Can medical grade retinol speed up androgenetic alopecia?

You can actually combine medical grade retinol cream with minoxidil lotion to make it more potent topically. So it should make your hair loss better specifically with androgenic alopecia.

Retinol, even at medical-grade strength, is primarily used to treat skin concerns like acne, fine lines, and hyperpigmentation, and it works by promoting skin cell turnover. There’s no evidence to suggest that topical retinol can speed up or trigger androgenetic alopecia (AGA). AGA is driven by sensitivity to dihydrotestosterone (DHT) in hair follicles, not by factors like retinol, which acts at the skin level.
Since you’re already on finasteride, which blocks DHT and helps manage AGA, using retinol for your facial skin shouldn’t interfere with your hair health. However, retinol can sometimes cause dryness or irritation, so if you notice any scalp issues from incidental contact with retinol, it's best to keep the treatments limited to your facial skin or speak with your dermatologist.
Overall, there’s no need to worry that retinol will speed up hair loss related to AGA. You can continue using both treatments without concern, especially since finasteride is working to protect your hair.

This is not very likely to happen, no. There js just not sufficient systemic absorption with use of topical retinoids to affect hair in any significant way. Now, oral retinoids is a different story of course. But I’ve never seen an convincing evidence that topical retinoids are a problem for those with AGA.