Hair loss 4 years after minoxidil - can oral therapy help with hair growth? 44 y/o female (photos)

Question

44/F. I've been on Minoxidil for 4 years now. I got good resuls but since Dec 2022, I've noticed that I've lost a lot of hair. No stress or sickness has afflicted me. It seems that Minoxidil is not longer making effect on my hair. Is it too late to start oral therapy, will it work? What is the best oral therapy for a female my age? PRP has not worked for me. Not considering hair transplant. I've lost hair all over my head.

Brooke Jeffy, MD · Answer

I do not think too late to start oral therapy and there are many options such as spironolactone, dutasteride, propecia and minoxidil. Potential to become pregnant and other medications would effect decision on which drug to try. There are more of us doing injectable minoxidil and dutasteride into the scalp as well. I also think a large factor can be stress and lack of sleep so be sure addressing those factors too!

Jeff Donovan, MD, PhD · Answer

With a story like this, you really want to do one thing and one thing only to start: see an expert for a proper evaluation. The scalp needs to be examined up close and your entire story needs review. You will need blood tests. No, minoxidil does not just suddenly stop working like this despite the myth ao something else is going on. While you report no symptomatic disease, you are forgetting about asymptomatic disease and your doctor can guide you through proper evaluation. Asymptomatic thyroid disease, asymptomatic covid can all cause hair loss as can vaccines. You really need a proper evaluation befofe jumping into the next step. It could be that some sort of asymptomatic condition has accelerated your underlying androgenetic alopecia or it could be that a new condition has surfaced. Be sure to have a thorough evaluation. You absolutely require thorough trichoscopic evaluation of the scalp by an expert and you need blood tests.

Samer Muala, MD - Account Suspended · Answer

In my practice I like to use oral spironolactone for women to block estrogen effect.  The best thing to do is to get a good work up if you haven't to check your hormone access.  If balanced, then I like to use Capillus laser cap therapy (the RX model with the most lasers) along with topical solution compounded in a certain way as well a hair supplement like Nurish or Nutrafol.  Please let me know if you have any questions- I can answer questions in all states except New Mexico (license pending).

Hair loss 4 years after minoxidil - can oral therapy help with hair growth? 44 y/o female (photos)

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