There are many questions patients have about hair loss medications. I’ve answered the most popular questions we receive in regard to hair loss medication. Whether you're experiencing hair loss or just looking to learn more about the topic, we hope to provide helpful information and insights.
should i start minoxidil treatment at the same time as a 5-alpha reductase inhibitor treatment?
I started a 5-alpha reductase inhibitor two weeks ago and would like to know when I should start minoxidil or wait. I've read it's not recommended to start a 5-alpha reductase inhibitor treatment and topical minoxidil treatments simultaneously since you won't know which treatment is working. It's better to start a 5-alpha reductase inhibitor first and wait around a year to see if any results come up; then, you will know if minoxidil would help.
When starting a hair loss treatment regimen, it is important to consider the combination of medications that can work together to achieve the best results. In the case of a 5-alpha reductase inhibitor treatment and minoxidil, I recommend starting both medications at the same time because 5-alpha reductase inhibitors work by blocking the conversion of testosterone into dihydrotestosterone (DHT), which is a primary cause of hair loss. Minoxidil, on the other hand, works by increasing blood flow and nutrient delivery to the hair follicles. By combining the two medications, you can attack hair loss from both angles, which can lead to a more effective treatment overall.
If you wanted to be a purist and know which one is helping, you could start one; the trouble is you have to wait six months (I don't recommend waiting any longer) to see how effective it is, and usually, we are trying to get on top of the hair loss situation faster than that. If you are considering using a 5-alpha reductase inhibitor and minoxidil to treat your hair loss, I recommend starting both medications simultaneously to get the most out of your treatment.
Will 5-alpha reductase inhibitor treatment lock in the hair growth gains from minoxidil?
Let's say someone uses a popular 5-alpha reductase inhibitor treatment in conjunction with minoxidil and experiences regrowth with this regimen. If they decide to go off minoxidil but stay on 5-alpha reductase inhibitor, would 5-alpha reductase inhibitor maintain the regrowth attributable to minoxidil, or would these gains ultimately reverse without minoxidil?
The drugs work differently, and if you stop taking minoxidil, you can potentially lose any hair growth achieved through the medication. Minoxidil works by stimulating blood flow to the hair follicles, which can promote hair growth and improve the health of existing hair; without this stimulation, the hair follicles may not receive the necessary nutrients and oxygen to maintain hair growth. A 5-alpha reductase inhibitor can't replace it because a 5-alpha reductase inhibitor doesn't stimulate blood flow; it blocks the conversion of testosterone into dihydrotestosterone (DHT), which is a primary cause of hair loss.
It seems like it’s better to start with topical 5-alpha reductase inhibitor treatment or topical minoxidil and only resort to the oral version of medication if you do not respond to topical. Is this true?
The oral version of both medications is more potent than the topical because higher levels of the medication metabolize in the liver than are absorbed into the scalp through the topical drug.
However, if a patient were on the topical version of either medication for six months and saw little improvement, I wouldn't necessarily go straight to the oral tablet.
With a 5-alpha reductase inhibitor treatment, I might try another medication or question whether or not you respond to a 5-alpha reductase inhibitor and recommend a DNA test to see if you are a non-responder.
- If there is no improvement after about six months of constant topical use, you may be a non-responder to a 5-alpha reductase inhibitor. If a person's hair follicles are highly sensitive to DHT, even low hormone levels after 5-alpha reductase inhibitor treatment can still cause miniaturization and hair loss. We have a DNA test that can confirm this.
If you were on Minoxidil, I would do a DNA test to see if you were a non-responder, and if you were a responder, I would switch to the oral tablet version.
- If there is no improvement after about six months of constant topical use, you may be a non-responder to Minoxidil. Minoxidil is converted into minoxidil sulfate (the active drug) by the enzyme SULT1A1, and this enzyme is different among individuals. If you lack SULT1A1 enzyme you will be a non-responder to minoxidil because you need the one thing that converts minoxidil into its active form, minoxidil sulfate. We have a DNA test that can confirm this.
If you have any questions about hair loss treatments, it's important to make an appointment with a trusted healthcare provider. I can assess your situation and guide you on the best course of action. Don't hesitate to schedule an appointment if you feel unsure or anxious about your hair loss. Seeking professional advice can help alleviate any concerns and put you on the path to finding a solution that works for you. Remember, taking care of your health and well-being is always a top priority.
