What Happens When You Stop Using Minoxidil
Studies show that within three-6 months of stopping minoxidil, any hair growth resulting from the drug is lost. After quitting minoxidil, hair counts can even temporarily fall beneath where they would've been had we never sought treatment at all, earlier eventually rebounding back to baseline.
Why does this happen? Is there a style to lessen the "withdrawal shed" from minoxidil? For those who've seen hair gains with minoxidil only prefer not to use it forever, at that place may be some methods to mitigate shedding after quitting minoxidil. This article explains the evidence, and provides an activity plan.
- Virtually Minoxidil
- Why People Stop Taking Minoxidil
- What Happens When Quitting Minoxidil
- Is Minoxidil Plus Microneedling the Reply?
- How to (Possibly) Prevent Shedding After Stopping Minoxidil
Nearly Minoxidil
Minoxidil is an over-the-counter drug canonical by the FDA to treat androgenic alopecia. Information technology's commonly known by the make name Rogaine. Along with finasteride, minoxidil is one of only ii drugs approved to treat androgenic alopecia in both men and women.
Nobody really knows how minoxidil works. Minoxidil was initially developed in the 1980s every bit an oral drug to treat high claret pressure. But when patients started reporting "unwanted" hair regrowth after three or more months of use, its manufacturers decided to reformulate it into a topical and begin testing it on men with androgenic alopecia. [i] https://world wide web.jaad.org/article/S0190-9622(08)00809-8/abstract
Today, we even so aren't sure how it works. Simply since side effects are minimal, information technology was nonetheless approved past the FDA for use. In that location are ii chief hypotheses on the mechanisms behind minoxidil.
Hypothesis 1: Minoxidil is a Vasodilator
One defining characteristic of androgenic alopecia is reduced blood flow to balding regions. While in that location'due south debate over whether reduced claret flow is a upshot or cause of pilus loss, information technology'due south undisputed that without proper blood supply to a hair follicle, hair cannot grow.
As a vasodilator, minoxidil widens blood vessels, potentially increasing blood flow to the scalp. In addition, Minoxidil opens potassium ion channels , which some researchers think works alongside vasodilation to improve hair growth. [2] https://pubmed.ncbi.nlm.nih.gov/9395721/
Hypothesis 2: Minoxidil Alters the Hair Growth Wheel
It's possible that minoxidil kicks miniaturizing pilus follicles back into the anagen (growth) phase of the hair cycle. Hairs thus get thicker, giving the appearance of overall improved pilus density. This could exist the consequence of minoxidil decreasing prostaglandin D2 levels while boosting other prostaglandins , like prostaglandin E2, to downregulate pro-inflammatory growth factors that are linked to hair shedding. [3] https://www.jidonline.org/article/S0022-202X(xv)42806-four/pdf
In addition, Minoxidil may prolong the growth stage of the hair wheel by maintaining beta-catenin activity in dermal papilla cells. [4] https://pubmed.ncbi.nlm.nih.gov/21524889/
How Long Does Minoxidil Take to Work?
Minoxidil's effect horizon is approximately 3-6 months. Over half of the people who effort information technology answer to minoxidil within this fourth dimension frame. Only early results tend to wane over time.
One report plant that at half-dozen months, men using 5% minoxidil twice-daily saw a nigh-60% change in pilus 'weight' in balding regions. [five] https://world wide web.sciencedirect.com/science/commodity/pii/S019096229970006X In other words, their pilus had thickened or regrown to weigh 60% more than it did at the beginning of the report.
That'southward huge.
Unfortunately, the aforementioned report showed that at 96 weeks, those pilus weights decreased to simply 25% higher than baseline. This also happens to be a consistent finding across most studies on minoxidil. Just see this 48-week chart on the furnishings of 2% and five% minoxidil on pilus counts. [6] https://pubmed.ncbi.nlm.nih.gov/12196747/ Results tend to superlative at calendar week 16, then decline thereafter.
