Hair Loss Gets Worse After Using Hair Loss Medicine... Is This Normal?

Source - PharmNews

Minoxidil

"After applying minoxidil, it seems like my hair is falling out more... should I stop?"

This is one of the most common questions asked at hair loss clinics.

Many people are shocked to see more hair falling out not even a month after starting minoxidil.

They end up feeling very confused, wondering whether the medicine is wrong or whether the hair loss has simply gotten worse.

But this shedding phenomenon may actually be a positive sign.

“Shedding” is a temporary hair loss phase that can occur shortly after using minoxidil.

Because hair continues to fall out even after treatment has begun, many people feel anxious, stop treatment, or start questioning whether it works.

However, shedding should not necessarily be seen only as a side effect.

It is more likely a transition process for new hair to grow.

It is like a tree dropping old leaves to make room for new ones.

So, can shedding actually be an indicator that predicts treatment effectiveness?

A retrospective study published in the 2025 issue of the Journal of Dermatological Treatment examined the correlation between shedding response and treatment effectiveness after minoxidil use in 232 male pattern hair loss patients from 2020 to 2022.

• About 57% of participants experienced shedding, and some felt as if their hair loss had temporarily worsened.

• However, the group that experienced shedding showed better long-term results from minoxidil.

Group	Shedding Rate	Hair Improvement Rate After 6 Months
Shedding present	56.9%	72.7% improvement
No shedding	43.1%	54.3% improvement

This statistical difference was significant and suggests that patients who experienced shedding were more likely to later have thicker and healthier hair.

The mechanism behind better results after minoxidil shedding is explained as follows.

• Minoxidil rapidly shifts hair follicles in the telogen phase into the anagen phase, and in the process, the existing weak and old hairs fall out first.

• New, healthy hair then grows in their place, improving hair density and thickness.

In other words, shedding may be the beginning of regeneration rather than just loss.

On the other hand, if there is no shedding, does that mean the treatment has failed? Not necessarily.

The absence of shedding does not mean the treatment is ineffective.

This is because various factors are involved, such as an individual’s genetic traits, the degree of hair loss progression, and follicle sensitivity.

That said, if shedding does occur, it can be understood as a positive sign that the treatment is working.

Rather than feeling anxious, it is important to understand it as a turning point and continue treatment.

Now it is time for hairhair, Kim Jino.

Pilsaengsinmo (必生新毛).

References

Bi, L., Kan, H., Wang, J., Ding, Y., Huang, Y., Wang, C., Du, Y., Lu, C., Zhao, M., Sun, W., Su, T. and Fan, W. (2025). Whether the transient hair shedding phase exists after minoxidil treatment and does it predict treatment efficacy? A retrospective study in androgenetic alopecia patients. Journal of Dermatological Treatment, 36(1), p.2480739. https://doi.org/10.1080/09546634.2025.2480739

[This post was written directly by a plastic surgery specialist for informational purposes in accordance with Article 56, Paragraph 1 of the Medical Service Act. Hair transplant surgery and treatment may have side effects, so please make a careful decision after consulting with a specialist.]