What to Expect When Starting Your Hair Loss Medication

If you have recently decided to take the plunge and start medical treatment for androgenetic alopecia, congratulations! A happy, hairy head awaits you. However, once that first bottle of tablets or spray arrives on your bathroom counter, a new set of questions often come up. Patients come to me with a mix of anxiety and high expectations. They want to know: When will I see hair? Why am I shedding more now? Is this side effect normal?

Managing your expectations is just as important as the medication itself. Because hair grows in cycles, the results don't happen overnight. Here is a realistic roadmap of what to expect when you begin your treatment, whether you’ve chosen oral or topical medications.

The First 30 Days: The "Shedding" Paradox

The most common reason people quit their hair loss medication is that they believe it is making their hair loss worse in the first month. This is known as "dread shedding," and, ironically, it’s actually a sign that the medication is working.

To understand this, we first need to understand the hair cycle. There are four phases: anagen (growth), catagen (transition), telogen (resting), and exogen (shedding).

85-90% of the hairs on your scalp are usually in the anagen (growth) phase and will be in this phase anywhere from 2 to 7 years. The catagen (transition) phase follows the growth phase and only lasts a couple of weeks. This is where the hair follicle shrinks and detaches from the dermal papilla of the follicle, which is what provides the hair strand with nutrients. The hair then enters the telogen (resting) phase, when it has stopped growing but remains attached to the hair follicle for about 3 months, whilst beneath a new hair begins to form. About 10-15% of the hairs on your scalp are in the telogen phase. The exogen (shedding) phase is when the hair is released from the follicle. The follicle then begins the hair cycle again. Losing hair is natural, and it is expected that we lose around 50-100 hairs per day.

In male pattern baldness, DHT shortens the anagen (growth) phase leading to thin, “miniaturized” hairs. Introducing a medication such as minoxidil or finasteride kickstarts the follicles. In order to grow new, thick, healthy hair, the follicle first has to kick out the old, thin, dying hair that is already there. You might notice an increase in hair in the shower drain or on your pillow. Don’t panic! This is just the old hairs making way for the new generation of stronger strands.

Months 2 to 4: The "Patience" Phase

By month three, the initial shedding has usually stabilized. This is often the hardest part of the journey because, to the naked eye, it might look like nothing is happening. Just remember, the little hairs are pushing hard to make themselves noticeable. 

Months 4 to 9: The First Signs of Life

This is when the magic comes to life. Around the six-month mark, you should begin to see fine, "vellus" hairs appearing along the hairline or in the crown. These hairs might look like peach fuzz at first—they are light, thin, and short. 

Hair grows only about half an inch per month and so it will take months from here to gain enough length and pigment to significantly change your appearance, but this is the exciting first step to hair regrowth. 

Month 12 and Beyond: Maintenance and Maturity

One year in is the true baseline. This is the point where we can accurately judge if the treatment is a success. By the twelve-month mark, those fine peach fuzz hairs should be maturing into what we call terminal hairs—thicker, darker, and more resilient.

At this stage, your goal shifts from regrowth to maintenance. Hair loss is a chronic condition; the medication is not a cure, but rather a management strategy. If you stop the medication, the DHT will eventually return to its previous levels, and the hair follicles will begin to miniaturize again within a few months.

Final Thoughts

Starting hair loss medication is a marathon, not a sprint! You are playing the long game. There will be days in the first few months where you feel discouraged, but I urge you to stay the course. The follicles you save today are the hair you will still have five, ten, or twenty years from now. Because of this, the best treatment for you will be the one that you can commit to using every single day without fail. Whether that’s a quick spray before bed or a tablet with your morning coffee, consistency is your greatest ally.

If you're ready to start, the best time was two years ago; the second-best time is today. If you want to speak to a hair loss doctor about your hair situation, book a free online consultation with one of our team. We will be able to chat to you about which treatments are available, and what will be the most safe and appropriate one for you. If you can’t see a time that suits you, get in touch with our team and we’ll find a way to assist you.

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An overview of the hair cycle: 

The Hair Growth Cycle: Phases, Factors, and Variations - Biology Insights