After stopping Minoxidil, are two months enough for all hair grown from the drug to fall down?

Question

I have been using Minoxidil for two years (last year only once a day) At first, it worked perfectly fine but it stopped working. (I'm not sure if it stopped working or that its still working but I am losing other hair) I decided to completely stop Minoxidil and do a Hair transplant in two months, hoping that all hair grown for the drug falls within these two months. Are two months enough for the hair transplant doctor to see my worst case and accordingly do the operation?

Amiya Prasad, MD · Answer

Thank you for your question. You didn’t submit photos, but describe you have been on minoxidil for about 2 years, and noticed after awhile it wasn’t working. You decided to stop the minoxidil, and you’re going to undergo a hair transplant in about 2 months. You’re asking if stopping minoxidil will allow the hair preserved with the minoxidil to be gone so your transplant doctor can do a more accurate and effective hair transplant.
I can certainly share with you my thoughts on your situation, even I don’t have the details of your clinical history, your age, the onset of your hair loss, the degree of progression, and the amount of anticipated grafts, etc. However, I can give you a global understanding of how I approach this type of situation in our practice.  A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. Hair transplant has been a significant part of my practice for many years. I am the founder of TrichoStem™ Hair Regeneration Centers based on a system we developed from hair transplant to help men and women with thinning hair manage their hair loss non-surgically.
When you think about hair loss treatment, you are dealing with a progressive condition. Regardless of the intervention, from minoxidil, and the oral drug finasteride that fall in the pharmacologic realm, as well as PRP, Hair Regeneration and transplant, what you are doing is managing hair loss. You’re managing in one strategy the effective lifespan of hair follicles, and in the surgical strategy you’re trying to place coverage in areas that are devoid of coverage. 
There is some benefit with minoxidil, but as is the case for any pharmaceutical, when you stop the drug, you stop the effects. The slow, progressive loss of effectiveness is very common with minoxidil. Minoxidil can prolong the growth cycle of thinning hairs, but those thinning hairs will still fall out. In my observation, a more effective benefit from a pharmaceutical would be finasteride, which in the right candidate, by blocking DHT or dihydrotestosterone, results in a prolongation of the hair growth cycle, and allows for a more sustainable, longer lasting effect when compared with minoxidil. Unfortunately, a lot of people are afraid to take finasteride, although clinically speaking, in my experience, it’s a viable choice in hair loss management. 
We developed a system for hair loss that evolved from hair transplant called Hair Regeneration. Hair Regeneration was developed as a result of using a wound healing material called extracellular matrix which is based on stem cell technologies. It’s not placement of stem cells, but rather your body’s recruitment of its own adult stem cells to expedite wound healing. This was in combination with PRP or platelet-rich plasma that is derived from your own blood. We developed over time a combination that helps people with hair thinning. What developed from hair transplant is we wanted the hair grafts to heal better, and have better yield, and improve the healing of the donor area where the hair is harvested. 
Anything that can prolong the lifespan of your existing hair and mitigate progressive hair loss is important, regardless of what transplant you do. People feel very good about getting hair transplant, and as surgeons we like doing them. However, the success of long-term coverage of the transplant is dependent on the integration of existing hair with transplanted hair, so what you want is to maximize the lifespan of existing hair. 
With Hair Regeneration, we learned over time, and have been at this for over 7 years, is that for the right candidate, which means someone with moderate rate of progression and moderate degree of hair loss, we’re able to, for both men and women, achieve with an injection treatment 5 years of improvement. Improvement is defined by stopping the progression, reactivating hair follicles that aren’t growing, and prolonging the growth cycle and thickening existing thinning hair. In effect, we’re getting the desirable coverage we want with a hair transplant, but without surgery. 
To answer your question about the minoxidil, it’s likely that hair not responding to the minoxidil which prompted your pursuit of hair transplant will likely not be present in any significant numbers by the time the hair transplant is ready to be done. Often, when you are doing hair transplant, to blend the transplanted hair with existing hair, these finer, thinner, wispier hairs are essentially not seen as significant, and the grafts are placed between them, or through them, and that is the reality of hair transplant.
It is important for you to discuss with your doctor what strategy for stabilization will be of benefit. We are helping a lot of patients from all over the world with Hair Regeneration as a primary treatment for male and female pattern hair loss, but we’re also helping people who undergo hair transplant. When the patient comes within the first month to 3 months after a transplant, we do this injection treatment, and are able to expedite the healing of the transplant, the regrowth of the transplant, and thicken existing hair so the transplant and existing hair blend very well, so the coverage is improved, and there’s a nice synergy. 
We have addressed the question about minoxidil, but I think it’s important for you to learn about ways to help stabilize as much as possible. Again, you can’t stop hair loss, but we can certainly slow it down and get coverage that can last as long as possible, depending on your genetic situation. I hope that was helpful, I wish you the best of luck, and thank you for your question.

Ilhan Serdaroglu, MD · Answer

Hair gets its pre treatment phase 4-6 months after you stop using minoxidil. But that is not enough to decide to have hair transplant, miniaturization level/degree is crucial.

Jeff Donovan, MD, PhD · Answer

It takes 6-9 months to lose hair that was gained after using minoxidil. Two months is not sufficient.

After stopping Minoxidil, are two months enough for all hair grown from the drug to fall down?

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After stopping Minoxidil, are two months enough for all hair grown from the drug to fall down?

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Everything you need to know about Hair Transplant

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