When considering non-surgical treatments for hair loss, it’s important to understand the expectations, limitations, and timelines for results.
Realistic expectations with current treatment methods are necessary before deciding to begin therapy.
Limitations
Non-surgical treatments cannot restore completely bald areas. The hair roots are no longer active once the scalp becomes smooth and shiny. If there were a cure for baldness, it would replace hair transplant surgeries. And it would be such a technological breakthrough that you would have heard about it on the news, and everyone who is bald would have a full head of hair!
Expectations
The goal of treatment is twofold:
- Stabilize hair loss: Slow or stop further hair loss, though some people may still lose hair slower. This means that some individuals may still lose hair in the future, but at a much slower rate than if they hadn’t started treatment. Essentially, this buys time for better treatments to be developed. For others, it can stop future hair loss so that the way they look today is maintained throughout life. The mainstay of any medical hair treatment is to minimize future loss
- Thicken thinning hair: Help thicken existing thinning hair, especially in the early stages. This thickening effect can help camouflage bald spots by making the surrounding hairs appear fuller and closer together
Individual results vary depending on how early treatment begins and consistency.
Initial Shedding
It’s common to experience hair shedding when starting treatments like minoxidil, as the weak hair shafts are pushed out to make way for new, healthier growth. Think “out with old and in with the new.” This is not a side effect but a normal process that can take up to 90-100 days.
Expected hair shedding is the most common complaint when initiating medication. It’s important to know that hair shafts are disconnected from the hair follicles (roots) as they shed. The ends of each hair shaft will have a white club-shaped bulb, which is keratin (protein) and is the same keratin that makes up your skin and nails. This indicates that the hairs are in the telogen (resting) stage of the hair cycle. Hair roots are not attached to these shedding hairs.
The average person has about 100,000 hairs, and it’s completely normal to shed up to 100 hairs a day, even when using hair loss treatments. This is because approximately 10% of your hair naturally enters the telogen (resting) phase as part of the normal hair growth cycle. Shedding during this phase is a healthy and expected process.
Timeline
Early signs of improvement usually begin around 4 months after the initial shedding phase, but full results can take 12 to 24 months. Hidden factors like hormonal imbalances, nutrient deficiencies, or scalp conditions can affect progress. Compliance with medication is key – your hair loss didn’t happen overnight, and meaningful results take time. Be patient and stay the course.
Evaluation
Regular follow-up appointments with photographs help track progress, as gradual changes can be hard to notice on your own. It’s also important to have annual surveillance to ensure the hair is holding steady due to your compliance with medication. Since no cure exists, we must confirm that your treatments remain effective and other factors now or in the future are contributing to your loss.
Medication Compliance
Hair loss can be frustrating, emotional, and slow to respond to treatment. That’s why it’s tempting to skip a dose here or there – or even stop medications altogether. But staying consistent for life is the single most important factor in whether your treatment works or not.
Lifelong Use
Many patients are surprised to learn that these treatments must be used daily for life. Hair loss is a chronic condition with no cure like hundreds of other diseases. Stopping treatment will lead to a return to pre-treatment hair loss conditions, and will likely progress. While lifelong treatment may seem overwhelming, think of it like brushing your teeth or maintaining a healthy diet – there are many things we already do daily to take care of our overall health, and hair treatments are no different.
