Is it possible that the minoxidil has caused a second TE for me?

Question

I was incorrectly diagnosed with AGA so started 5% minoxidil end of January. After seeing two hair loss specialists I was told I have TE and advised to come off the minoxidil as my shedding during this time was immense. I came off minoxidil in May. Since then my shedding is starting to peak again. Is it possible that the minoxidil has caused a second TE for me? And if so when could I expect this to stop or is there anything I could do?

Mehmet Erdogan, MD · Answer

When minoxidil is started, it can induce an initial shedding phase due to synchronization of hair follicles entering anagen. When it is discontinued, a secondary shedding phase may occur 2–4 months later. This is not a new episode of Telogen Effluvium, but rather a physiologic shift of follicles that were being pharmacologically maintained in the growth phase.
If minoxidil was stopped in May, a peak in shedding during the following 2–4 months would be consistent with expected timing.
Minoxidil itself does not cause true telogen effluvium in the systemic sense. However, TE can persist or recur if the underlying trigger has not resolved (e.g., iron deficiency, thyroid dysfunction, hormonal shifts, stress, illness, surgery).
At this stage, the recommended approach would be:
Ensure appropriate laboratory evaluation (ferritin, TSH, vitamin D, B12 if indicated)
Avoid restarting minoxidil unless androgenetic alopecia has been confirmed clinically or trichoscopically.
Provide reassurance, as shedding after cessation typically stabilizes within several months
If shedding continues beyond 6 months or signs of miniaturization become evident, reassessment for coexisting Androgenetic Alopecia would be appropriate.

Glenn Charles, DO · Answer

If you stopped the Minoxidil in May then it is unlikely that has anything to do with you have in a period of TE now. Both PRP and Low level laser therapy have been successful in some patients to slow down or stop the TE. However, like all non surgical hair loss options they work for some patients and not others. Never a guarantee.

Is it possible that the minoxidil has caused a second TE for me?

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