Topical minoxidil is one of the most popular and effective treatments for regrowing hair. That’s why it may seem counterintuitive that it can cause temporary hair loss. The truth is, this side effect is commonly the first sign that the treatment is working. 

Minoxidil hair shedding is a normal and expected side effect of starting topical minoxidil. Read on to learn about why it happens and how long you can expect it to last. 

What causes minoxidil hair shedding?

Minoxidil is most widely known for its role in treating hair loss. So, you might be surprised to learn that this medicine was initially developed to treat hypertension (high blood pressure).¹ However, researchers discovered an intriguing side effect: It could stimulate hair growth.²

Today, topical minoxidil is widely recognized and approved for treating androgenic alopecia, a common form of hair loss.³

To understand why minoxidil can cause hair shedding, it helps to understand the hair growth cycle. 

The hair cycle

Hair growth isn’t continuous, but occurs in phases:⁴

• Anagen: The growing phase

• Catagen: A transitional phase

• Telogen: The resting phase

The anagen phase, which can last from 2 to 7 years, determines the length of our hair.⁵ After this, hair enters the brief catagen phase (around 2-3 weeks) before moving into the telogen phase, which lasts about 2 to 4 months.⁶ After the hair completes its life cycle, it falls out to make way for a new hair and the cycle begins again. 

How minoxidil affects the hair cycle

When minoxidil is applied, it primarily affects these phases in two significant ways. Firstly, it shortens the telogen phase, pushing dormant hairs out so they can reenter the growth phase sooner than they would naturally.⁷ This premature transition can lead to a phenomenon known as telogen effluvium, where increased hair shedding is observed.⁸ 

This shedding is somewhat comparable to skin purging observed during the initial phase of acne treatment. Essentially, it’s a commonly known potential side effect, although it can be a bit unsettling at first.

Simultaneously, minoxidil extends the duration of the anagen (growing) phase. This not only increases the length of the hair but also its thickness.⁹ Over time, this leads to visibly fuller and denser hair.¹⁰ So, while initial hair shedding might be disconcerting, it is a transitional phase towards healthier hair growth.

Minoxidil isn’t an instant solution—it requires patience and consistency. Typically, patients may begin to see hair regrowth within 4 to 8 months of consistent use, the results stabilizing after 12 to 18 months.¹¹ Using the medication as directed is crucial to achieve the best outcomes.

In summary, minoxidil hair shedding is a temporary phase that occurs due to the medication’s effect on the hair cycle. It accelerates the transition of hair follicles from the resting to the growing phase, which can initially cause shedding. Over time, this leads to longer, thicker hair.

Can you prevent minoxidil shedding?

Experiencing hair shedding during the initial weeks of using minoxidil can be concerning, but it’s important to understand that this is a common part of the treatment process. About 18% of patients using topical minoxidil report a transient increase in hair loss in the first few weeks of treatment.¹²

This shedding is a common potential side effect. It’s a temporary phase that many (but not all) users experience.

To maintain the benefits of minoxidil, you’ll have to use it indefinitely to sustain hair growth. If you stop treatment, you can expect the hair shedding to resume within 3 to 4 months.¹³ 

This is because minoxidil doesn’t cure the underlying cause of hair loss; it only treats the symptoms. If you stop treatment, the hair follicles will eventually return to their previous state, leading to renewed hair loss.

Beyond hair loss, are there other potential side effects when starting minoxidil?

When you start using topical minoxidil to address hair loss, it’s reassuring to know that it’s generally well-tolerated.¹⁴ However, like any medication, topical minoxidil can have side effects that you should be aware of.

Here are some side effects you might experience:

Skin irritation: You might notice some redness or irritation on your scalp where you apply minoxidil.¹⁵ If it becomes bothersome or severe, it’s worth discussing with your healthcare provider.

Scaly changes of the scalp: For some, minoxidil can worsen seborrheic dermatitis, which causes flaky, scaly patches on the scalp.¹⁶ If you already have this condition, monitor your scalp closely when starting minoxidil.

