Start fin and min at the same time or separately?

[Balding Bad]

Hey all, so after years of doing research and reading through forums and what not, but not actually doing anything about it, I'm at that point in my hair loss where action must finally be taken.

Just a little bit about myself, I am currently 28 years old and have noticed my hair loss starting at 20. This first six year upon noticing my hair loss it was gradual and not noticeable to anyone but myself, however upon approaching 26 was when it started becoming an issue to the point where I could no longer style my hair a certain way anymore.

Fast forward to today and I'm on the verge of ordering Kirkland Minoxidil and finpecia (both were recommended by two friends who have been taking each drug respectively and have had great results). From what I've been seeing and reading it seems that when both drugs are taken together the results have the potential to be even more amazing!

With that being said should I start with one over the other first (and see how I react to each) or should I go all in and start both at the same time?

And if I should start with one over the other then which should I start with first?

Thanks in advance!

BB

[mark8]

It takes several months to assess if they are working, so if you wait on one or the other you will lose a good amount of time. And as you are balding bad, you might not want to lose that time.

If I were you I'd go on both. If you have side effects from one or the other it should be easy enough to determine which drug they came from.

disclaimer: FWIW I'm only on min, not fin.

[Dench57]

Start both together.

[Balding Bad]

Thanks for the reply Mark and Dench.

Mark - would you say that both fin and min have unique side effects that it'd be easy enough to decipher which effects relate to which drug? Also how long have you been on min for and did you experience any side effects?

Dench - could you please elaborate as to why I should start both at the same time?

Lastly does both fun and min both cause shedding at first? If so should I expect double shedding if that's the case?!

[Dench57]

Why not? They both work in completely different yet complimentary ways. Odds are you'll get better results using both than just one. What is your aim - maintenance? Regrowth?

[Paul Shapiro, MD]

Balding Bad
I usually suggest patients start Finasteride and Minoxidil together.
They promote hair growth by different mechanisms and together can have a synergistic effect. They have different side effects so you should be able to tell if a side effect is from Finasteride or Minoxidil.
Finasteride has a much more profound effect on hair growth then Minoxidil but the effects can take up to 6 months to be apparent. Shedding can happen with finasteride but is not common.
Minoxidil does not has a much and effect, but the results usually are seen sooner than Finasteride. Shedding is more common on Minoxidil, but not always seen. If it does happen it is not a bad thing. It just means the hair that shed is going into a resting phase and should grow back thicker and longer.
I tell patients that if they are only going to take one medication to take Finasteride because it is so much more effective.
But if you are going to take both you may as well start both at the same time. If you get shedding just be patient. And the side effect profile of each is completely different so you should know if you’re having any side effects.
I hope this is helpful
Dr Paul

[BaldingHelpMe]

Balding Bad
I usually suggest patients start Finasteride and Minoxidil together.

Dr Paul,

I've heard ketoconazole shampoo has the similar effect of Minoxidile. Is it proven, or is it effective in your opinion?

[Balding Bad]

Balding Bad
I usually suggest patients start Finasteride and Minoxidil together.
They promote hair growth by different mechanisms and together can have a synergistic effect. They have different side effects so you should be able to tell if a side effect is from Finasteride or Minoxidil.
Finasteride has a much more profound effect on hair growth then Minoxidil but the effects can take up to 6 months to be apparent. Shedding can happen with finasteride but is not common.
Minoxidil does not has a much and effect, but the results usually are seen sooner than Finasteride. Shedding is more common on Minoxidil, but not always seen. If it does happen it is not a bad thing. It just means the hair that shed is going into a resting phase and should grow back thicker and longer.
I tell patients that if they are only going to take one medication to take Finasteride because it is so much more effective.
But if you are going to take both you may as well start both at the same time. If you get shedding just be patient. And the side effect profile of each is completely different so you should know if you’re having any side effects.
I hope this is helpful
Dr Paul

Hi Dr. Paul, thanks for taking the time to read and reply to my thread.

From some of the before and after photos I've been seeing of both Fin and Min taken together it has finally motivated to take action and to use both simultaneously. I actually just ordered Kirkland Minoxidil a couple days ago and I am currently awaiting a prescription for Finpecia to be written to me so I can order some.

Just out of curiosity though, would taking both Fin and Min at the same time result in double the shed (if shedding was to occur with me)? Or would the shed be "normal"? This is a major concern of mine...

[Balding Bad]

Why not? They both work in completely different yet complimentary ways. Odds are you'll get better results using both than just one. What is your aim - maintenance? Regrowth?

Dench, the aim here is both: regrowth AND maintenance!