This is echoed on 5-year studies on minoxidil, which prove a steady decline in not-vellus hair counts in target areas later on twelvemonth 1: [7] https://pubmed.ncbi.nlm.nih.gov/2180995/
Somewhat relatedly, other studies have demonstrated profoundly increased pilus counts that failed to translate to visual improvements in hair density. [8] https://www.jaad.org/article/S0190-9622(08)00809-8/abstract
Long-story short: over time, minoxidil's efficacy begins to wane. And while minoxidil can temporarily increment pilus counts, these increases don't always lead to corrective levels of hair regrowth.
Why is this?
Minoxidil helps kickstart hairs back into the anagen (growth) phase of the pilus cycle. However, it doesn't address DHT-driven hair follicle miniaturization. And so, while hair counts increment, hair diameters go along to decline, leading to a loss of hair volume and thereby hair thinning over time.
Most people who endeavour minoxidil quit inside a year as their results stabilize or slowly reject.
Let'south take a closer await at why, and what happens when they do.
Why Stop Taking Minoxidil?
People who stop taking minoxidil tend to fall into two main camps. Either minoxidil is only not working for them at all, or it is working, but for various reasons, they'd adopt to pass on a twice-daily awarding for the residuum of their lives.
Minoxidil Non-Responders
Some people simply don't respond to minoxidil. This could exist a sign their hair loss stems from a condition other than androgenic alopecia. But as we'll see, minoxidil only doesn't always work well on its ain.
Is it Androgenic Baldness?
Non-response to minoxidil could signify that hair loss is not due to androgenic baldness but something else. There's some evidence that oral minoxidil might better hair shedding disorders like chronic telogen effluvium, but it's technically not FDA-approved for that status. [9] https://link.springer.com/article/10.1007%2Fs40257-018-0409-y
Is information technology Potent Enough?
When choosing between two% and five%, choose the more potent formula. Studies evidence that in men, 5% minoxidil is improve than the 2% formula, and the aforementioned is likely true for women. Prescriptions are available for concentrations of x% or xv%, and studies evidence minoxidil non-responders often see better pilus growth after switching to these strengths. [ten] https://pubmed.ncbi.nlm.nih.gov/28078868/
Is it in Use equally a Monotherapy?
The reality is that minoxidil only isn't very effective past itself. To understand why information technology helps to learn virtually an enzyme called Sulfotransferase.
In order to become active, minoxidil must come into contact with Sulfotransferase. About 40% of balding men just don't have enough Sulfotransferase to elicit a response to Minoxidil – which happens to closely correspond with the percent of non-responders of minoxidil.
What might assist increase Sulfotransferase levels? Nosotros'll get to that later.
The Downsides of Minoxidil
Even minoxidil responders may not desire to employ it forever. It can be costly and inconvenient, and it does accept some pocket-sized side effects.
Price
Monthly minoxidil use costs betwixt $15-$xl. Hair loss sufferers will need to try it for 6 months and spend close to $200 just to run across if they're a responder. Stick with it for years, and they could cease upwards spending thousands. Some users find that as their results taper off, information technology no longer warrants the ongoing expense.
Note: the toll of minoxidil can be dramatically reduced by purchasing in bulk and through big brands – like the minoxidil offered from Kirkland. But these formulations tend to come with propylene glycol and other carrier ingredients that can irritate the scalp.
Side Effects
The biggest side outcome of minoxidil seems to be peel irritation. Between 2% to 6% of users report this. [eleven] https://www.researchgate.cyberspace/publication/221695328_Minoxidil_Use_in_Dermatology_Side_Effects_and_Recent_Patents However, allergy testing suggests that upwards to 80% of skin-irritation related side effects from minoxidil may not exist caused past the minoxidil itself, but rather, a carrier ingredient called propylene glycol. [12] http://www.thaiscience.info/Journals/Article/JMAT/10986429.pdf
There are brands that offer minoxidil without propylene glycol, and then be sure to check the labels if you lot have whatever concerns of allergies.
Additional side effects include toxicity to cats, nether-eye numberless, and potential eye palpitations. But these are all relatively rare.
