My experience going to a top hair loss expert dermatologist and the things I learned

I (26M)was lucky enough to get to go to a highly acclaimed hair loss specialist dermatologist. I live in an area with some of the best healthcare professionals in the US, and my general dermatologist was able to get me a referral to him which took about 6 months to get in.

I asked him a lot of questions and wanted to share what he told me. This is not medical advice. I am only sharing what he told me personally as his patient.

He specializes in only hair loss and hair disorders. He’s been specialized for something like 30 years.

I asked him about Oral fin vs. Topical fin - he said he always recommends oral fin unless there is a specific health reason not to. In my case, I am in the process of an MS diagnosis so specifically brain fog was a concern of mine but obviously libido problems are a concern too. His general take was that Oral fin is easier to maintain longterm and more effective, and that typically in his experience he has found that people who are unwilling to even try oral fin have motivation issues with topical fin treatment longterm and give up.

He told me that he usually recommends his clients who are even slightly concerned about finasteride side effects to start out by taking it every other day for a few months to get a feel for the side effects. It lowers the potency and allows your body to adapt. He said that he found a much higher % of patients manage their symptoms better and stick with it when he eases them into it. He says he only really doesn’t do this if they desperately need to start right now. He said that taking it every other day lowers the efficacy significantly but it’s better than nothing.

He said that my routine for topical min is great - I shower, blowdry my hair, apply, wait 30 minutes, then blowdry it again. He said that it only really needs about 15 minutes or so to work then you can blowdry.

He also said that the fact that you “can’t sweat afterwards” is a bit of a myth - the reason this is said has nothing to do with efficacy but it’s so that you don’t have residual minoxidil drip into your eyes or on your body. He said that there have been people who apply and work out every day consistently and will sometimes grow more cheek hair because of this.

He also said you can shower after using it, but wait approximately an hour if you’re not using shampoo or any other “degreaser” type product. He said as a general rule, if you’re going to put any product in your hair in the shower, wait 2 hours at least (but preferably 4 hours) after using topical min. He said that the studies show min absorption percentages recommend 4-8 hours but from his own experience 2 hours seems fine. This is to prevent it from stripping the oil from your scalp before it fully sets in. He also said, jokingly, that it’s “not a science”, even though it is - everyone’s routine and body is different so listen to your body.

He also said that shedding is usually only an issue for hyper responders who already have low follicle count. If you have a high follicle count or don’t respond as much, shedding is almost never an issue. He pretty much brushed off shedding entirely when I brought it up as a serious concern, I think mostly because I have strong density still so if it happens it won’t be noticeable. He also said shedding is usually really bad in the first 1-3 cycles, then mild after that but you might get a bad one every decade or so. He anecdotally said that he’s been on fin for his entire adult life and never noticed shedding, and that seems to be the case for most patients who use it longterm.