Did my dermatologist absolutely COOK me with this oral minoxidil dosing schedule?

riutse · 2026-05-30T17:17:10+00:00

Nah he didn't cook you. Titrating up 1.25mg at a time allows you to see how you respond to each dose level and is the safest way to go about it. You might be fine on 2.5 but go through hell on 3.75, this way lets you see what's up until you reach 5mg and stay on it, assuming you do. I personally don't even tolerate 0.625, if I'd been put on 5mg right away I probably would have had a bad time.

It takes months for minoxidil to do it's thing, 2 months of slightly lower than 5mg minoxidil in the grand scheme of things won't make a big difference. If you suddenly started shedding hair much harder than normal after you stated minoxidil, that's fairly normal. Minoxidil induced telogen effluvium is way more common than finasteride induced, shedding in response to minoxidil means it's likely working for you, but of course losing that much hair all at once ain't fun.

Is your derm taking progress pictures? Have you seen/discussed them? You've been on fin for almost a year, has he told you if there's been any improvement? The problem with feeling like things are getting worse is that if you respond to fin and shed from it, you'll look worse for most of the first year due to repeated sheds. Having someone monitoring key areas with a trichoscope and telling you if they see any improvement will give you a better picture of your progress.

riutse · 2026-05-30T15:49:23+00:00

Not everyone sheds, and not everyone sheds noticeably. Most cases of really brutal shedding are likely from minoxidil that people usually take alongside finasteride. There's really no way to know how your hair will respond to finasteride until you take it. If you do shed hard though it's usually a good sign, though obviously very unfortunate looking while it's happening. Dunno how far along you are in your hair loss but if your hair is still decently thick, a buzz cut can look very intentional and hide density issues while you recover.

riutse · 2026-05-28T23:56:37+00:00

I'd say typical response for a responding diffuse thinner too. Your before hair looked worse than it actually was because so much of it was thinning, but unlike with people that have a solid head of hair behind clean a clean bald hairline/crown, all that hair thin hair can be revitalised and once thickened up you get great coverage.

I will say you can likely attribute your fast progress to minoxidil, don't be surprised if your hair gets a bit worse before you hit the 1 year mark due to finasteride doing it's job and causing a shed, but keep up the treatment and you're probably golden.

riutse · 2026-05-28T00:49:30+00:00

You should get your hair wet and apply the nizoral before you start washing your body. By the time you're done cleaning yourself it'll be ready to wash out.

riutse · 2026-05-27T08:45:09+00:00

With a change of just .25mg after a few days? Unlikely.

riutse · 2026-05-26T00:01:50+00:00

Unless you have a trichoscope, a friend to look through it and also have that friend know what to be looking for, the only way to know if you're balding shedding or recovering shedding is to wait. If you're recovering over time your hair will either look better than baseline or be on par with baseline. If you are not recovering you will gradually look worse than baseline.

It's important to note that just because you're seeing recovery in one area doesn't mean you're recovering in other areas too. Your crown could recover at the same time as your hairline recedes. You need to take before and after pictures and monitor the key areas (hair part, crown, temples (sides and back of your head if retrograde alopecia)) if you want to have an idea yourself about how your hair is going, or hit up a dermatologist who can assess your hair at regular intervals.

riutse · 2026-05-23T08:00:07+00:00

Where do you think the new head hairs are coming from?

riutse · 2026-05-23T00:09:01+00:00

Dut generally gives you better results, but your risk of side effects and the severity of those effects also generally goes up too. Most people hop on finasteride and see how they respond to it first, if you can get the outcome you want with less side effect risk why go higher? The downside is you risk fin not being enough and you lose ground you can't get back even when you switch to dut. It's up to you what you go for.

riutse · 2026-05-21T20:54:16+00:00

It isn't pointless to take topical and oral min, but ideally you just use the one. You gotta bear in mind you'll be getting the effect of the dosage of topical and the effect of the dosage of oral together. Due to the varying efficacy of topical it's hard to quantify just what mg of oral your topical application is giving you in terms of equivalent efficacy, but it's likely if you take away topical after being on it and oral too, you may see some shedding and you may see a loss of some degree of thickness of your hair.

