Minoxidil Shedding (A Temporary Side Effect)

When starting a treatment regimen for hair loss, the last thing anyone wants is to lose more hair. But that’s exactly what some people experience shortly after starting to use minoxidil, an FDA-approved treatment for both male and female pattern hair loss. Minoxidil comes in foams and liquid solutions of 2 percent and 5 percent concentrations.

While minoxidil shedding can make it look like your hair loss is getting worse, it is actually a normal, temporary phase and a sign that the treatment is working. In about 6 weeks, this temporary side effect should stop. And once it does, your hair should grow back stronger, thicker, and fuller.

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What Is Minoxidil Shedding?

Minoxidil shedding is a short-lived phenomenon characterized by accelerated hair loss. It occurs during the first few weeks of starting this hair loss treatment. It is not clear what percentage of users of topical minoxidil experience minoxidil shedding, but studies have reported that this number ranges from 17 to 55 percent. (1,16,19)

Minoxidil Shedding vs. Alopecia Shedding

Hair shedding is a perfectly natural part of the hair growth cycle. Typically, you can lose between 50 and 100 hairs a day. This occurs when the hair follicle is ready to grow new hairs by pushing out any old hair strands.

But some men and women experience excess hair shedding as a sign of hair loss. This type of shedding can occur when more hair follicles than usual are in a dormant part of the hair growth cycle (which always ends with them being shed). Excess shedding occurs when more hairs are resting or being shed (instead of actively growing).

Sometimes, disruptions to the hair growth cycle are temporary, like in the case of stress-related hair loss (also known as telogen effluvium). But in other cases, they may be permanent. Androgenetic alopecia, a genetic disorder that’s also linked to hormones, is the most common cause of male and female hair loss. (2)

Hair shedding can also be caused by autoimmune issues. For example, in a type of hair loss known as alopecia areata, the immune system launches an inflammatory attack against the body’s hair follicles. (18) This condition can cause sudden bursts of hair shedding. Untreated, both alopecia areata and androgenetic alopecia can result in permanent hair loss.

Unlike the hair shedding in hair loss disorders, minoxidil shedding is temporary and does not involve inflammation. (7) Minoxidil shedding can be more intense and abrupt, but it will always stop after a period of time.

Why Does Minoxidil Shedding Occur?

Minoxidil shedding is caused by a disruption to the hair growth cycle. This short-term side effect can be considered to be a drug-induced form of telogen effluvium caused by a mechanism called ‘immediate telogen release’. (3)

Hair grows in a cyclical manner. The anagen stage (also known as the growing phase) lasts between 2 and 6 years. During this stage, 86 percent of hair follicles are actively dividing and proliferating. Once this phase has ended, hair follicles enter the catagen phase. (4)

The catagen stage is a transitional phase lasting 1 to 2 weeks. In this segment of the hair growth cycle, 1 to 3 percent of all hair follicles lose cells, decrease in size, and stop growing hair. (4)

After the catagen stage, the follicle enters the telogen stage. In the telogen phase (also known as the resting stage), hair follicles become dormant for about 12 weeks before the hairs produced by them are shed. This is the part of the hair growth cycle that is affected by minoxidil. (3,4)

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In androgenetic alopecia, the follicle’s natural cycle is disrupted by circulating levels of a hormone called dihydrotestosterone (DHT). This potent androgen can easily bind to hair follicles, triggering a process known as miniaturization.

When DHT binds to scalp hair follicles, the hormone decreases their blood supply. In a way, the hormone is strangling the follicles to death, causing them to gradually shrink over time. DHT also forces hair follicles to stop growing too soon and remain in the telogen phase for longer. As a result, hair strands affected by DHT grow back shorter, finer, and weaker each time. (5)

Topical minoxidil (commonly known by the brand name Rogaine) is an FDA-approved treatment for androgenetic alopecia and one of the most widely-used hair loss medications in the world. When you start using minoxidil, it releases chemicals that widen blood vessels in the scalp, supplying miniaturized follicles with nutrients and oxygen necessary for cell division and healthy hair growth. (6)

As follicles get the nutrients they need, they are released from the deep slumber of telogen and forced into an actively growing stage rather abruptly. (7) But for new hairs to grow, the old hairs must be pushed out to make space, much like baby teeth have fall out in order for adult teeth to grow back in their place.

What occurs next can happen any time someone first starts using minoxidil. As growing hair pushes the old hair out, the Rogaine shedding phase begins. Fortunately, the phenomenon of immediate telogen release from minoxidil is a good thing – it means the anagen phase has been re-initiated.

How Bad Is Minoxidil Shedding?

Everyone is unique in their experience of Rogaine hair shedding. That said, you can expect minoxidil hair fall to be sudden and intense, as typical with telogen effluvium. You can expect to shed anything from 150 to 300 hairs per day. (8)

You should know that the hairs that are shed are the strands that are already resting or in the process of shedding (the telogen phase). Only this time, minoxidil speeds up the shedding process. It is also worth noting that telogen effluvium rarely affects more than 50 percent of your existing hair. (9)

So, however inconvenient or alarming, the best thing you can do if you’re experiencing minoxidil shedding is to focus on the positive and be patient. Your follicles will eventually stabilize and will be able to grow back healthier hairs.

