6 bottles of Kirkland Minoxidil beside balding man's head

Minoxidil DOES NOT Prevent Hair Loss – Read This Before Using It!

Why Minoxidil Does Not Prevent Hair Loss

The first thing you need to know before you start using Minoxidil is that Minoxidil does not prevent hair loss.

Typically, when a man starts noticing male pattern baldness, he may go to his doctor and say, “I'm losing my hair, what do I do?”

More often than not, a doctors' first recommendation will be Rogaine (Minoxidil).

Kirkland Minoxidil bottle and Rogaine bottle

What you need to understand about Minoxidil is that it does absolutely nothing to prevent hair loss, despite it being FDA approved for hair loss prevention.

You need to understand the mechanism of how it works first before you start slapping this stuff on your head.

There is some data that implies it may have an anti-androgen like effect, but the majority of Minoxidil's efficacy stems from its ability to increase circulation to hair follicles.

Minoxidil is a vasodilator.

It increases oxygen and blood flow to the scalp where you apply it.

Why is that good?

Well, when you start losing your hair, it is because of a mechanism of action commonly referred to as miniaturization.

Androgens trigger a cascade of events that miniaturize hair follicles and prevent them from growing to maturity.

When blood flow and oxygen gets cut off to hair follicles, they slowly miniaturize more and more until they are so weak that they are no longer visible to the naked eye.

This is the process of androgenic alopecia.

Minoxidil increases blood flow and oxygen to the hair follicles, thus encouraging growth. .

That's why you would otherwise not be able to maintain Minoxidil-dependent hairs grown by Minoxidil, as that level of circulation would otherwise be impossible to sustain if it weren't for Minoxidil application sustaining it.

Understand and Address Androgen Miniaturization First

The main male sex hormone is testosterone.

This hormone converts via 5-alpha reductase into dihydrotestosterone (DHT), which is multiple-fold more androgenic than testosterone is.

Not only does Testosterone bind to hair follicles itself and miniaturize them, but DHT does as well.

DHT is much more effective than testosterone at miniaturizing hair follicles because it has a much higher binding affinity for the androgen receptor.

miniaturization of hair follicles

Basically, if you use Minoxidil, while you may be encouraging more growth and better growth on your head, you're still doing nothing to prevent the endogenous androgens in your body from miniaturizing hair follicles.

You might be able to visually offset hair loss because you're growing hair at a faster and better rate.

Despite Minoxidil being capable of growing better looking, thicker, denser hair, if you're doing nothing to prevent your existing healthy hairs from falling out of your head still, you will eventually continue losing ground.

If you only take Minoxidil, even if you do experience improved hair growth, all of your existing healthy hairs will still be miniaturized.

Eventually, you're going to get to a point where despite however many Minoxidil-dependent hairs you've grown, the healthy ones that miniaturize via androgens will offset the amount that you've grown with Minoxidil.

By that time, you're going to start to notice receding and/or diffuse thinning again.

The first thing you should be doing is tackling miniaturization from androgens as opposed to throwing growth agonists into your protocol.

Minoxidil Side Effects

Minoxidil is probably the most side effect-ridden hair loss prevention drug.

I got brutal water retention from Minoxidil.

I know people who have had severe heart palpitations from it.

I've seen people who have had their face aged from it.

One of my friends even experiences Orthostatic Hypotension induced fainting from Minoxidil.

Every time he stood up, he would pass out from low blood pressure, and he also indirectly had Tachycardia as a result.

He would walk around with a resting heart rate above 100 and pass out intermittently throughout the day.

Despite the half-life being less than 24 hours, it can take months for this to correct itself even after discontinuation of Minoxidil [R].

It's actually more common to get side effects from Minoxidil than most other hair loss prevention treatments in my experience.

Minoxidil Should Be the Last Thing You Add to Your Hair Loss Protocol

I wouldn't advise Minoxidil off the bat because it's not actually protecting your hair.

Most of the reported side effects of Minoxidil are cardiovascular related, which is the main thing I'd be concerned about as opposed to androgen deficiencies or hormonal imbalances that can be manually corrected with greater ease.

Not to mention that any hair grown with Minoxidil is Minoxidil dependent, meaning you will likely experience a substantial shed should you discontinue its use, regardless of what else you're using for protection.

This shed can be mentally taxing, and traps a lot of men into staying on Minoxidil even when they want to come off, as they don't want to induce severe telogen effluvium.

This is another big factor to keep in mind before you start Minoxidil, as you will likely be on it for life once you start, unless you are able to persevere through the shedding phases.

Obviously, everyone has their own individual response to everything.

There's always going to be a few people who respond poorly to drugs.

