While Rogaine is a popular treatment for pattern baldness, it does cause a disturbing occurrence in the beginning of use: shedding. In this article, you’ll learn why Rogaine shedding happens, how long it lasts, and how much loss you can expect.
Additionally, you’ll learn of natural methods you can use – either alone, or alongside Rogaine – to stop shedding and grow your hair more quickly.
Using Rogaine to Treat Thinning and Receding Hair
Rogaine is a hair loss treatment – consisting of a drug, called minoxidil – that is applied to the scalp on a daily basis.
The main use for Rogaine is in the treatment of Male-Pattern Baldness (MPB), the most common form of alopecia.
When applied regularly, the active ingredient minoxidil works to promote blood circulation and reduce the effects (such as inflammation and hair miniaturization) caused by DHT.
Unfortunately, as with any medication, this drug does have some side effects associated with use.
These include local irritation (itching, redness, rash), but also some systemic side effects, such as dizziness, excess facial/body hair, and fast/irregular heartbeat.
Another “side effect” of Rogaine/minoxidil use is hair shedding, popularly referred to as “dread shed”.
Before we get into the cause of minoxidil shedding, let’s discuss the hair growth cycle.
The Hair Growth Cycle
To understand why medications like minoxidil and finasteride trigger shedding at the start of treatment, it’s important to understand how hair grows. The process can be explained by the hair growth cycle.
There are four stages of the hair growth cycle. They are…
The active growth phase when hair grows and lengthens for a period of two to six years.
In men and women with pattern balding, the anagen phase is considerably shorter for the follicles impacted by hair loss. The result is shorter, thinner hairs that will cycle through the rest of the stages outlined below on an increased timeline.
The transitional phase when the base of the hair follicle, known as the bulb, begins to detach from the follicle’s blood supply. The detachment begins once the follicle receives a chemical signal to stop growing.
At what point in the anagen phase the hair follicle receives the signal will depend on various factors. Body and facial hairs, for example, will receive the signal at a quicker rate than scalp hair that may have entered anagen phase at the same time. This is because body hairs are characteristically finer and shorter than their scalp counterparts.
This stage can last up to a few weeks.
The resting phase when the bottom of the hair strand (the bulb) has completely detached from the follicle. The hair strand doesn’t immediately shed from the follicle. Instead, it waits for a newly formed hair strand to grow from the follicle and push it out of its place which can take up to three months.
Telogen hairs can shed from typical activities, too, such as hair washing or brushing. These are often the types of hairs you’ll find in your hair brush, in the shower drain, or on your pillow.
When the telogen phase hair finally sheds from its follicle, it has entered the exogen phase.
Exogen is a phase that’s often overlooked or lumped in with telogen, as it’s not so much a standalone phase like the other three above. Instead, it’s characterized by the end of one phase (telogen) and the beginning of another (anagen).
What Causes Rogaine Shedding?
During the course of the normal hair growth cycle, shedding takes place. About 100 hairs are shed per day in a healthy individual, and this just means that the telogen phase has ended and anagen is next.
When shedding takes place while on hair growth treatments, including Rogaine, the reason is the same.
Rogaine and Propecia – the only two FDA-approved baldness treatments on the market – both bring your hair from the resting phase to the active growth phase.
They do this in different ways, but the end result of both is excess shedding.
When using treatments like Rogaine and Propecia, you expect to see one result: hair growth. That’s the likely result when you use these medications as directed.
But how do you get there?
There are two ways that Rogaine works to promote hair growth:
- It triggers hair growth in dormant hair follicles, and;
- It lengthens the anagen phase so as to promote longer, thicker hair.
Just as the hair growth cycle outlined above indicates, for this to happen the dormant hairs must be shed. This is why you’ll see an increase in the number of shed telogen hairs in the first few weeks of treatment.
The good news is that an increase in shedding is a sign that the medication is working as intended.
How Common is Rogaine Shedding?
It helps to think of Rogaine shedding as less of a side effect and more of a stage of use.
This is something that happens in the beginning of treatment – typically in the first 2-8 weeks – but that should subside as treatment continues (1).
Of course, not everyone will suffer from shedding as a result of use, especially if your hair loss has progressed to the point of baldness. But, the majority of users will experience some level of shedding.
