Can I reduce the dose of minoxidil for treating my AGA and if so, how?
Minoxidil (Rogaine) for the treatment of Androgenetic Hair loss: How soon after starting can I go down on the dose?
I’ve selected this question below for this week’s question of the week. It allows us to the review some key concepts in the treatment of androgenetic alopecia - particularly the need for ongoing lifelong treatment.
Question
I have female pattern hair loss and I’ve been on minoxidil 1/2 cap daily for about 1 year now. It seems to be helping. I was advised this week by my provider that it’s okay to go down to 3 or 4 times weekly. What protocol do you recommend for reducing the dose and how do you taper safely so as to not lose hair?
Answer
Thanks for the question. The answer is simple: If you have androgenetic alopecia and Rogaine is helping you, then this medication probably can’t be tapered to any significant degree without you losing some hair.
If Rogaine has not been helping you all these months and you’ve actually been wasting your time in the last 12 months applying it - you can stop it without any immediate negative effects. The hair won’t mind at all that Rogaine was stopped because it wasn’t helping in the first place.
However, if Rogaine was helping (which I imagine for you it probably must be), it can NOT be tapered without losing hair. I don’t know how this concept has started permeating in this world - I’ve heard it myself. But Rogaine can’t be stopped if it was helping. You can’t go from 7 days a week to 5 without some negative effect on the hair. You can’t go 7 days to 4. You can’t go twice daily to once daily. Sure you might be able to go 7 to 6 but there’s a fine line for what its acceptable.
If all a person is able to do is apply Rogaine 5 or 6 days per week, then I say try to apply it five or 6 days per week. That’s fine. It still has a chance of helping even if it’s not perfectly daily. . But to start at a higher dose and then reduce the dose at a future time just doesn’t work well for most people.
Reducing the dose of Rogaine usually leads to hair loss (if it was helping). Consider the female patient who starts using Rogaine 5% twice daily because she really wants to try to stop her hair loss, or the patient who even uses a full cap instead of the recommended 1/2 cap. Then, imagine that the patient winds up in the clinic of a specialist 12 months later and the specialist says confidently to her“Oh, Rogaine for women only needs to be used once daily at 1/2 cap - so you can reduce your dose”
Guess what happens when the patient goes from a full cap twice daily to 1/2 cap daily?
She loses hair! !!!!!!
Hair is not pleased with a four-fold reduction in the dose.
Summary and Conclusion
All the treatments for androgenetic alopecia are lifelong. If a patient is going to use Rogain to treat their AGA, then they should plan to start it with the intention to use it lifelong. If a patient is going to use anti androgens to treat their AGA, then they should plan to start it with the intention to use it lifelong. If a patient is going to use low level laser therapy to treat their AGA, then they should plan to start it with the intention to use it lifelong. If a patient is going to use PRP therapy to treat their AGA, then they should plan to start it with the intention to use it lifelong.
We would to think that it’s possible to reduce the dose of Rogaine after some time. It sure sounds like a nice plan …. and a convenient one too! It’s just that it doesn’t really work like this and reducing the dose carries a high risk of hair loss.
Now for all the people who are using Rogaine for other types of hair loss besides androgenetic alopecia - the rules are a bit different. If one uses Rogaine for alopecia areata, one can stop Rogaine once the hair grows back. Sometimes (but not always) that’s true for other types of hair loss as well. But for androgenetic alopecia the rules are pretty straight forward. If a certain dose or amount of Rogaine has helped, then that dose or amount needs to bee continued exactly the same way to maintain results. A reduction in dose will likely lead to hair loss.
The following chart is helpful to differentiate the use of Rogaine in these conditions
