Imagine after months or years of successfully using your hair loss treatment, your progress out of nowhere just starts to stall or reverse. You’re not alone. This is one of the most frustrating and yet least talked about bit of treating hair loss. Unfortunately the experience can be so traumatic that people panic and start throwing random products at the problem. In some cases they may even stop the hair loss treatment entirely wrongly believing it has stopped working. However, a plateau can mean several different things and doesn’t always mean the treatment has failed. In this article, we look at the common reasons hair loss treatment stops producing results. We’ll also review what to do to restore hair growth if your progress plateaus.
Has Your Hair Loss Treatment Actually Stopped Working?
It seems obvious, but the first thing to figure our is whether your hair loss treatment has stopped working or if you’ve just moved into maintenance. You see, treatments like minoxidil, finasteride and dutasteride don’t grow your hair indefinitely. There’s usually a noticeable early phase where there is less shedding and more hair regrowth which peaks at around 18-12 months in. After that, you enter a phase where the same treatment is reducing hair loss and steadily maintaining your progress. This is is what most people experience and it’s important to appreciate that the treatment is still working because it’s maintaining your gains.
True treatment failure is rare and usually results in a stalling of progress followed by an increase in shedding and hair thinning. If the treatment has fully stopped working then the hair may eventually reverse all its gains. The best way to judge how your treatment is working is by taking photos at regular monthly intervals and comparing them to your pre-treatment baseline. If you’re worried or unsure, it’s worth getting a professional assessment to help assess whether your treatment is still working.
Why Does Hair Loss Treatment Stop Working?
Whilst it’s unusual for treatment that was producing results to completely stop working, there are things that can make it less effective. Some of the most common reasons that prevent hair loss treatment from working fully include:
- Non-response to minoxidil: As we’ve covered previously, minoxidil doesn’t work for everyone as many people can’t efficiently convert topical minoxidil into its active form. Some people may be partial responders and hence see some progress but it quickly plateaus and even increasing strength doesn’t always work.
- Not tackling cause of hair loss: Most people use just minoxidil which is great for stimulating hair growth. However, it doesn’t block DHT which is what drives follicular miniaturisation and hair loss. This process continues in the background until the hair follicles become permanently damaged. When this happens the minoxidil is no longer effective as it can not stimulate damaged hair follicles.
- Inconsistency: Hair loss treatments need at least 3-6 months of consistent use to see results and ongoing use to maintain them. Missed applications and cycles of starting and stopping all undermine results.
- Incomplete diagnosis: Telogen effluvium from stress, illness, nutritional deficiency or hormonal changes can layer on top of pattern hair loss and trigger hair shedding. As such things like thyroid dysfunction, iron deficiency and vitamin D deficiency can make hair loss worse but go undiagnosed so people incorrectly assume that their treatment has stopped working.
- Scalp issues: Chronic inflammation, seborrhoeic dermatitis or irritation from the treatment itself can all impair hair follicle function and cause hair loss. If your scalp is itchy, flaky or sore, this has to be addressed otherwise your hair loss treatment will not be effective.
What Should You Do if Your Hair Growth Stops?
It can be extremely tempting to make changes and try to get back on track. However, it’s worth taking a moment to properly figure out what’s happening in order to take the right steps. Before making any changes, it’s worth running through a few things systematically:
- Take stock with photos: Compare your hair now against baseline photos from before you started. After that review both against photos between these two periods. This will help you understand whether your progress is progressing at a slower rate, has stalled or is reversing.
- Review your consistency: Have you been using the treatment daily as prescribed? If not, the first step is to establish a reliable routine before concluding the treatment doesn’t work.
- Get blood tests done: If they haven’t been done recently, ask your doctor to check thyroid function (TSH), serum ferritin (iron stores), full blood count, vitamin D and zinc. Deficiencies in any of these can independently drive hair shedding and undermine treatment response.
- Assess your scalp: Persistent itching, flaking, redness or soreness need addressing as these cause hair loss. Sometimes the scalp issue is caused by the treatment formulation itself. In this case, switching formulas or adjusting concentration can help.
- Revisit the diagnosis: If the pattern of hair loss has changed, if shedding has become much more diffuse than expected or if there are new symptoms, it’s worth getting a reassessment. This is because there maybe something else other than androgenetic hair loss.
What Treatment Changes are Worth Considering?
Once you’ve figured out why your hair loss treatment seems to have stopped working, there are some changes that you can make. The most common adjustments to androgenetic hair loss treatment worth considering include:
- Add a DHT blocker: If you’ve been on minoxidil alone, adding finasteride or spironolactone can help address the hormonal driver of pattern hair loss. This is often the single most impactful change someone can make when results from using minoxidil alone plateau.
- Switch to a stronger DHT blocker: Moving from finasteride to dutasteride (which reduces DHT by over 90% vs ~70% for finasteride) could help. Topical formulations are available for those worried about systemic side effects.
- Add tretinoin: Tretinoin improves minoxidil absorption and boosts sulfotransferase activity when combined together in compounded formulations.
- Add supporting actives: Caffeine and melatonin target additional hair growth pathways including oxidative stress and follicle protection.
- Consider oral minoxidil: Oral minoxidil bypasses the scalp enzyme pathway so may be better for poor responders. However, it has a bigger side effect profile and needs medical monitoring.
- Add microneedling: Regular microneedling stimulates wound-healing pathways which may boost hair growth. It also improves absorption of topical treatments.
- Address nutritional deficiencies: Correcting low iron, vitamin D or zinc can improve overall hair cycle function.
- Add LLLT: Low-level laser therapy uses light energy to stimulate cellular activity in the follicle. It is available as an at home treatment which you can be add to your existing haircare routine.
When Should You Consider More Advanced Treatments?
If you’ve optimised your medical treatment and given the new plan at least 6-12 months but are still losing ground, it may be time to look at more advanced options. Whilst there aren’t ahuge number of evidence backed in clinic hair loss tretaments, the below may be of beenfit to those whose treatment has stopped responding especially where there is advanced minuritsation:
- PRP therapy: This delivers platelet-derived growth factors directly to the scalp. It is usually used alongside topical or oral medical hair loss treatments rather than instead of them. Whilst there’s good evidence behind using PRP for hair loss, it is not a licensed treatment. Results also vary hugely from person to person.
- Hair transplantation: Surgery is usually reserved for cases where medical treatment has been optimised but significant thinning remains. Most surgeons normally recommend continuing medical treatment alongside a transplant to protect the remaining native hairs.
A treatment plateau is frustrating but it doesn’t always mean treatment has failed. Often it means the treatment has moved into maintenance which is still a meaningful result. When hair loss treatment has genuine stopped working, it is important to try to not panic or make rash changes. The best approach is to properly figure out what has happened and make targeted adjustments to rectify the situation. It’s also always worth getting a medical opinion. This will ensure there isn’t an underlying reason for progress stalling or even seeming to rebound.
We believe in an individualised approach to haircare. This is why we offer personalised hair loss treatments for women and men through our online skin clinic. Our doctors create custom hair growth treatments using actives such as Minoxidil, Finasteride, Dutasteride, Spironolactone, Melatonin, Caffeine and Tretinoin where appropriate for each and every patient. Start your virtual consultation and begin your journey to great hair today.
This article is intended for general informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Always consult a qualified medical professional with any concerns about your hair or treatment options.
