Questions About Combining Treatments

ZombiesOMG · Nov 14, 2016

Hey everyone,

I have some questions about treatments for hair loss that I'm hoping someone can answer. First of all, I'm 27 and my hair has started thinning/falling out at the temples (the dermatologist made it sound like it's thinning at the crown too, but I can't see it). The hair loss seems to have started rather suddenly--in the last 3 months or so--even getting slightly worse in the 3 weeks between scheduling an appointment with a dermatologist and the actual appointment.

When I talked with the dermotologist he gave me the option of either minoxidil or finasteride and said I could also combine them as some people have better results doing so. I went ahead and got a prescription for finasteride since it seems to be the first line of defense from what I've read online.

My questions now are this: should I start using the minoxidil too or would it be better to wait and see what results I get from the finasteride first? Obviously I'd like to stop the hair loss and regrow as much as possible, but I also don't want to have to use more products than necessary since I'll have to use them for life. Also, if I wait to see how the finasteride works how long should I do so and is there any chance the minoxidil will be less effective if I wait as opposed to starting it now?

Lastly, and somewhat unrelated, when people say it takes at least 3 months to start seeing results, what do they mean by "results?" Regrowth? Cessation of hair loss?

I feel like I've taken the most important step, but these other questions are still nagging me. Thanks in advance.

science_d · Nov 15, 2016

ZombiesOMG said:
Hey everyone,

I have some questions about treatments for hair loss that I'm hoping someone can answer. First of all, I'm 27 and my hair has started thinning/falling out at the temples (the dermatologist made it sound like it's thinning at the crown too, but I can't see it). The hair loss seems to have started rather suddenly--in the last 3 months or so--even getting slightly worse in the 3 weeks between scheduling an appointment with a dermatologist and the actual appointment.

When I talked with the dermotologist he gave me the option of either minoxidil or finasteride and said I could also combine them as some people have better results doing so. I went ahead and got a prescription for finasteride since it seems to be the first line of defense from what I've read online.

My questions now are this: should I start using the minoxidil too or would it be better to wait and see what results I get from the finasteride first? Obviously I'd like to stop the hair loss and regrow as much as possible, but I also don't want to have to use more products than necessary since I'll have to use them for life. Also, if I wait to see how the finasteride works how long should I do so and is there any chance the minoxidil will be less effective if I wait as opposed to starting it now?

Lastly, and somewhat unrelated, when people say it takes at least 3 months to start seeing results, what do they mean by "results?" Regrowth? Cessation of hair loss?

I feel like I've taken the most important step, but these other questions are still nagging me. Thanks in advance.

It is true that using finasteride and minoxidil together produces a more powerful effect than using either one on its own (http://press.endocrine.org/doi/abs/10.1210/jcem.74.2.1309834). However, there is nothing wrong with testing how well one of them works on its own, if you want to try out various regimens.

Is it "better" to wait and see what results you get from finasteride first? If by "better" you mean more effective, the answer is almost certainly no. Adding minoxidil to finasteride will most likely lead to the BEST outcome when it comes to hair regrowth. However, it is possible finasteride would lead to satisfactory results for you, so there is nothing wrong with testing that first and seeing if it does what you want it to.

If you're going to test a treatment, use it consistently for 6 months, not 3 months. That is when a treatment will be showing results (if it is working), based on the human hair growth cycle. "Results" typically means regrowth of hair that was miniaturized, which is often manifested by a greater density and/or more hair in areas that were thinner at the beginning of treatment. However, in my opinion, cessation of hair loss would seem to be a positive result too.

My suggestion is to use finasteride consistently for 6 months; if you see positive results at the end of 6 months and are satisfied, then you don't have to worry about minoxidil and can simply keep taking finasteride. However, if you want an extra "kick" to your hair growth, adding minoxidil would almost certainly help a lot.

ZombiesOMG · Nov 15, 2016

science_d said:
It is true that using finasteride and minoxidil together produces a more powerful effect than using either one on its own (http://press.endocrine.org/doi/abs/10.1210/jcem.74.2.1309834). However, there is nothing wrong with testing how well one of them works on its own, if you want to try out various regimens.

Is it "better" to wait and see what results you get from finasteride first? If by "better" you mean more effective, the answer is almost certainly no. Adding minoxidil to finasteride will most likely lead to the BEST outcome when it comes to hair regrowth. However, it is possible finasteride would lead to satisfactory results for you, so there is nothing wrong with testing that first and seeing if it does what you want it to.

If you're going to test a treatment, use it consistently for 6 months, not 3 months. That is when a treatment will be showing results (if it is working), based on the human hair growth cycle. "Results" typically means regrowth of hair that was miniaturized, which is often manifested by a greater density and/or more hair in areas that were thinner at the beginning of treatment. However, in my opinion, cessation of hair loss would seem to be a positive result too.

My suggestion is to use finasteride consistently for 6 months; if you see positive results at the end of 6 months and are satisfied, then you don't have to worry about minoxidil and can simply keep taking finasteride. However, if you want an extra "kick" to your hair growth, adding minoxidil would almost certainly help a lot.

Thanks for the reply. I guess I'll try the finasteride alone for 6 months like you said to see how that goes before starting the minoxidil.

My main fear is that if I wait and I'm not happy with the results from the finasteride alone that the minoxidil will be less effective or I'll have more irreversible hair loss than if I hadn't waited. I don't want to see things get worse or miss an opportunity because I didn't start with the minoxidil right away.

science_d · Nov 16, 2016

ZombiesOMG said:
Thanks for the reply. I guess I'll try the finasteride alone for 6 months like you said to see how that goes before starting the minoxidil.

My main fear is that if I wait and I'm not happy with the results from the finasteride alone that the minoxidil will be less effective or I'll have more irreversible hair loss than if I hadn't waited. I don't want to see things get worse or miss an opportunity because I didn't start with the minoxidil right away.

No problem. I wouldn't worry about that too much, as the finasteride will be halting or slowing down the thinning process during the entire 6 months you are using it (remember, it takes 6 months to NOTICE the results, but finasteride acts immediately when you start using it). Also, 6 months isn't that long, so if you are not happy after 6 months of finasteride alone (which is when you can accurately assess how well it is working), you can immediately add minoxidil before you would ever lose any significant amount of hair "irreversibly," which I doubt will happen anyway. This is how I would do it if I were in your shoes, so my advice is based on that. (The only situation in which I would not recommend this is if your hair loss is very aggressive.)

I also think it is important to warn you that when you start to use a treatment, sometimes your hair loss will appear to get much worse in the form of increased shedding and/or your hair feeling thinner. This is normal, as treatments can force dormant "telogen" hairs to fall out in order to make room for new hair growth. So don't be alarmed if your hair seems worse from Month 1 - Month 4 after starting to use finasteride. Hang in there and be diligent, use the treatment consistently for the full 6 months before drawing any conclusions and making your assessment.