How Much Shedding Should You Expect?
As mentioned, whether shedding occurs will vary. The same can be said for how much shedding takes place.
During the usual hair cycle, about 100 hairs per day are shed during the telogen phase.
It’s not uncommon to experience more than this during the first few months of minoxidil use, as many hairs will be prematurely pushed into telogen.
So, when should you worry?
If shedding continues for more than 8 weeks, or if it seems to worsen as treatment continues, I recommend you speak with a hair loss specialist.
If you choose to stop minoxidil, be aware that shedding can also occur as a result of this, so you may notice an increase in shedding for a few weeks.
Is It Possible to Avoid Shedding?
As a hair follicle can only house one hair strand at a time, and since you want a newer hair strand to grow, it’s impossible to avoid the shedding of dormant hair.
You may be able to shorten the shedding process, though, by improving the general health of your scalp.
How to Shorten the Shedding Period
Let’s look at a few ways you can promote overall scalp and hair health.
Improve Your Diet
Just as with all other bodily processes, the hair growth cycle is supported by the nutrients you consume. If you are lacking in key nutrients and minerals, then the hair growth process will suffer.
By eating a balanced diet, including carbohydrates, proteins, and fats, you can ensure that your hair follicles and scalp are receiving the nutrients they need to thrive.
There are certain vitamins and minerals that have been proven to support hair health and growth, including iron, biotin, niacin, and zinc (2). And macronutrients, especially proteins and fats, also play a key role in hair growth and repair (3).
So if you want to promote an overall healthier scalp environment while also potentially speeding up the shedding phase of minoxidil, then an improved diet is highly recommended.
As Rogaine works by increased blood flow to the scalp, it can be beneficial to add in your own scalp stimulation routine to boost results.
There are two basic ways to stimulate the scalp manually: One is simple massage, and the other is microneedling.
For scalp massage, all you need is your hands. Of course, you can also add in some oils, or even use a scalp stimulation tool to make it a bit easier.
I recommend performing a massage for about 5-10 minutes every day.
The second way to stimulate the scalp is with microneedling.
This is a technique used commonly to reduce scarring on the face, but it’s also proven to be beneficial in hair growth. In fact, microneedling performed alongside minoxidil treatment improved results significantly, as shown by a 2013 research study (4):
To perform microneedling at home, you can use a dermaroller. This is a handheld tool that can be easily used on a regular basis to provide you with the same effects as in-office microneedling.
An additional tool – though, a bit pricer than a traditional dermaroller – is the dermastamp (5). This tool has increased precision, and is great for beginners. However, the dermaroller works just as well, and is cheaper and more accessible.
Other Minoxidil Side Effects to Consider
When adding a new medication to your treatment regimen, it’s important to consider all potential side effects. While shedding is the most commonly discussed side effect, it’s not the only one.
The most common side effects associated with minoxidil use are irritation and rash at the site of application. This could be an indication of an allergic reaction, or it could be contact dermatitis due to one of the inactive ingredients, like alcohol.
One inactive ingredient found in many minoxidil formulations is propylene glycol. This ingredient has been shown to cause contact dermatitis which includes itching, burning, redness, rash, and irritation (6). The good news is that minoxidil formulations, like minoxidil foam, don’t include propylene glycol. This makes them an ideal alternative.
As minoxidil was initially developed as an anti-hypertensive medication, it may cause side effects such as dizziness and lightheadedness. These and other symptoms related to vasodilation are unlikely, however, as you would need to absorb a considerable amount of active ingredient to experience its vasodilative effects (7).
Shedding is common in the very beginning stages of minoxidil (Rogaine) or finasteride (Propecia) use. It’s simply a part of the process, and is nothing to be worried about in the majority of cases.
As hair cycles from the resting to growth phase it “sheds” the old, thin hair. This is so the hair follicle can enlarge and start growing new, thicker hair. This has to happen and is part of the treatment process.
It is not possible for the hair follicle to thicken an already thin hair. It has to “shed” it and start building anew.
However, if you’d rather avoid “dread shed”, or if you’re looking for a more natural, healthier alternative to minoxidil and finasteride, I recommend you follow the course of action outlined above.
While over-the-counter treatments can be effective, their positive results stop as soon as treatment does.