Minoxidil grows hair every time fast on my face and micro hairs on the scalp

Xander94

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But never restores terminal hairs. Why is that?

What kind of scalp skin changes occur that minoxidil cannot reverse
 

Norwoody

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This is a good question, albeit with no simple answer.

I have experienced an increase in vellus hair on minoxidil and I believe other treatments as well. Some of those hairs are NW0 and won't really ever go terminal unless I was to do something like HRT.

Getting them to turn terminal is going to be a matter of 1. how extreme are you willing to go with your treatments 2. what are you currently taking 3. genetics / when were they last terminal, if ever.

Minoxidil alone is still powerful enough for most to get some kind of regrowth, but a lot of times it is not going to be powerful enough to regrow a significant amount of hair in the NW1 area. If you caught it very very early, maybe there is an exception. But in general, the lower the Norwood area the hair is in, it seems the hair in those areas is generally more sensitive to androgens and the more dependent on estrogens. Essentially, you have a few "sprouts" but they will require a very specific environment in order to thrive and extend their growing phases.

I think what gives us the best chance is trying to do as well-rounded of an approach as we can. If you have vellus in NW3 and beyond territory, and the follicles haven't completely died, I think that it is going to be a lot easier to gain those back, as hormonal sensitivity/dependency is usually weaker in those areas compared to NW0-1 areas. The genetic pattern is important there too. This is why people lose hair in the very front of the hairline or in the very of the center of the crown before it gradually progresses outwards.

Ways that we can address the scalp to promote an environment for increased growth:

1. Decrease androgens
A. Decrease BOTH main types of androgens (use antiandrogens that address both DHT AND T)
B. Inhibit T from converting to the more potent DHT

2. Increase estrogens

3. Stimulate / restore blood flow (minoxidil, stemoxydine, dermarolling, castor oil, massage, etc)

4. Reduce scalp inflammation (ketoconazole, other shampoos, anything that reduces the itch)


The most common way of addressing this problem in the hair loss community is 1B, 3, and 4. And sometimes 1A. Few go the estrogen route, unless one is transitioning, as the risk of things like gyno goes up, especially if combined with 1A and 1B.

Obviously, those who are transitioning are willing to (or even welcome) side effects that increase feminization. And there are plenty of them who have regrown NW0 hairlines. However, I think it's possible to try and address all of these things, for some individuals, without a risk of de-masculinizing effects if that is the goal. Someone might handle a topical antiandrogen (or even a systemic one), use finasteride or duta, use low dose of topical or systemic forms of E, minoxidil in liquid or oral form, needle, and other treatments. The problem for most is they cannot tolerate side effects from certain treatments and are losing the battle in a few key areas. For example, if you can't handle a 5ARI, or estrogen, then usually you're going to have a very hard time trying to restore NW1 hair.

But I think the bottom line is that you need to attack as many of these areas as is possible for the individual, even if the dosage is small because it provides at least some kind of protection and contributes to an environment where hair can thrive. Sometimes people can get serious regrowth by loading up on less treatments, but often that leads to definite side effects.

Hope this helps
 

LouisSarkozy

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But never restores terminal hairs. Why is that?

What kind of scalp skin changes occur that minoxidil cannot reverse
do you notice negative skin cahnges on minoxidil ( wrinkles etc ) and if so how do you negate them if you manage to. saw another reddit post success story with min i want to go back on minoxidil badly i'm an ultra responder to Telogen Effluvium drug but it fucks me up everytime i go back on it
 
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Norwoody

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do you notice negative skin cahnges on minoxidil ( wrinkles etc ) and if so how do you negate them if you manage to. saw another reddit post success story with min i want to go back on minoxidil badly i'm an ultra responder to Telogen Effluvium drug but it fucks me up everytime i go back on it
I've been hearing that tretinoin helps topical minoxidil's efficacy by increasing sulfotransferase in the scalp.
 
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