Minoxidil: Does It Work?

MASTERS OF BEAUTY - ALL THINGS HAIR w/ World Leading Hair Transplant Expert, Dr. Benjamin Paul

 

Dr. Shah:

I'm going to say something controversial... Minoxidil. I don't know if it's as powerful as people think, because I haven't yet seen... You know, I've seen women grow hair on their face afterward, an unwanted side effect. I've seen some men grow hair with beards, but I haven't seen like, you know, a remarkable, maybe you have, but I haven't seen a remarkable turnaround with just minoxidil. Have you?

 

Dr. Ben Paul:

No, not with minoxidil alone. I've seen it sort of like in combination with things. I actually sometimes think minoxidil and PRP together work pretty well. And I think that minoxidil you know, there's studies showing it's better on the back half and potentially in the front. But if somebody has miniaturization and they want to try to get the hair thicker, it's a good place to start because the side effect profile is so minimal.

 

Dr. Shah

What do you take, Ben?

 

Dr. Ben Paul

For my own hair? Finasteride four days a week.

 

Dr. Shah

Four days a week? Oh, cool!

 

Dr. Ben Paul

Every other day dosing.

 

Dr. Shah:

How important is it for men who come in... You know, you have that 24 year old, 25 year old face. I get a lot of these patients who come and say they want along their temples. How important is it for them to be on prophylactic treatments, maintenance treatment? And when do you start them on Finasteride?

 

Dr. Ben Paul:

So I think that everybody has their moment when they're like, “Oh my God.” Not everybody, but people who are going to experience hair loss have this moment where they're like, “I'm really starting to see hair loss. And it's really bothering me.” That's the moment to start. In terms of true prophylaxis. I'm cautious with the kids and their sort of young twenties because the sexual maturity may not be fully there. And so it's case by case, but if you're going to lower somebody's temples, you're taking hair that's going to be permanent, growing for life and putting it in a place where they may never grow there. Then they could go fully bald and only grow hair in this front spot. And that could look off. So I actually don't do that very often at all. And if I was going to do it, it would have to be on somebody who is absolutely stable with their hair and I would prefer them to be on Finasteride.

 

Dr. Shah:

What's the trickiest area for you to fill with a hair transplant talking about that. Do you think it's front or the crown and why?

 

Dr. Ben Paul:

A hundred percent. I think the Vertex is trickier than the front because I do the front every day. And I think that the blood supply to the Vertex is just not as strong. It's a tight area on people's scalp. And I think actually in the recovery of Vertex transplants, that's when minoxidil has shown or shined through for me, because I think it's improving blood flow to the grafts. It's a smooth muscle relaxer. That's how it originally worked. And it definitely improves blood flow around the scalp. And so I've used it for that and seen results with it.

 

Dr. Shah:

And you'd have them start minoxidil after a hair transplant, how soon after?

 

Dr. Ben Paul:

So if they've never been on it, I wait six weeks because I just want the grafts to settle in, not to be disturbed by any chemicals. If they've been on it, I want to get them back on as soon as possible. So probably two weeks. And we'll just take the risk. What about you?

 

Dr. Shah:

Yeah, about two weeks. I don't like anything messing with the grafts.

 

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