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Elderly individuals who use minoxidil may experience increased sensitivity to cold temperatures. These side effects may be temporary and naturally resolve once your body adjusts to the medication. Most of the side effects of minoxidil go away when you stop using the product. Some people tolerate the foam products better than the solution, as the solution contains more of a compound called propylene glycol (which can irritate the skin). However, if it’s been six months, and the shedding gets worse or you don’t see any results, it could be a sign of other underlying hair loss disorders. Although, you may start to notice improvements as soon as two months.
Why Does Rogaine (Minoxidil) Cause Hair Shedding?
There has been an increase in the use of a novel formula, minoxidil sulfate-based solution (MXS) since it is an active metabolite of minoxidil. Side effects were tolerable irritation, erythema, and folliculitis.46 Therefore, we believe that MXS is a promising agent for those who are MS non-responders. When people seek a prescription treatment for a non-approved purpose, this is called “off-label” prescribing. Off-label prescribing of oral minoxidil, potentially for use in alopecia, may have contributed to shortages of Loniten® tablets in recent years. This can reduce availability of this medicine for people who need it for high blood pressure. While it may seem counterintuitive, an initial increase in hair loss may be a sign minoxidil is stimulating your hair follicles.
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It typically isn’t covered by insurance, and it can be expensive, Mirmirani says. Alopecia areata is an autoimmune disease that causes hair to fall out in nickel- or quarter-size patches. “Your body’s immune system is attacking the hairs,” Brodell says.
Alternative Remedies for Hair Growth
Topical minoxidil (generic Rogaine) has no known drug interactions. However, you should avoid using other skincare products—especially those that contain alcohol—in the same area you apply minoxidil unless approved by a healthcare provider. You can use hair color, relaxers, and perms, but wash the scalp before applying the hair treatment. Also, you should not use minoxidil 24 hours before or after the hair treatment. When people seek a prescription treatment for a non-approved purpose, this is called "off-label" prescribing.
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What are the potential benefits of using minoxidil?

The telltale signs of these conditions are chronic inflammation of the scalp and the scarring of hair follicles, which can result in irreversible hair loss, Agbai notes. Alopecia areata is an autoimmune condition that is characterized by “round patches of hair loss on the scalp,” although it can occur elsewhere on the body, Agbai says. While the exact reason for this type of hair loss is unknown, it is generally understood that “the immune system mistakenly attacks hair follicles, leading to hair loss,” she adds. A 2021 review of 15 studies — including several large randomized control trials that are the gold standard for medical research — found that laser therapy increased hair count in both men and women.
If it doesn’t subside after two weeks, however, you might consider consulting with a doctor. If you experience any hair damage, it might be caused by other irritants, like over-the-counter hair dye or other chemical products. Topical minoxidil has been approved by the FDA for the treatment of AGA. Minoxidil is a medication that increases new hair growth in cases of hereditary hair loss. You can apply this topical solution or foam on your scalp to promote hair growth. Early in treatment you might notice a temporary increase in hair shedding, as it alters the hair cycle to make way for new growth.
Can you prevent minoxidil shedding?
Evidence notes that when a person quits smoking, it is possible to undo some of the damage caused by the harmful effects of smoking. For example, within a couple of weeks to a few months, a person’s circulation may improve. Dr. Fu and colleagues noted that the earliest time point at which LDOM should be expected to demonstrate efficacy is 3-6 months. “Baseline testing is not routine but may be considered in case of identified precautions,” they wrote. If you have alopecia, you can help hold onto your tresses by avoiding behaviors that are known to contribute to temporary and permanent hair loss, Mirmirani says. A review study published in 2022 found that it significantly increases hair diameter and hair count in patients with several types of alopecia.
Pharmacology of topical minoxidil
A scalp enzyme called sulfotransferase converts the minoxidil into a salt called minoxidil sulfate. It works by shortening the telogen, or resting, phase of the hair and causes the hair to enter the anagen or growing stage. There is some evidence that minoxidil can increase the thickness of the hair.
This medication, which is sold under the brand name Propecia, is FDA-approved to treat hair loss, specifically in men with androgenetic alopecia. Some providers have prescribed low-dose oral minoxidil for the off-label treatment of hair loss, and research has found the treatment has generally been effective. Here's what to know about using minoxidil orally for hair loss—and how to bring it up to a dermatologist. In 1987, scientists developed a topical minoxidil solution that is suitable for treating hair loss in both males and females. The solution is available in either a 2% or 5% concentration.
Rogaine is most effective for people who start using it at the first indications of hair loss. Minoxidil only works for people that have the SULT1A1 enzyme. To find out if you have it, take the Daniel Alain Minoxidil Response Test.
However, the pills have been researched regarding their off-label use, or the way a medication can be used beyond treating certain conditions. Rogaine (minoxidil) is an over-the-counter medication that you apply to the scalp for hair loss. Rogaine works by improving blood flow to the hair follicles, which increases the size and strength of hair strands and stimulates hair growth.
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While hair shedding is evident, according to the American Academy of Dermatology Association, minoxidil showed its effectiveness in promoting hair growth rates in both men and women. Even though you might see your hair thinning, it’s a sign that the treatment is working. Shedding old hair encourages extending the growth phase, promoting more new hair growth than usual. Since Rogaine isn’t appropriate for all types of hair loss, it’s important to get a correct diagnosis from your doctor before starting this product, even though it’s widely available over the counter. Rogaine works only for certain types of baldness and only if you keep up with its application.
Also tell them if you smoke, drink alcohol, or use illegal drugs. You can read the consumer medicines information sheet for more information about using over-the-counter minoxidil products. Propecia is expected to work better than Rogaine, but these medications have not been directly compared in clinical trials. Keep in mind you need a prescription for Propecia, while Rogaine is available OTC.
As long as you continue to treat your hair with the Rogaine, you should start to see improved hair growth in about four months. When Rogaine boosts hair growth, it pushes out the smaller finer hairs that were already on their way to being shed. As your thin, fine hairs begin shedding, thicker hairs will soon take their place. It’s important to stick to the plan and continue using Rogaine every day even though it can be nerve racking watching your hair fall out at the beginning.
Absorption into the body may affect the heart and blood vessels and cause unwanted effects. Appropriate studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of topical minoxidil in the elderly. However, studies have shown that the medicine works best in younger patients who have a short history of hair loss. Minoxidil has not been studied in patients older than 65 years of age . If you’re dealing with male- or female-pattern hair loss, you have a variety of treatment options at your disposal. In a nutshell, topical minoxidil helps stimulate hair growth or slow balding when applied to the scalp once or twice a day.
Rogaine can lead to unwanted hair growth on the face if the medication comes into contact with it. Rogaine has a shelf life of two to three years, depending on the formula. Keep the product at room temperature conditions of 68 to 77 degrees Fahrenheit. High temperatures can cause the product to lose effectiveness. Also, the product could be flammable and should be discarded after the expiration date. Even though there’s no assurance that you won’t shed during this period, several minoxidil users noticed shedding.
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