Should I take prophylactic Minoxidil? 23 years old, fit & well patient

I think it is great that you are watching yourself closely for evidence of the beginnings of male pattern baldness considering your family history.  There is a good chance that you may never lose your hair.  Because you don't have active hair loss now I would not use minoxidil or any other hair loss prevention method.  Medications such as these, while very uncommon, still have potential of side effects.  And I believe that you shouldn't take a medication to prevent a process that may never occur.  The best thing to do is to continue monitoring yourself.  If you feel you are having the beginnings of hair loss it would be wise to be evaluated by an experienced hair restoration surgeon.

Yes if you have hair thinning or baldness in your family then you are okay to use Minoxidill to help strengthen your hair.

Both minoxidil and finasteride have the potential to work as a preventative for male pattern hair loss. However, I agree with Dr Donovan, unless you have a hair loss process, I would not consider treatment at this point. Nutraceutical vitamins or topical peptides maybe an alternative. Jeff Rapaport MD

This needs an in-person evaluation. I suggest seeing a hair loss expert now to evaluate and go over your condition and provide you information about your best treatment options. There are great non-invasive options like prp/progesterone and/or hair transplantation. See an expert. Best, Dr. Emer

While minoxidil works for some, the problem with the medicine is that it does not stop hair loss, and the DHT will continue is binding to the hair shaft which will eventually overtake any additional growth caused by the Minoxidil and die, perhaps just slightly later than it would have without the medicine
Also, the alcohol base required to support the active ingredients also cause irritation of the scalp and severe reactions for many people, such as the increased shedding you are describing. The fact is that it does not work for everyone.
The best thing to do would be to see a doctor who specializes in hair regrowth and the re-balancing of body biochemistry who can diagnose the cause of your hair loss. Good luck on your search.

Many things in life aren’t yes or no, black and white. One thing is certain: if you don’t have hair loss you should stay far away from hair loss drugs. It’s an easy answer really. These drugs can be wonderful when needed. They tell the hairs to do things they otherwise don’t want to do. If things are fine, no hair follicle needs to be receiving such messages. There is a time and place for medications. This is not one.

Finasteride would be a great place to start. The sooner you begin the better it helps slow down loss long term.

Minoxidil is not a good preventive medication. Finasteride is a better preventive medication but before you consider this, get a diagnosis in hand by an expert physician in this field.