Inconvenience
As hair growth treatments go, minoxidil is relatively piece of cake and convenient. Still, not everyone wants to commit to twice-daily use for the balance of their lives, regardless of its effectiveness. And as nosotros mentioned earlier, minoxidil alone is not an effective long-term treatment. To keep results from waning, using minoxidil in combination with other therapies is recommended, which only adds time and expense.
So if someone decides to finish taking minoxidil, what are the expectations?
What Happens When Stopping Minoxidil
In 1999, researchers conducted a written report on the effects of abruptly ceasing minoxidil after long-term treatment. [13] https://www.jaad.org/commodity/S0190-9622(99)70006-X/fulltext Not simply did the grouping who stopped minoxidil shed hair, but for a month or two, they actually crossed below the threshold of where they would have been if they'd never used minoxidil to begin with.
Let'south have a closer wait at what happened.
The Report on Stopping Minoxidil
Researchers spent more than 2 years post-obit four separate cohorts. One grouping was treated with 2% minoxidil, another group with 5%, one group was given a placebo, and the fourth group did cipher.
Both the 2% and 5% groups saw improvements in hair counts by the 3-month marking. As we've said, these improvements leveled off a bit from that point forrard but were still college than hair counts in the placebo and control groups.
Afterward most 2 years of treatment, at the 96-week mark, the investigators took the people in the ii% and 5% minoxidil groups and discontinued treatment. We can run across the exact moment this occurred by looking at the data on hair weights, which soon started decreasing.
3 months later, by week 108, their hair loss had dipped well below the placebo group and beneath where they were at the beginning of the study. Some other three months after that, past week 120, both the ii% and 5% groups had rebounded to rejoin toss sufferers will finish up correct where they started.
As mentioned, any excess shedding should not be permanent, as pilus will readjust to new homeostasis without the drug.
And so the question becomes, is there a method to weaning from minoxidil that tin forbid or reduce shedding?
Is Minoxidil Plus Microneedling the Respond?
In the above report, minoxidil was used as a monotherapy. And nosotros know from t he research that combining minoxidil with additional therapies, such as microneedling, can improve outcomes for non-responders and may foreclose results from waning later the initial 3-6 months of usage.
So could microneedling also prevent (or delay) shedding if i decides to stop taking minoxidil? Let's investigate what happens when we use these two therapies in tandem.
About Microneedling
Microneedling is a micro-wounding process that involves pricking the skin with tiny needles using either a roller or a pen-shaped besides l. Studies accept shown microneedling elicits growth factors, signaling proteins, and the enzymatic action of Sulfotransferase, which we referred to earlier.
In some studies, Microneedling plus Minoxidil seems to elicit a fourfold greater event on hair count increases than Minoxidil alone. [14] https://world wide web.ncbi.nlm.nih.gov/pmc/articles/PMC3746236/
In fact, when combining minoxidil with microneedling, new data prove that all new pilus gains might hold for much longer – fifty-fifty after quitting all treatments.
The Information on Combined Therapies
Permit's have a closer look at a 2020 study to run across why microneedling could be the key to maintaining pilus growth, even after quitting minoxidil. [15] https://pubmed.ncbi.nlm.nih.gov/29028377/
In the written report, researchers split men into 3 groups. One treated their pilus loss with minoxidil only, another group with microneedling but, and one group combined the two therapies. As other studies take shown, the combined therapies were significantly more effective in terms of hair growth.
But what the researchers did next was interesting. They stopped all treatments for each of the 3 groups, and then brought them in 6 months later to ask, 'how much hair growth did you retain, even in the absence of handling?' Here were their results:
- Minoxidil Just – 90% lost all new hair growth (just 10% retained new growth)
- Microneedling Only – 70% retained some new hair, twenty% retained all new pilus, 10% lost all new pilus
- Combined Therapies – seventy% retained some new hair, xx% retained all new hair, ten% lost all new hair
Then the group that combined minoxidil with microneedling not only experienced at least twice the pilus growth of the other two groups, only lxx% of them held on to at least some of this new growth, even after stopping all treatments. And yet, before we conclude that microneedling plus minoxidil is a fail-condom method for maintaining hair growth afterwards treatment ends, in that location are some possibilities to consider.