There are a lot of people who will have no issues with topical Minoxidil too.

This is just where I stand on its risk to reward ratio.

The foundation of your hair loss protection regimen should be based upon protecting yourself from androgens induced miniaturization.

Once you're protected from further miniaturization or have minimized it, then focus on regrowth and improving the density of your hair with growth agonists if necessary.


While there are obviously cases where you could visually offset hair loss to such an extent where it appears you haven't lost any ground for a few years, or even potentially decades after you start Minoxidil treatment alone, the fact remains that you have androgens in your system that are miniaturizing healthy hair follicles, however slowly.

Minoxidil can only grow so much to offset that loss.

Eventually, the loss is going to outweigh the amount of new hair you've grown with Minoxidil.

It's also the most hassle-ridden treatment in my opinion, as it requires two daily applications which can result in your hair looking greasy 24/7.

Again, my advice would be to deal with androgens first.

Once you've established your foundation of protection, then you can move on to growth agonists like Minoxidil if needed.

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12 thoughts on “Minoxidil DOES NOT Prevent Hair Loss – Read This Before Using It!”

  1. Great write up,

    Only new to the whole hairloss scene, I have ordered the Shampoo you recommended , Nizarol. What would be best to start with now, to be honest Minox doesn’t seem a good idea, ages your skin etc. Would fin be a good idea with an anti estrogen (as i am prone to gyno) my hairloss isn’t bad i’m still near a nw1 but have a big forehead from birth. I’m 20 and my brother who is 25 has temple recession and going by what i’m seeing i will end up near to him. I will also be taking a sarms soon, so i was thinking of running anti dht, with anti estrogen while cutting, what would you say to this?

    Many thanks.

    1. 5-ar inhibitor or topical antiandrogen are good places to start. I wouldn’t run an aromatase inhibitor unless absolutely needed (AI’s will wreck your hair and your health).

  2. What about topical Finasteride with Minoxidil? I’ve read its more effective at reducing DHT in the scalp and doesn’t effect DHT levels in the body as much. Interestingly studies have shown that its still get into the serum slightly and has a slight effect but not as much. If Finasteride can get into the serum doesn’t this mean RU58841 is very likly to as well which could cause even more negative side effect that you might not even notice. See: hairverse(.)com/topical-finasteride/

  3. Hey Derek in your previous articles you were for/ using minoxidil with your RU did you stop using it? I also have diffuse thinning and recently just got a side from fin I’m pretty sure.. Hopefully not gyno but doing blood tests next week what levels should I be looking for? Is minoxidil worth trying since I can’t take fin anymore?

    1. I never used Minoxidil with my RU, I just had an article outlining how to mix them if you someone wanted to do that and happened to use both. Minoxidil is not a replacement for an anti-androgen or 5-ar inhibitor. Totally different mechanisms of action.

  4. Hello,
    I’m only beginning to get into the topic. But lets say I am a bit late. Most of the hair on the top of my head is shedded away and I’m looking into ways to reverse it. Ofcourse the first thing I came across was minoxidil. My problem is: there is not much to prevent anymore. So I don’t think that Finasteride or RU58841 won’t help that much because 70-80% of my hair is shedded (but no bald places yet). What do you guys think?

    Thanks in advance and greetings from germany

    1. Torge,

      I have read most of Derek’s archived write-ups on hair loss/prevention protocals. I personally run generic Finasteride, RU58841, and I Dermaroll with the Derminator2 once per week. That regiment is pretty noninvasive as it’s one topical scalp treatment per day, usually at night because I use the pre-mixed RU48841 and it makes my hair greasy, one pill each morning, and one roll with the dermaroller once per week.

      As a side note, Derek is spot on with the side effects of minoxidil. It definitely went systemic for me as I had sore nipples and itchy skin after a few weeks of use. As soon as I cut it out my symptoms went completley away. I also had terrible water retention and looked like a bag of shit. My face got deep wrinkles all of a sudden. I honestly can’t believe you can just buy it over-the-counter.

  5. I am on TRT, daily mirco-dosing of Test C (12.5mg) alongside daily HCG (100iu). High/normal levels (UK), with zero low T symptoms – life is great in that regard.

    However, I have noticed in the past year that my hair is slightly recessing at the temples. Could this be from me restoring normal androgen levels, the fact that I am over 40 (42) or that I am converting too much into DHT?

    My TRT doctor isn’t that sympathetic and sees hair-loss purely as vanity…brave the shave. But to me it matters. Not really sure what the appropriate next steps should be?

    Worried about anti-DHT meds as lived for such a long time with Low T and have just got my love life back on track.

    I know you are also on TRT and wondered how you have adjusted this with a view of minimising hair loss

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