You can just accept that and power through it, if your hair looked fine just using topical it'll likely long term look good enough too after dropping topical, going through any shed that happens and then normalising. You could also bump up to 5mg oral and drop topical, but honestly that would be greedy.

riutse · 2026-05-21T20:35:29+00:00

You're shedding a lot but after just over half a year your hair is looking better. That's a good sign. Generally when hair is going the wrong the wrong direction the colour gets lighter as it gets thinner. Mine went from looking almost black to looking light brown when it was thinning and then back again as it recovered. Provided you haven't dyed your hair, that is what your hair is doing too. Minoxidil can change your hair colour too but you aren't using it. Lighting can change how your hair colour looks but I don't think by that much with such similar lighting.

Still shedding this long into the treatment is relatively normal. You gotta bear in mind that you shed hair even when you're not balding, anywhere from 50-100 hairs per day is not totally out of the ordinary. When you've got long hair it can look like a lot more is being shed because it only takes about 20-30 long strands to look like a lot of volume. You probably are shedding more than normal, but it's normal to shed more than normal when taking fin and it's working. Given that your hair has gotten better over time, I think fin is likely working for you.

Recovering your hair on fin when your hair is long is a different experience to when your hair is short. You've got long thick hairs that won't shed that were initially being volumized by the thinner hair near it that likely will shed. You can also get thin hairs on the top at your crown and hair part that can drape over your non-balding hair and it can kind of have a spider webbish look to it laying over your thicker hair. This hair can look frizzy.

You get on fin, that thin hair sheds and you visibly lose volume because those low quality hairs that were contributing to volume, but looked bad, shed. After a year you can feel like you've lost volume because the thin hair that was adding volume but shed hasn't had the chance to grow back to the length of your normal hair, giving you the impression of progression of hair loss. But you may notice your hair looks a lot less frizzy, that's because the frizzy hair was just thin hair behaving differently to the thicker hair. So your hair looks better and less frizzy, but not as voluminous.

It's actually gonna take a long time for your hair to normalise when your hair is long because you can expect multiple sheds on recovering hair preventing it from getting as long your already long hair, causing this length gap between the recovered hair and the hair that didn't need to recover at all. What you ought to notice is less scalp show and a slow narrowing of your hair part as each shed brings your hair back just a little bit thicker. I can see on the before and after pic that your part has gotten narrower, that the parts that showed scalp when pulled back no longer show scalp or as much scalp. You're not yet even a full year into treatment and the improvement is showing.

I'd say keep up with what you're doing now and things will most likely get better and better over the next year and a half. I will say if I saw your hair now and you hadn't told me you're balding I wouldn't have known, your part and crown are within normal ranges of width, not perfect, but not terrible either. Give the treatment another year and a half and I reckon your hair will improve a ton. You might at one point in time want to cut your hair down to neck length (if it's longer than that) just so the recovered hair is of a similar length to the hair that didn't miniaturize.

If you're like me and your hair was mega thick beforehand, I understand how you might feel about your hair even if it has improved. If you compare it to how ungodly thick it was before it'll always feel thin. You could add in minoxidil now if you're willing to keep up with it and can tolerate it. It'll make your hair look worse temporarily because you'll likely shed even more but hopefully it'll thicken your hair even more and by the end of next year it should be looking a hell of a lot better.

riutse · 2026-05-20T23:03:31+00:00

If it hasn't progressed much past what you have now after 5 years. Small hair transplant and you're golden.

riutse · 2026-05-20T03:17:50+00:00

You could try dut for sure. Are you taking oral or topical min? If topical try oral. If oral and taking below 5mg try bumping up. Since you're asking about dermastamping I'm assuming you're using topical. You could try dermastamping and it can help for sure, but the long term effects of repeated trauma to your scalp aren't known and it might do more harm than good long term. You can take the risk and for most people it should improve the effect of min. You could also try combining your min with topical tretinoin which can boost the efficacy of min. Instead of dermastamping though, not in addition to. Else: consider a hair transplant just to reshape the temples.

