Should I use Minoxidil 5% leading up to hair transplant?

Question

I'm healthy for my 56 years. I had HT surgery at 54 but the crown was not prioritised. A trichologist has advised using Minoxidil for a couple of months to stimulute dormant follicles to improve the donor area before opting for further surgery. A different trichologist has advised not to use Minoxidil and it would be pointless as any growth will fall out when usage is stopped and besides, it won't show the true situation before surgery. Can you advise?

Anna Chacon, MD, FAAD · Answer

Hi,

This is a very thoughtful question, and I can understand why you’re receiving mixed advice. Both perspectives you’ve been given have some validity.

Minoxidil 5% works by prolonging the growth (anagen) phase of hair follicles and can stimulate miniaturized or “dormant” hairs to thicken temporarily. In some patients, using it before a hair transplant may:

Improve the appearance of density

Potentially strengthen miniaturized hairs

Help stabilize ongoing shedding

However, the second trichologist is also correct in that:

The effects of Minoxidil are maintenance-dependent. If you stop using it, stimulated hairs often shed.

It can temporarily “mask” the true baseline density, which may make surgical planning slightly less straightforward if discontinued before surgery.

Importantly, Minoxidil does not increase the number of donor follicles—it cannot create new grafts. It can only enhance the performance of follicles that are already there. So it won’t fundamentally change your donor capacity, but it may optimize the health of existing hair.

At 56, especially after a prior transplant, the key considerations are:

Stability of your hair loss

Quality and density of the donor zone

Long-term maintenance strategy

If you plan to continue Minoxidil long-term, starting it before surgery can be reasonable. If you do not plan to use it consistently after surgery, then starting briefly beforehand may offer limited benefit.

Should I use Minoxidil 5% leading up to hair transplant?

Answers (1)

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