Why hair loss starts again after we stop using minoxidil products?

Minoxidil is a medication that is FDA approved for treating androgenetic alopecia (also called male and female pattern hair loss). You are correct that the medication needs to be used continuously - or all benefits go away.

Essentially, minoxidil is a chemical that provides hairs with new instructions on "how to grow"

Here's an example I often review with my own patients as to why minoxidil needs to be used continuously.

During youth, hair follicles have a specific set of instructions on how to grow. Let's call this "manual 1". Everyday the hair grows, it follows the rules laid out in "manual 1"

In someone who develops genetic hair loss, hairs get handed a new manual - "manual 2". This new manual tells hairs to grow slower and become skinnier. That's what genetic hair loss is all about. Some people get handed this new manual in the 20s, and others at age 30 or 40. Some people's hair follicles never get handed this manual and continue following the instructions laid out in "manual 1"

Following the same example, minoxidil provides the hairs with yet another manual - "manual 3" - and a whole new set of hair growth instructions. For some people, hairs can easily follow the instructions in "manual 3" and these people get improvement in their hair but for other people, the hairs don't seem to follow "manual 3" and the hairs only adhere to the instructions in "manual 2".

But suppose minoxidil is working well and now you stop it. Well, the "manual 3" instruction book gets thrown out and all the hair has to rely on is the previous "manual 2"- the instruction book that tells hairs to get thinner over time.

Minoxidil is not a cure - but rather a stimulant for hair growth. It needs to keep being used if one wants hairs to follow a hair growing pathway!

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Jeff Donovan MD PhD FRCPC FAAD
US & Canadian board-certified Dermatologist
Toronto, Canada

Yes, that is exactly what happens. Minoxidil needs to be used continually. If treatment is stopped the hair that has grown disappears and you revert back to the way you first were. To avoid this from happening keep on using minoxidil.
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