature take its course. 

You remind me of a patient I visited with some 15 years ago.  He'd been a long time user of Fin.  Decided to get off of it just to check what would happen.  Within a year he lost all his hair.  And, once gone, it will not return.  These are very inexpensive meds - why play with fire? 

Just to be clear I’d NEVER stop fin. My doctor suggested I may stop Min, which is why I considered it. I definitely responded to the meds, just not sure which one improved my hair (I think it was at least partially fin that more than maintained & regained because I shed within a month of starting it alone)

[LaserCaps]

9 minutes ago, Savemyhairline said:

Just to be clear I’d NEVER stop fin. My doctor suggested I may stop Min, which is why I considered it. I definitely responded to the meds, just not sure which one improved my hair (I think it was at least partially fin that more than maintained & regained because I shed within a month of starting it alone)

Based on your explanation, we can assume you did experience a visual change.  If so, you'd be classified as a positive responder.  Please continue and don't stop.  I'm surprised given the results anyone would suggest you modify the regimen.  What, to confirm what med did what? Truly makes no sense.  While unlikely - but let's play the game - let's assume it's Rogaine that helped the most...Why would you get off of it?

[Savemyhairline]

9 minutes ago, LaserCaps said:

Based on your explanation, we can assume you did experience a visual change.  If so, you'd be classified as a positive responder.  Please continue and don't stop.  I'm surprised given the results anyone would suggest you modify the regimen.  What, to confirm what med did what? Truly makes no sense.  While unlikely - but let's play the game - let's assume it's Rogaine that helped the most...Why would you get off of it?

I know Dr. Hasson, who did my procedure, in general isn’t the biggest fan of minoxidil. His tech told me it’s “bad for the skin”. Maybe when I’m older and less risk averse to hair loss I’ll try dropping it just to see if it’s one less thing to have to do, but I’m thinking for the foreseeable future I’ll continue just to be safe, worked very hard to get to this point.

[KSA91]

9 hours ago, Savemyhairline said:

Right. I wish I started them at different times so I could assess if I did actually respond to minoxidil or if it was as all finasteride. The shed part doesn’t matter I’m about to shed anyway from the transplant. I’m thinking I might want to just be as safe as possible and continue minoxidil, then maybe in a couple years if I’m feeling like the risk is worth it, stop and then re-assess. Minoxidil is pretty cheap at least. Dr. Hasson seemed pretty confident minoxidil doesn’t do much compared to finasteride, I know many other doctors have varying opinions on the long term effectiveness of minoxidil.

Dr Hasson now! I've heard Doctor Couto say the same thing about Minoxidil.  Dr Bisanga also sort of hinted at that with his recent podcast with Melvin. Dr Bisanga was pushing for Oral Minoxidil. He doesn't believe topical Minoxidil is as effective for most people.

[Savemyhairline]

10 minutes ago, KSA91 said:

Dr Hasson now! I've heard Doctor Couto say the same thing about Minoxidil.  Dr Bisanga also sort of hinted at that with his recent podcast with Melvin. Dr Bisanga was pushing for Oral Minoxidil. He doesn't believe topical Minoxidil is as effective for most people.

I had an in person consult with Dr Bisanga a year back and he was pushing oral minoxidil. I respectfully declined, I’m not convinced it won’t have cardiovascular consequences in the long term. A lot of people use it for a month or two, report no sides, and assume it’s always gonna be safe. Your heart is too important to risk imo, literally your most vital organ. 5AR inhibitors are objectively more important to your long term hair maintenance anyway. I’m sure oral is more effective for hair thickness but I wont be taking it.

[TEXAN35]

I also have some reservations about Minoxidil. I did have very minor dizziness when I was on it even though it was just topical.  Have been on and off due this this. For me it is more concerning than Finasteride as its side or mostly tied to libido unlike minoxidil which can have cardiovascular impact. And even if you are not noticing any symptom does not necessarily mean that it is not impacting the body in long term.

[Turkhair]

18 hours ago, Savemyhairline said:

I know Dr. Hasson, who did my procedure, in general isn’t the biggest fan of minoxidil. His tech told me it’s “bad for the skin”. Maybe when I’m older and less risk averse to hair loss I’ll try dropping it just to see if it’s one less thing to have to do, but I’m thinking for the foreseeable future I’ll continue just to be safe, worked very hard to get to this point.

I stopped for a different reason but when I used topical version, my face was becoming like “moon face” 😂

Later I learned from Kevin from haircafe that it is a side effect of Minoxidil and he takes tretinoin or some other chemicals to counter the skin damaging effects of Minoxidil. 

So yeah you’re not wrong to want to stop it. 

[GoliGoliGoli]

Personally, I think the effects that minoxidil has on facial appearance are solely related to fluid retention. Basically, you apply topical min, it brings fluid up to your head and makes you look a bit puffy. I don't really believe the collagen depletion stuff or that it damages your skin. If I stop using topical for a few days I go back to my normal chiseled facial structure! 

Edited August 31, 2023 by GoliGoliGoli

[asterix0]

If you quit minoxidil expect a huge shed, research what happened to other people when they quit minoxidil. 

