In short, if you want to keep your results, yes. Treatments for male pattern baldness (MPB) only work for as long as you’re using them. If you stop, your hair loss will carry on at the same rate as before you started treatment.
We’re going to talk about finasteride and minoxidil as treatments for male pattern baldness specifically.
Treatment, not a cure
As it stands, there’s currently no “cure” for male pattern baldness. A one-off course of treatment that means you’ll never have to worry about losing your hair again hasn’t been developed, but there are medications and procedures which help stop hair loss when used regularly.
We like to compare it to taking medication for high blood pressure: if you take it regularly, your blood pressure will stay at a steady and healthy level. If you stop taking it, your blood pressure will go back up.
It’s the same idea with hair loss treatment. MPB happens when DHT binds to hair follicles and disrupts the normal growth cycle. The follicle stops growing thick, healthy hairs, leading to gradual thinning. Hair loss treatment, depending on which one you take, helps prevent or counteract damage to hair follicles so they can keep functioning as normal (aka keep growing hair). If you stop treatment, the hair loss will kick back in as before.
What happens when you stop
When you stop using hair loss treatment, your hair loss resumes and is likely to go back to your ‘baseline’ level (the hair loss you had before starting) within 6-12 months and continue to worsen if left untreated.
Studies show that all or most of the progress gained from treatment is reversed once treatment is stopped. In a two-year study of more than 1,500 men with male pattern hair loss, researchers found that finasteride not only slowed hair loss but also increased hair growth. After one year, men taking finasteride had an average of 107 more hairs in a target area of scalp than those taking placebo, who continued to lose hair. The benefits continued to build over time, with even greater improvements seen after two years than after one.
Some participants stopped taking finasteride during the second year of the 70089-9/abstract" target="_blank" rel="noopener noreferrer">study. In those men, the improvements were partially or completely reversed by the end of the trial. In other words, much or all of the hair gained during treatment was lost after stopping. This suggests that continued treatment is needed to maintain the benefits.
It’s a similar story for treatment with topical minoxidil. In a long-term study, men used topical minoxidil for almost three years and saw substantial improvements in hair counts while using the treatment. However, men who reduced application from twice daily to once daily lost some of the hair they had gained. This shows that minoxidil works best when used consistently and that reducing or stopping treatment can lead to a loss of results.
Is it safe to use long-term?
Long-term studies and reviews suggest that both finasteride and minoxidil are generally well tolerated when used appropriately. In clinical trials of finasteride 1 mg, sexual side effects were reported in approximately 1-2% of users and occurred slightly more frequently than with placebo. For topical minoxidil, side effects are usually limited to scalp irritation and other local reactions. Typically, side effects usually improve after a while or resolve once the medication is discontinued.
Are transplant results permanent?
You might be thinking: what about a hair transplant, won’t that last forever?
Generally, yes, transplanted hairs will stay in place for a long time. The transplanted hairs are DHT-resistant, which means they can keep growing long-term. But a hair transplant doesn’t stop the natural progression of hair loss of your original, un-transplanted hair. That’s why a lot of transplant clinics will recommend using treatment like finasteride and minoxidil after a transplant to prevent hair loss around the transplanted hairs. Protecting your original hair from further thinning helps maintain the overall look of full, thick hair in the long run.
All of our blog articles are reviewed by our Medical Director before publication.