[Dench57]

Dench, the aim here is both: regrowth AND maintenance!

Then yes, use both. The best success stories on any hairloss forum are all Fin+Minox. Like Dr. Shapiro said though, Finasteride will be doing the heavy lifting in actually halting the balding process. Minox is a growth stimulant which needs to be continuously applied - and any hair you grow with Minox will be dependent on Minox (if you drop Minox, you lose those hairs).

[ElocT9]

I am actually more a newbie as well here and have to make a decision as well.

What I am wondering about is if it makes really sense taking both at once. I mean I heard that they do not work with everyone. I would like to see what works and what not so that I may give up on Minox if it does not help any. Would that be possible?

[Paul Shapiro, MD]

Here are my answers to the questions posted today.
When using both Finasteride and Minoxidil the shed should be about the same as using only one. It would not be double the shed. And don’t worry, if you do shed, it usually is not a large percentage of hair. We shed about 100 hairs a day naturally and don’t even notice it. The shedding may make you look a bit thinner, but not significantly thinner in most cases. And in 3 months you will look thicker. If the shed bothers you, using cover up like DermMatch can help. But if you are exteremely worried about shedding I would just start the Finasteride and wait 3 to 6 months to start the Minoxidil.
The reason for the shed is that some of your hairs that are in the growing stage when stimulated to grow more by these medications go into the resting phase and shed. This resting phase last about 3 months. But only some of the growing hairs do this. We are not exactly sure why.
Ketokonalzole is an antifungal agent which also has an anti-inflammatory effect. We don’t know why it helps prevent hair loss in some patients, but it is not as effective as Minoxidil.
As I said if a patient is very worried about the shedding I would start Finasteride first. Since it will block the formation of DHT which is the cause of male pattern hair loss it is much more affective then Minoxidil. And studies have shown that the sooner one starts Finastgeride the better it is for hair loss. Then if you want to try Minoxidil down the road you can start it.
I have a lot of patients that are only on Finasteride because they do not like the hassle of Minoxidil or it irritates their scalp.
One can start both together, of start the Finastride first. I consider Minoxidil an adjunct in helping thicken hair. The only patients I have only on Minoxidil are ones who cannot tolerate Finastride and female patients.
I hope this is helpful
Dr Paul

[JDW]

Balding Bad
I usually suggest patients start Finasteride and Minoxidil together.
They promote hair growth by different mechanisms and together can have a synergistic effect. They have different side effects so you should be able to tell if a side effect is from Finasteride or Minoxidil.
Finasteride has a much more profound effect on hair growth then Minoxidil but the effects can take up to 6 months to be apparent. Shedding can happen with finasteride but is not common.
Minoxidil does not has a much and effect, but the results usually are seen sooner than Finasteride. Shedding is more common on Minoxidil, but not always seen. If it does happen it is not a bad thing. It just means the hair that shed is going into a resting phase and should grow back thicker and longer.
I tell patients that if they are only going to take one medication to take Finasteride because it is so much more effective.
But if you are going to take both you may as well start both at the same time. If you get shedding just be patient. And the side effect profile of each is completely different so you should know if you’re having any side effects.
I hope this is helpful
Dr Paul

Dr Paul,
thanks for answering questions, much appreciated. Quick one if I may. I've been on combinations of Dut and Fin for years with seemingly no effect. I'm currently on 0.5mg Dut ED and 2.5 mg of Fin ED yet still lose hair rapidly. Have you seen cases of such strong medication not working? Also is there any point in me adding Minox if the other meds haven't stopped the loss?

Many thanks in advance!

[BaldingHelpMe]

Dr Paul,
I'm currently on 0.5mg Dut ED and 2.5 mg of Fin ED yet still lose hair rapidly. Have you seen cases of such strong medication not working?

Exactly my problem before. Have you tried using only either one, but not both at the same time? For some reason, I lost a lot of hair while taking both drugs each day, and I was previously only on fin. I'm now back to only on fin now.

[Paul Shapiro, MD]

There are some patients who do not respond to these medications. The studies showed that 90% of patients respond to Finasteride. You may be in that 10% who don't respond. What I would suggest is to stop the finasteride and start Dutasteride at a higher dose. In the studies on Dutasteride they used up to 2.5 mg a day and saw more growth on that dose. I know it is expensive. This may help.
There is no need to take Finasteride if you are taking a large dose of Dutasteride.
Also I would suggest seeing a dermatologist that specializes in hair and possible getting a biopsy. Sometimes other dermatological conditions such as diffuse Alopecia Areata and Difuse LPP can look like Male Pattern Balding.
Hope this is helpful.