[Savemyhairline]

1 hour ago, GoliGoliGoli said:

Personally, I think the effects that minoxidil has on facial appearance are solely related to fluid retention. Basically, you apply topical min, it brings fluid up to your head and makes you look a bit puffy. I don't really believe the collagen depletion stuff or that it damages your skin. If I stop using topical for a few days I go back to my normal chiseled facial structure! 

Hmmm. My body fat % has been high for the most part since I started Min, my face was quite shredded before I gained weight which I liked. I guess the first 6-8 months I started Min my body fat was low enough and I still had the sunken cheeks, jawline etc so I guess I can’t say Min makes my face retain water, that I noticed anyway. I’m planning to cut back down to a good body fat % in the next 9 months especially now that I’m recently single lol.

 

Idk man maybe it is worth dropping. My crown was never that bad, there was minor thinning but even pre drugs people didn’t really notice it IRL. 4k grafts into my frontal third (which was by far my worst area) I’m not worried about that anymore so long as I stick with a 5AR inhibitor which I always plan to. And honestly I think I regained more thickness with fin but I can’t say with certainty. Kevin Mann suggested I stop Min for 5 weeks and assess

[Savemyhairline]

17 minutes ago, asterix0 said:

If you quit minoxidil expect a huge shed, research what happened to other people when they quit minoxidil. 

I just got a HT so I’m gonna be shedding soon anyway. Might have to JuSt ShAvE iT bRo for the next 6-9 months, and wear a hat everywhere (which I basically did for the last several years anyway). I work remotely at least 

[GoliGoliGoli]

21 minutes ago, Savemyhairline said:

I just got a HT so I’m gonna be shedding soon anyway. Might have to JuSt ShAvE iT bRo for the next 6-9 months, and wear a hat everywhere (which I basically did for the last several years anyway). I work remotely at least 

The shedding of your transplanted hairs is completely different and completely unrelated to a shedding that would be induced by stop minoxidil. They're both called a shed but that's literally the extent of the similarity. 

[Savemyhairline]

27 minutes ago, GoliGoliGoli said:

The shedding of your transplanted hairs is completely different and completely unrelated to a shedding that would be induced by stop minoxidil. They're both called a shed but that's literally the extent of the similarity. 

I know. My point is it’s not like my hair is gonna look good either way for the next 6 months. And again idk how much “shedding” stopping minoxidil will cause as I’m not sure if it even did anything for me.

[GoliGoliGoli]

Right, but the fact that you're going to shed the transplanted hairs soon should have no bearing on whether you stop minoxidil or not. They're completely unrelated unless all you care about is the next 6 months.

As to whether min is doing anything for you, there's no way of knowing.

 

[Savemyhairline]

57 minutes ago, GoliGoliGoli said:

Right, but the fact that you're going to shed the transplanted hairs soon should have no bearing on whether you stop minoxidil or not. They're completely unrelated unless all you care about is the next 6 months.

As to whether min is doing anything for you, there's no way of knowing.

 

I know man, I’m just saying I’m not worried about the temporary cosmetic affects of a shed. Now of course if Min did actually have an impact then I would lose some hair density that would not return if I stayed off of it. Maybe I’ll just continue it to be safe (and by “Safe” I mean ensure I have the best hair I can while still in my 20s) then in a couple years down the line I’ll drop it and see what we’re working with. My attention to detail is pretty high though sometimes I get worried I could be having facial aging/bloating/increased anxiety etc from min that I’m just not noticing. Less so with the facial aging because i only apply foam and let it dry before bed but still, people reporting that is kinda freaky.

 

 

now it’s possible that minoxidil had a very minor effect, causing me to shed a bit, but the hairs would come back just not as strong. Minoxidil doesn’t bring back hair from the dead and I never had totally dead follicles, just severely miniaturized. 

Edited August 31, 2023 by Savemyhairline

[asterix0]

Minoxidil is like the mafia dude. Once you start it, you are in for life. 

[Gatsby]

If you car enough to the point of having surgery then I would definitely stay on the meds (unless you are experiencing side effects). I'm not a doctor but that's definitely my opinion. All the best!

[hongkongfue]

Dr. Wong also recommended to me to stop topical minox also since he said it ages the skin. I have not gone back on it, but I do really question if I should.  But it is hard not to follow his advise since he has now done 2 surgeries on me, albeit 18 years apart. 

[Savemyhairline]

2 hours ago, hongkongfue said:

Dr. Wong also recommended to me to stop topical minox also since he said it ages the skin. I have not gone back on it, but I do really question if I should.  But it is hard not to follow his advise since he has now done 2 surgeries on me, albeit 18 years apart. 

Yeah, I’ve known H&W aren’t the biggest proponents of minoxidil long before I got my procedure done. People constantly fear monger finasteride on the Internet but minoxidil has the potential for way, way scarier side effects, especially oral. Topical min is pretty safe at least which is why I even bothered with it in the first place. My body tolerates finasteride great and that is what is most important in the hair maintenance game, that or dut.