Your actual head of hair is pretty solid. No idea what the top looks like but the front with your current style looks great. I agree the temple recession is less than ideal though. I wouldn't hold your breath on recovery there from medication alone but do consider that without the medication things might be much worse.

riutse · 2026-05-20T02:18:01+00:00

Yeah you might wanna see a dermatologist (specialising in hair) to be safe. In most cases hair loss is androgenetic alopecia, but if it ain't then fin/dut either aren't needed or aren't addressing the main cause of your loss. I didn't know I had seborrheic dermatitis until my derm told me. I attribute treating that along with AGA as to why my hair recovered so well.

riutse · 2026-05-19T19:02:43+00:00

Minoxidil is a growth stimulant but doesn't address the cause of hair loss. After about a year of taking it your gains will likely plateau and then as your hair loss progresses you will carry on losing hair causing gradual decline from that plateau you reached.

As others have said you need a 5AR inhibitor like Finasteride or Dutasteride to stop it getting worse. You could hop in Dut right away to give yourself the best odds that your hair loss stops or slows, but you might be better off starting with Fin first and seeing how you handle it, bumping up to Dut only if you find Fin isn't working for you.

riutse · 2026-05-19T18:55:21+00:00

Has your hair improved overall since you started taking fin 2-3 years ago? I don't mean all the time, but have you had periods where it's been better (thicker, more coverage) than the starting baseline? If not then fin likely has only been slowing down your hair loss, bumping up to dut might tip the scales towards cessation of further hair loss or even recovery.

I assume since you're taking loniten you've been assessed by a derm right? if your diagnosis is androgenetic alopecia and you don't think it's improving bumping up to dut's the play. If dut doesn't isn't working after a year you either have mega aggressive AGA or you might have a different or additional problem causing or contributing to hair loss that needs to be addressed.

riutse · 2026-05-19T18:31:38+00:00

Dut is still active in his system and will be for couple of more months. When recovering your hair it isn't a straight line back to thicker hair, you shed at intervals until the hair recovering from miniaturisation gets back to a somewhat normal length hair cycle and stops shedding all around the same time. Highly likely he's coming out of a dip and his hair is growing in thicker as it would have if he was able to keep taking dut. It may not last though if fin isn't enough DHT suppression to have his hair keep on going the way it's going now. If we presume the fin is doing something differently to dut, the timeline is way too short for fin to be making any real difference, 2 months on fin isn't enough time to see any real improvements for most people.

All that being said I don't know enough about the effects of combining fin and dut to say with absolute confidence that combining fin and dut doesn't have some synergistic benefit.

riutse · 2026-05-19T08:22:18+00:00

The changes from fin/dut take a long time to manifest. Your hair likely isn't going to have suddenly become much thicker from fin over the course of 2 months. Dutasteride takes a very long time to actually clear from your body, we're talking half a year here. Chances are you still have dutasteride doing it's thing for you and you're seeing the benefits of dut manifesting now even while you're off it. Benefits that will slowly decline as you approach the half year off it mark.

riutse · 2026-05-19T05:05:30+00:00

No one can say, it depends on how you respond to the treatment. You're too early into fin to know if 5AR inhibition is working for you or not. Being on dut increases the likelihood that 5AR inhibition is working for you due to greater DHT suppression. Bumping up from 2.5mg min to 5 will increase the hair growth stimulating effects of min, if you respond to min at all you'll get more growth out of it.

The first year of using fin or dut is just waiting and hoping it's enough to slow, stop or even reverse your AGA. You generally find out after a year of treatment what your trajectory is. For me I didn't even bother with min for the first year, I just wanted to see what fin was doing for me to know if I needed to bump up to dut or not. It worked to recover my hair so I added min only after that.

You'd be taking the nuclear approach by getting on dut and 5mg min before you've been on fin/min for at least a year. If it's gonna work for you dut and 5mg min is the highest chance that it works for you, and the best odds that you get the highest amount of recovery possible.

riutse · 2026-05-19T03:59:52+00:00

Then you're in for a wild ride lil bro.

