Had success with Minoxidil + Viviscal for 3 years and then tried ALMI + PRP. Will I have success with Minoxidil again?

Question

Stopped using minoxidil 10 weeks ago after having ALMI + PRP, one follow up PRP and started wearing laser cap. Horrible shedding and loss. (1) if I had success with minoxidil before and re-start do i have a chance at success again? (2) was this just an expensive experiment to do ALMI/PRP/Laser Cap -- and all i really need is minoxidil?

Arbella Sarkis, MD · Answer

Surprised you stopped the Minoxidil in the first place. You've likely lost hair that was dependent on it. If you stopped because you were tired of using it, then consider whether or not you will seriously maintain its use in the future? 
If you will, then restart. If not, don't restart and create more dependent hair only to be lost when you stop.
In any case, I recommend another PRP w/o ALMI treatment or two to see if you can regain what you lost. Restarting Minoxidil will likely not regain what you lost on its own. Continue with the cap.
Wishing you a good outcome!
Warmly,
Arbella Sarkis, MD

Amiya Prasad, MD · Answer

Thank you for your question. You are asking if minoxidil will work for you after stopping it 10 weeks prior, when you did ALMI+PRP treatment, with succeeding treatment of PRP alone, and using a laser cap. However, you’ve experienced a lot of hair shedding since then. You had previous success with minoxidil and Viviscal for 3 years.
I can certainly give you some guidance about this, even without a photo for reference, and without a physical exam. I’m a Board Certified Cosmetic Surgeon and Fellowship-trained Oculoplastic Surgeon. I’ve been in practice in Manhattan and Long Island for over 20 years. I’ve been performing hair transplants since I started my practice, and have been prescribing finasteride to male pattern hair loss patients since 1997. I’m also the founder of TrichoStem Hair Regeneration Centers, based on a system we developed for non-surgical treatment of pattern hair loss for men and women.
To first explain the possible cause of hair shedding, it is quite common to experience this shortly after stopping minoxidil. Minoxidil appears to work by delaying the normal hair shedding cycle, and extending active hair growth phase so having more hair on your head disguises hair thinning. Minoxidil doesn’t actually thicken thinning hair, but it can make hair density look more full by delaying hair shedding. When minoxidil use is stopped, the hair that was prevented from shedding can suddenly shed, often all at once.
While I don’t use ALMI and PRP for pattern hair loss treatment, I am among the pioneers of using PRP+ACell for treating pattern hair loss in men and women in a treatment I call Hair Regeneration. This particularly important because there often comparisons with PRP+ACell treatment with PRP+ALMI. While not all PRP+ACell treatments have the same results as Hair Regeneration, our Hair Regeneration patients can consistently stop using minoxidil altogether, or be weaned off minoxidil to prevent a sudden hair shed, which sounds like what you are experiencing. The Hair Regeneration treatment is a one-time treatment for most patients which can last 3-5 years, but some patients with moderate to severe pattern hair loss get a second treatment at 12-24 months after the first. There no treatments in between of PRP alone, which I find to be more effective in stimulating short-term hair growth,which requires multiple treatments, and more treatment sessions indefinitely to try to sustain growth. I also haven’t found low-level laser light therapy (LLLT) caps and machines to have much of an impact on pattern hair loss, so I don’t put my patients on it, either. Only patients such as young men with high DHT-sensitivity are prescribed a DHT-blocker like finasteride along with the Hair Regeneration treatment, but other patients don’t require additional medications like minoxidil, and spironolactone. Viviscal’s primary ingredient is biotin, which is a B vitamin that helps with hair growth and health, but does not treat hair thinning due to pattern hair loss, which is a genetic issue, not a health issue.
The effects of minoxidil can wane with time, even if used daily, so minoxidil may not be the best long-term solution. You can start again with minoxidil, but it will take some time to build up hair density again by delaying the hair shedding cycle, and this effect is not usually sustainable for the long-term.
Female pattern hair loss is difficult to treat as there are less treatment options available when compared to men. We have successfully treated over 99% of female pattern hair loss patients, who saw thinning hair get thicker, and stimulated growth from dormant hair follicles. We have been able to do this with results that last 3-5 years, and without additional medication. However, we have also been offering this treatment much longer, since 2011, than other treatments like ALMI+PRP, which may not have the patient data available yet for predictable results. I hope you found this information helpful. Thank you for your question.

William Rassman, MD (retired) · Answer

It is never a good idea to experiment with a successful treatment. Once you stop minoxidil and lose the minoxidil dependent hairs, it may or may not come back. Try it again

Had success with Minoxidil + Viviscal for 3 years and then tried ALMI + PRP. Will I have success with Minoxidil again?

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Had success with Minoxidil + Viviscal for 3 years and then tried ALMI + PRP. Will I have success with Minoxidil again?

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