Can Minoxidil Worsen Hair Loss?

For a while, it may seem like minoxidil is worsening your hair loss. It’s normal to start seeing more hair caught in your brush and the shower drain. You’re likely going to be vacuuming more and may even be avoiding mirrors.

But more often than not, this is a sign that minoxidil is actually doing its job. It’s not a sign that it’s worsening hair loss. So, it’s important to remain calm and consistent when applying this treatment in order to give your follicles enough time to reset.

The only way minoxidil could worsen hair loss is if you were allergic to the medication or an ingredient found in minoxidil products. One common allergen is propylene glycol, a chemical additive that enhances the absorption of active ingredients. People with allergies to propylene glycol develop symptoms like itching, scaling, and burning sensations on their scalp, along with worsening hair loss. (10)

Fortunately, propylene glycol isn’t found in every minoxidil product. In general, this ingredient is more commonly found in liquid solutions instead of foams. (17) Many people who react to this common allergen can use other propylene glycol-free minoxidil products without issue.

The Minoxidil Shedding Timeline

Minoxidil shedding will not last forever. However, you should know that the minoxidil shedding timeline varies from person to person. On average, most people experience this short-term side effect for 1.5 to 2 months. (11,12)

How Long Does Minoxidil Shedding Last?

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Generally speaking, telogen effluvium can start 4 to 12 weeks following a triggering event and could last up to 6 months. (11) But with minoxidil, immediate telogen release, can occur after just a few weeks of use and shouldn’t last over 10 weeks in total. (12)

Some reports show that shedding begins 2 weeks after treatment starts. It gradually subsides within 6 to 8 weeks once your hair cycle starts to normalize. (12) After a few months of use, you should start seeing visible new hair growth.

If your hair shedding continues or worsens after this period, you should talk to your doctor in order to rule out other possible causes of hair loss. Telogen effluvium can also be triggered by nutritional deficiencies, severe infections, or medications. It could also be due to another health issue, like thyroid problems. It’s also possible that your hair loss has progressed to a stage where minoxidil is no longer enough. (11)

You should know that hair shedding may also occur if you stop using minoxidil. Without minoxidil to increase blood flow, it is impossible for follicles to keep producing the same type of healthy hair. If you have androgenetic alopecia and you stop using minoxidil, your follicles will go back to gradually shrinking due to the circulating levels of DHT. This means that you need to keep using minoxidil indefinitely if you want to keep your hair follicles healthy.

Does Minoxidil Shedding Grow Back?

The hair that you lose during the minoxidil shedding process always grows back. Because it happens so suddenly, some people may opt-out of the treatment prematurely, which is potentially the biggest mistake anyone (who is not allergic) could make at this time.

It may be hard to believe, but minoxidil starts to restore and improve your natural hair cycle as soon as you start using it. When the minoxidil shedding phase ends, this medication will work to keep the growing phase longer and the resting phase significantly shorter. However, with hair only growing about 0.3 to 0.5 inches (0.8 to 1.3 centimeters) each month, it takes at least 3-4 months for minoxidil to produce an appreciable amount of hair growth. (13,14)

Does Every Type of Minoxidil Cause Shedding?

All formulations of minoxidil have the potential to cause shedding, though not all people may experience this short-term issue. However, using certain types of minoxidil – like those that aren’t FDA-approved for hair loss – can increase your risk of this side effect or change the way shedding affects your hair.

For example, around 15 to 20 percent of FDA-approved liquid and foam minoxidil users are thought to experience minoxidil hair shedding. (1) In contrast, a study of oral minoxidil users found that 22 percent of participants experienced increased hair loss after using minoxidil. (15) However, although more people experienced oral minoxidil shedding, this side effect was only reported it for an average duration of about 4 weeks. (15)

Higher concentrations of minoxidil are also known to cause more side effects. In a study comparing the efficacy and safety of 5 percent and 10 percent minoxidil solutions, researchers found that the higher concentration 10 percent minoxidil solution was less effective at increasing hair growth and caused an increased amount of hair shedding. (16)

There’s not much you can do to avoid shedding from minoxidil, but to reduce your chances, choose only the FDA-approved minoxidil concentrations of 2 percent or 5 percent. While you may want to speed up your hair growth by applying it more regularly, it’s best to use it exactly as the label and packaging instruct you to.

Does Minoxidil Shedding Stop?

Minoxidil hair shedding is a highly distressing phenomenon that can significantly worsen existing psychosocial issues that typically come with hair loss. On the bright side, it is a sign that your hair follicles are adequately responding to the effects of this medication. You can see it as a positive, since minoxidil speeds up the process of shedding in order to make way for new healthy hairs to come through.

There’s currently no way to pinpoint which users are more likely to experience minoxidil shedding. The best thing you can do is use the FDA-approved concentrations of minoxidil and be consistent with the daily applications.

On average, minoxidil hair shedding has a duration of 2 months. You can expect this temporary side effect to start as early as 2 weeks into the treatment and go on for 8 weeks. If you keep up with your daily regimen, you can expect to see stronger, thicker hair peeking through your scalp about 3 to 4 months later, once your hair growth cycle has returned to normal.

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