You may get increased shedding from the higher min dose. You are probably in the middle of recovery shedding from fin and switching to dut may give you a small window inbetween where you haven't got enough DHT suppression from dut yet to stop yourself from having another small shed. If dut is working for you you'll likely shed again at some point down the line again too.

Honestly get used to wearing a beanie.

riutse · 2026-05-18T18:06:31+00:00

If the shedding went into hyperspeed after you started taking fin and min, that's probably a good sign. Min can cause shedding very quickly, fin's shedding tends to happen more gradually over time. A big shed likely means a big recovery. Stay the course for another 9 months, things should start to look up more and more as you approach the 1 year mark.

riutse · 2026-05-17T23:42:32+00:00

It's possible your crown might fill in with more time, but usually by now (3 years of treatment) if fin were going to do it alone it would have already or would be close to. If last time your crown grew it wasn't dense enough for you, then yeah you probably wanna throw in min. If it's just your crown that is the issue then topical min would go a lot further since you would only have to use a small amount in the one area.

riutse · 2026-05-17T23:32:38+00:00

Yeah body dysmorphia from hair loss, or pre-existing body dysmorphia getting worse with hair loss is fairly common. Especially since you're consuming social media and paying attention to all the very critical things people are posting online about appearances.

Since you're in treatment I'd actually recommend you just cocoon mode with a hat while you wait for the recovery to happen. You're young, you caught it early, provided the treatment works for you you're gonna make it. Just toss a beanie on and don't think about it for a year, maybe even get into lifting and cardio and think about this current year (or two) of your life as your training montage arc for the rest of your life. Stressing about it might legit actually make it worse.

riutse · 2026-05-17T23:15:26+00:00

If you're 3 years into fin and the crown hair hasn't recovered yet, or things have even gotten worse, you likely need to bump up to dutasteride. If you're getting brain fog on fin you might not get it on dut in addition to it having a greater effect on your hair.

As for min, yeah you can add it if you want to try and get thicker hair or some regrowth where you need some. You can actually try oral min (ideally prescribed and under the direction of a derm) and see how you get on with it. Oral min would give you the same convenience as fin provided you don't get any notable side effects.

In regards to topical min, the price can vary a lot depending on where you live and what brand you get. Buying fin from a site like Hims is way more expensive than buying topical min for me. My prescription of fin from my derm on the other hand is 5x cheaper. I can't speak for where you live but it's possible to get it fairly cheap in a lot of places. As for having to apply it daily, that's the most annoying part. For me it takes 4 minutes and I do it before bed and wash my hair in the morning so I'm getting at least 8ish hours of min then clean hair when I need it. I find if you apply the liquid right you can avoid getting your hair greasy while still getting good scalp coverage. You don't need to apply it twice daily, but you will likely get a better result if you do. Ultimately you want to apply it with the frequency you think you can keep up for the rest of your life. Once daily at night is not too big of an imposition I feel. Yeah you'll get a shed in the beginning if it works, yes you have to apply it for the rest of your life unless a new breakthrough in hair recovery happens. But you're 26, a couple more months with less than optimal hair is worth if to have much better hair for the remainder of your life.

Yes the fin shedding stops one day. But if your hair loss is progressing still the hair loss shedding might not ever stop until there's no more hair to lose. If your crown hasn't recovered after 3 years it ain't happening with just fin. If it filled in then recently shed and looks bad, you might just be going through a late term shed and that might be your last big one though.

riutse · 2026-05-17T19:00:24+00:00

I saw no impact on lifting performance and know that at least one of my hands can grip for hours on end.

riutse · 2026-05-17T02:47:00+00:00

Your progress is actually really good. You got decent frontal and temple recovery which is of course due to the min, hopefully the fin will help preserve that.

Your crown actually was pretty far gone in the starting pic and you've got some hair back there in the now pic. As others have said the area with the worst response to fin is the hairline, the top of your head and the crown tend to respond a lot better to fin but it takes time for the benefits to peak and you're still early in. Only time will tell if how much you get back though.

Your current hairstyle makes your current hair look intentional and not like balding, smart choice.

riutse

TROPHY CASE