Hair Loss/minoxidil


QUESTION: hi doc i have a history with minoxidil  
when i used it for the first time it was a consult from a doctor he told me that i should use it for six months and then quit it and so i did i used it for six months constantly twice a day and the results were great i had my hair back then after i quit it i lost the whole hair i gained and i became even balder but i did not quit i started looking for answer and i get it that i should not quit it so i start to use it again and after few months it grew up again and it was great then i used it for one time not twice then i lost my hair again but not as fast as the first time so i used it again twice a day but i still losing my hair in some areas and i have been losing my hair since then from tow months i just want to know why ?? and will my hair grow up again if i constantly used it twice a day ? and another question i am thinking of start wearing a hat until it grow up again so is it bad for my hair ?
please help me doctor i am a desperate teenager i am 17 years old
and forgive me for my language i am not very good at English .
thanks doctor sorry for the long speech .

ANSWER: Mohamed,
 5% minoxidil should be used twice a day to keep old fine thin hairs in an active growth phase instead of shrinking and then getting so small and old that your body will scar the roots and they die. That is what happens to hairs in areas where you have inherited the bald genes.  Even with the bald genes minoxidil can sometimes make the hairs continue to grow but when you stop those hairs will fall out and sometimes they can not grow back because they were in their last life cycle. Every hair only has a certain number of life cycles which are programmed in the hair from birth. Each life cycle is about 5 years. Hairs grow 1/2 inch per month for 4 to 6 years and then fall out and start over again.  The ones in the front hairline may only have one or two life cycles after being exposed to male hormone. This means that you are seeing balding due to those hairs which only had one life cycle programmed into them. Trying to keep them alive by artificially stimulating them to grow despite getting the message to die from your dihydrotestosterone (DHT) is a hard way to keep them alive. It is easier to lower the DHT by taking 1mg Finasteride- also known as Propecia. When you take this pill once a day it lowers the DHT 66% and that is enough to stop balding in 85% of men.  I suggest you continue to use minoxidil but seriously consider taking Finasteride to prevent more loss and perhaps even bring back the lost hairs. There is a possibility some of those hairs are not able to grow back because the final growth cycle ends with scarring of the roots.
 Wearing a hat will not help or hurt your hair growth.

This page on my website will describe the phases of the growth cycles of scalp hair:

This page will describe why DHT tells hair to grow old:

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QUESTION: Thanks doctor but another questions if i did not take those bills my hair will continue to fill ?? and i am losing my hair for tow months now although i am using minoxidil twice a day is it normal or not? and is there is any hope to grow back ? because it became worst when i move my hand over my hair i see hair in my hand but also i am seeing thin hair in the bald areas but what makes me worry is that the thick hair falls .
i am sorry again for the long speech .

If you do no take the pills to lower the DHT hormone which tells the hairs to grow old and die then you can expect to gradually continue thinning. Minoxidil works sometimes to slow down this process but if you are noticing a shed despite using it twice a day then you may have loss due to stress.
In Chapter 4 of my book you can read about hair loss due to stress. Sometimes those hairs do not grow back and no one can not predict now whether you will get this hair back.


Stress can cause a type of hair loss called telogen effluvium. This condition is not caused by the general accumulated stress of ordinary interactions with people at home and at work, but rather by sudden severe emotional or physiological incidents. Severe stressful events can cause some or most actively growing hair follicles to prematurely shift into the regression phase, and then the resting phase, during which the hairs fall out easily.

There is usually a delay of a few weeks to a few months before the shedding is noticeable, but after this delay the shedding seems to occur quite suddenly. Because the shedding is delayed, this type of hair loss is often a mystery to the person suffering the condition. The stressful event that triggered it is frequently forgotten, and it is rarely thought to be connected with the “new problem.”

Examples of sudden severe emotionally stressful events include the death or terminal illness of a family member or close friend, marriage, divorce, and unexpected job loss. Severe physiological stressful events shock the body, and some examples are heart attacks, major surgery, and illnesses with prolonged high fever such as malaria, viral pneumonia, and severe cases of the flu.

In most cases of telogen effluvium, the hair follicles recover and soon shift back to the regular growth cycle.

However, repeated instances of telogen effluvium can result in premature hair loss in people predisposed to lose their hair late in life. The average growth cycle of a hair follicle takes about five years, but each follicle is “genetically programmed” for only a limited number of growth cycles. For example, if a particular hair follicle were “genetically programmed” for only ten growth cycles, after about fifty years that follicle would stop producing new hairs. When all the follicles at the hairline or crown of the head are “genetically programmed” this way, a receding hairline or bald spot appears after all the growth cycles for the follicles in those areas have been cycled through.

Hair Loss

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Peter J. Panagotacos, <B>M.D.</B>


I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery.


I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery. More information can be found at my website

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