I'm shedding or have I damaged my scalp/hair follicles?

Question

Im currently on Finasteride(4m) and Minoxidil(2m). 2m ago I tried a dermaroller 1,5mm once. I used it carefully and without any noticeable bleeding, my scalp got little sore for a day, the dermaroller was of poor quality. My hair have got thinner since starting medication, so I can't judge if my hair is thinner because of shedding or if the dermaroller is the cause and that is really stressing me out. Is it likely that the dermaroller is the cause of this hairloss? If yes, is it permanent?

Anna Chacon, MD, FAAD · Answer

It’s very understandable to feel concerned when you notice increased thinning while on treatment. What you’re experiencing is most likely shedding related to the initiation of finasteride and minoxidil, rather than permanent damage from dermarolling.

Finasteride and minoxidil commonly trigger shedding in the early months of use. This happens because the medications push older, weaker hairs into the shedding phase before stronger hairs regrow. This usually stabilizes after a few months and is considered a normal part of the process.

Dermarolling with a 1.5 mm device can sometimes cause temporary irritation or soreness, but when used once without bleeding, it is very unlikely to cause permanent follicle damage. The quality of the dermaroller matters for safety, but permanent loss from a single careful use is extremely rare.

Your thinning is much more consistent with treatment-related shedding rather than scarring or follicle injury. Over time, the medications should help improve density if you continue with them consistently.

Jeff Donovan, MD, PhD · Answer

this is 100 % impossible to know with certainty. if too many things are done at the same time, one can not determine a cause and effect relationship in any way. Statistically speaking, one would predict that the dermaroller is rather unlikely to be a cause here and minoxidil and finasteride being more likely. But this is only am estimate of statistical probability. Other causes also need to be considered ways include stress, infection in the last 6 months, blood tests results in last 6 months, weight loss, other supplements and hair products used. Be sure to see an expert to help clarify these issues.

I'm shedding or have I damaged my scalp/hair follicles?

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