- It'due south possible if researchers asked the same question 12 months versus half dozen months later, all groups would study an equal amount of hair loss. We've seen with other therapies, Finasteride for case, that gains disappear over a longer timeline.
- While the number lxx% sounds big, the sample size in this study was relatively pocket-size. Each group contained just twenty men. So, while it's great that xiv men maintained at least some of their results for 6 months later handling ended, information technology's possible this percentage could change inside a larger sample.
So, while the study higher up is promising, we don't actually have enough data to definitively say whether or not hair shedding after quitting minoxidil can be prevented.
We've yet to encounter whatever literature that would assistance predict who will or will not shed badly from minoxidil. However logically, it may exist that those who respond better to minoxidil (or the more than hair minoxidil helps i go along during utilize) simply have more hair to lose during withdrawal.
Anecdotally, about fifty% of the male Perfect Hair Wellness members who take slowly weaned from minoxidil while maintaining microneedling therapy noticed no cosmetic differences in their hair counts later.
Basically, they're able to maintain similar visuals even without the drugs. The other 50% exercise see a decline visually, just it's nowhere near baseline or very rarely all the way back to baseline.
If pilus loss sufferers do get to a indicate where they're happy with their pilus and desire to wean away from drugs, doing and so with the correct tapering protocol while standing the use of microneedling could exist a solution.
The Best Way to Quit Minoxidil
When is the all-time fourth dimension to call it quits? Never, if you'd similar to take every bit much risk off the tabular array as you tin can.
Otherwise, the following tips may help minimize whatever shedding related to minoxidil withdrawals.
- Kickoff microneedling earlier quitting. Minoxidil and microneedling are synergistic treatments. Endeavour them together for at least 3-6 months before dropping the drug.
- Don't quit cold turkey. Follow a tapering protocol to minimize abrupt changes to the scalp environment. (We have a detailed weaning protocol in our membership.)
- Continue with alternative treatments. An effective weaning protocol takes up to 6 months. Go on with microneedling during this fourth dimension.
- Replace minoxidil with natural therapies. Individuals may wish to experiment with other topicals instead, such as 2-v% rosemary oil.
For the well-nigh part, minoxidil requires lifelong use to concur onto any pilus maintained or regrown. As such, shedding often occurs for 3-half-dozen months following a stop in minoxidil application. But, we can significantly mitigate this shed by combining minoxidil with additional therapies and following a tapering protocol.
Summary
Minoxidil can be an effective treatment for androgenic alopecia, although inquiry says when used alone, results taper off over time. Combining minoxidil with wounding therapies such as microneedling can get in more effective.
When stopping minoxidil, hair loss tin be expected. Research shows losses will exist greatest inside the first 3-half-dozen months of quitting simply will eventually rebound to where hair counts would have been had minoxidil never been applied.
This doesn't mean hair loss sufferers are stuck taking minoxidil for the rest of their lives. The aforementioned microneedling therapies that make minoxidil more effective may help sustain results afterward quitting the drug. This is especially true for those who commit to a strict tapering protocol versus quitting minoxidil cold turkey.
So should people apply minoxidil?
For many, it's worth a attempt. Some people will see visual improvements, some of which tin be maintained with a proper weaning plan. I n the worst example, people will nearly likely stop upward where they would've been without handling, just not worse off.
Rob English language is a researcher, medical editor, and the founder of perfecthairhealth.com. He acts as a peer reviewer for scholarly journals and has published five peer-reviewed papers on androgenic alopecia. He writes regularly about the scientific discipline backside pilus loss (and hair growth). Feel complimentary to browse his long-form articles and publications throughout this site.
What Happens When You Stop Using Minoxidil,
Source: https://perfecthairhealth.com/how-long-after-stopping-minoxidil-before-we-lose-our-hair-gains/
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