Itching: A feeling of itchiness on your scalp after application is another possible side effect. Usually, this is mild and temporary.¹⁷ 

Allergic contact dermatitis: Although rare, some people might be allergic to minoxidil, leading to symptoms like redness, itching, or swelling.¹⁸ 

Hair overgrowth: In some cases, minoxidil can cause hair to grow in areas other than the scalp, especially if the medication accidentally spreads to other parts of your face or body.¹⁹

When to see a healthcare provider about hair shedding

When you start a minoxidil treatment for hair loss, it’s common to experience some initial hair shedding. This can be concerning, but it’s a normal response in most cases, and you won’t need a visit to a healthcare provider. This shedding phase usually resolves on its own after a few weeks.²⁰

However, if you notice your hair is still shedding significantly after this initial period, it might be time to consult your healthcare provider. Persistent hair shedding could indicate other underlying health issues that need to be addressed.²¹

Several factors other than minoxidil could contribute to ongoing hair shedding, including but not limited to:²²

• Stress

• Hypothyroidism

• Hormone changes

• Medications

• Nutrition deficiencies

Your healthcare provider can help determine if these or other factors are contributing to your hair shedding. They may recommend blood tests, changes in medication, dietary adjustments, or other interventions based on your specific situation. 

Remember, while hair shedding can be a normal part of starting minoxidil, persistent or severe shedding should be evaluated to ensure no other underlying causes.

Here’s how Curology can help

While you don’t need a prescription for certain strengths of topical minoxidil, it can still help to talk to a licensed healthcare provider, like those at Curology. We’ve been providing custom treatments for skin conditions like acne, rosacea, and signs of aging. Now, Curology also offers prescription-strength formulations to help treat hair loss with our Hair Formula Rx. 

Get your personalized skincare routine with Curology

Get your personalized skincare routine with Curology

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Getting started is easy!* You’ll be paired with one of our licensed dermatology providers who can help you decide if topical minoxidil is right for you. 

P.S. We did the homework so you don’t have to: 

1. Patel, P., et al. Minoxidil. StatPearls. (2023, December 4).

2. Patel, P., et al. Minoxidil. StatPearls. Ibid.

3. Patel, P., et al. Minoxidil. StatPearls. Ibid.

4. Al Aboud, A.M. & Zito, P.M. Alopecia. StatPearls. (2023, April 16).

5. Al Aboud, A.M. & Zito, P.M. Alopecia. StatPearls. Ibid.

6. Al Aboud, A.M. & Zito, P.M. Alopecia. StatPearls. Ibid.

7. Patel, P., et al. Minoxidil. StatPearls. Ibid.

8. Patel, P., et al. Minoxidil. StatPearls. Ibid.

9. Patel, P., et al. Minoxidil. StatPearls. Ibid.

10. Nestor, M. S., et al. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. Journal of Cosmetic Dermatology. (December 2021).

11. Nestor, M. S., et al. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. Journal of Cosmetic Dermatology. Ibid.

12. Müller Ramos, P., et al. Female-pattern hair loss: therapeutic update. Anais Brasileiros de Dermatologia. (July-August 2023).

13. Suchonwanit, P., et al. Minoxidil and its use in hair disorders: a review. Drug design, development and therapy. (2019, August 9).

14. Patel, P., et al. Minoxidil. StatPearls. Ibid.

15. Patel, P., et al. Minoxidil. StatPearls. Ibid.

16. Patel, P., et al. Minoxidil. StatPearls. Ibid.

17. Patel, P., et al. Minoxidil. StatPearls. Ibid.

18. Patel, P., et al. Minoxidil. StatPearls. Ibid.

19. Patel, P., et al. Minoxidil. StatPearls. Ibid.

20. Müller Ramos, P., et al. Female-pattern hair loss: therapeutic update. Anais Brasileiros de Dermatologia. Ibid.

21. Hughes, E.C. & Saleh, D. Telogen Effluvium. StatPearls. (2023, May 29).

22. Hughes, E.C. & Saleh, D. Telogen Effluvium. StatPearls. Ibid.

23. Müller Ramos, P., et al. Female-pattern hair loss: therapeutic update. Anais Brasileiros de Dermatologia. Ibid.

24. Nestor, M. S., et al. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. Journal of Cosmetic Dermatology. Ibid.

25. Müller Ramos, P., et al. Female-pattern hair loss: therapeutic update. Anais Brasileiros de Dermatologia. Ibid.

26. Müller Ramos, P., et al. Female-pattern hair loss: therapeutic update. Anais Brasileiros de Dermatologia. Ibid.

27. Nestor, M. S., et al. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. Journal of Cosmetic Dermatology. Ibid.

28. Nestor, M. S., et al. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. Journal of Cosmetic Dermatology. Ibid.

Camille Dixon is a certified Physician Assistant at Curology. She received her Master of Medical Science in Physician Assistant Studies from Midwestern University in Downers Grove, IL.

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Written by

Curology Team

Medically reviewed by

Camille Dixon, PA-C