Today, we’re tackling some of the more common concerns regarding hair loss and minoxidil as a treatment. Our goal is to give a balanced perspective on some of these frequently asked questions, so that you make your own informed opinions about your hair loss treatment.
Why Don’t Doctors Recommend Minoxidil?
If your doctor hasn’t immediately suggested Minoxidil for your hair woes, there’s no need to be overly concerned. Minoxidil has a well-established role in treating hair loss, and its effectiveness is backed by strong evidence. This is especially true for androgenetic alopecia, where it has shown remarkable benefits for patients, but it’s considered a safe and effective option for various hair disorders.
The reason your doctor may not recommend it at first is not because minoxidil doesn’t work, but rather the nature of hair loss itself.
Hair loss is a complex symptom with many possible causes, and many doctors want to be thorough in investigating whether certain medical conditions are contributing. In particular, they might be looking for evidence of iron deficiency, thyroid disorders, or autoimmune conditions. If those causes are missed, you’re unlikely to get the desired results you want from minoxidil itself.
Some doctors may also hesitate to recommend minoxidil if they are worried about compliance. This is because minoxidil is not a short-term fix. It requires consistent, ongoing application to deliver and maintain benefits. Stopping too early, becoming frustrated by slow results, or using it inconsistently, will almost certainly limit its effectiveness. This is something you and your GP do need to consider before starting any long-term treatment.
As for side effects, they tend to be mild but also are very well documented. There is a chance of scalp irritation, dryness, and even an initial increase of shedding. If you’re already self-conscious about your hair, these side effects can be quite discouraging. This is why certain doctors may prefer to explore alternatives, especially if you’ve had issues with sensitivity in the past. Note that compounded treatment can also be a potential solution to this problem (more on this later).
Frankly, some practitioners just lean towards systemic treatments in general, such as oral finasteride for men. Minoxidil is effective, but it isn’t always the first or only choice on the table.
What Is Better, 2% or 5% Minoxidil?
A question we get a lot at the pharmacy is whether someone should be using 2% or 5% minoxidil. Both are widely available, but they aren’t always interchangeable.
There’s evidence to suggest that 5% minoxidil tends to deliver more noticeable results, with greater improvements in both hair density and thickness compared to 2%. In fact, one study done on male participants suggested that 5% minoxidil is significantly superior to 2%. As you can probably guess, 5% is a stronger concentration of the active ingredient, which is the simplest explanation for its greater effectiveness.
So, is there a catch? Well, in the aforementioned study, both the 2% and the 5% were well tolerated by the trial participants, without evidence of systemic effects. Due to this, it’s not uncommon to start with higher strength. Increasingly, women are also being recommended 5% as well.
Of course, stronger is not always better for everyone. Despite both strengths being well tolerated during the trial, everyone is different. If itching, flaking, or irritation is occurring with the 5% formulation, there’s a good chance that the 2% will offer better tolerability. Traditionally, women were directed towards 2% due to concerns about side effects like unwanted facial hair growth. Nowadays, this is more of a case-by-case consideration, as many women have had success with 5% when monitored properly.
The formulation itself is something to also think about, regardless of the strength. Liquid solutions, which often contain propylene glycol, can cause irritation in some users. Foam formulations are generally better tolerated because they leave out this ingredient, while also feeling less greasy and drying faster. Many patients don’t like the feel and look of liquid minoxidil, but it can be easier to apply to the scalp.
If you cannot tolerate standard pharmacy options, compounded formulations are another solution, allowing adjustments in strength, base, or combination with other active ingredients. Although uncommon, some patients are even sensitive to foam treatments, or find that neither 2% or 5% is the right concentration for them.
Will Hair Fall Out After Stopping Minoxidil?
Before you start treatment, you need to be aware that minoxidil works by prolonging the growth phase of hair follicles and improving scalp blood flow. When you stop using it, those follicles gradually return to their baseline state. Yes, that means any hair that grew because of treatment is likely to shed.
After stopping treatment, some customers feel like they are “losing more hair than before,” but in reality, they are simply losing the regrown strands that were maintained by the medication. Stopping minoxidil will not worsen the underlying hair loss condition, but it will resume its natural course.
For that reason, minoxidil is considered a maintenance treatment. Long-term use is expected if you find initial success. Our advice? Place extra importance on finding the correct dosage and formulation that works best for you, and consider a compounding pharmacist who can precisely tailor your hair loss solution. With any treatment that requires a fairly large commitment, tolerability and practicality become some of the major considerations you should be speaking to your GP about.
What Happens After 2 Years of Minoxidil?
If you manage to hit the two-year mark with treatment success and a well-maintained routine, that’s a great sign.
As for what comes next, that will differ from person to person. It is true, however, that the majority of the regrowth you are likely to achieve will occur in that 2-year timeframe.
The peak of success usually occurs within the first 6–12 months, with an expected plateau afterwards. Regardless, continued use helps maintain gains and slow the natural progression of androgenetic alopecia. The value of this stability shouldn’t be underestimated.
As mentioned earlier, long-term use of minoxidil is generally safe, with side effects rarely worsening over time. Side effects themselves can often be well mitigated with supportive scalp care and a precisely calibrated treatment plan.
That said, after initial treatment starts to plateau, it’s not a bad idea to broaden your horizons. Some examples include combining minoxidil with oral finasteride (for men), adding topical agents like retinoic acid or caffeine through compounding, or exploring additional options such as low-level laser therapy. Minoxidil can still be part of a broader management plan, even if it’s not the only tool in the kit.
Is Minoxidil Over the Counter in Australia?
In Australia, topical minoxidil is available without a prescription, which makes it one of the more accessible treatments for hair loss. Zenith Pharmacy stocks 2% and 5% solutions or foams that you can purchase online or in-store.
If you’re in need of more specific options, then it’s slightly more complicated. For example, oral minoxidil is an option that may suit some patients, but it’s prescription only. Options over 5% in strength also require a prescription.
Another distinction comes with hair loss compounding. If you require a customised strength, a formulation that removes specific irritants, or a bespoke product that combines minoxidil with other actives, this will require both a prescription and a compounding pharmacy.
It must be mentioned that although you can buy typical minoxidil products very easily, we still strongly recommend consulting your GP before doing so. This is especially true if you are taking other medication or have any other medical conditions. But anyone will benefit from having a discussion with your doctor and learning more about your particular type of hair loss.
Contact Us Today
At Zenith Pharmacy, we understand that hair loss doesn’t affect everyone in the same way. If you’d like further on what is the best course of action for you, feel free to contact our experienced team via our online form. As experienced compound pharmacists, we are always happy to provide safe, tailored advice.
Written By
Zen Xiao
