Is Hypertrichosis from Hair Loss Treatment Reversible?'

Name: George

Question: I get hypertrichosis all over my body from taking oral minoxidil for MPB. The tiny hairs get longer and darker and I want to know if it is reversible? Do I have to stop treatment for it to stop happening? Or should I switch to topical minoxidil. I don't want to stop treatment if possible.

Answer: Hi, George. Hypertrichosis - excessive hair growth - is a possible side effect from minoxidil. It may sometimes present on the face, or, rarely, on the body.

Oral minoxidil is more likely to cause hypertrichosis than topical applications of high strength minoxidil. However, in both cases, the hypertrichosis should reverse once this treatment is stopped.

Hypertrichosis generally presents as thickened vellus hairs, stimulated by minoxidil, which, therefore appear more visible.

You may wish to switch from oral minoxidil - which is not currently MHRA-licensed nor FDA-approved as a hair loss treatment for Male Pattern Baldness - to a topical formulation. This should be done in consultation with your current doctor, dermatologist or hair loss specialist, who can help to find the best option for your needs.

When using the topical hair loss solution, rather than taking minoxidil in tablet form, certain steps can be taken to help reduce the severity of this side effect. For example:

• Wash your hands after application
• Don’t let the solution drip on the face; tilt the head slightly backwards when applying minoxidil avoid it dripping forward
• If it does drip onto the face, wash the area immediately
• The evening dose may be applied at least one hour before bed to prevent any residue on the pillow (and hence, being transferred to the face)
• The same applies for head scarves or other scalp coverings ensure there is no medication on the fabric and wash these, and pillowcases, regularly to ensure there is no build-up of minoxidil residue
• If none of this helps, the formulation's strength can be reduced, and/or the dose frequency. Again, this should be advised upon by an appropriate professional.

If you do choose to switch to topical minoxidil and none of the above recommendations help and the hypertrichosis is severe, we would advise stopping treatment. Alternatively, hair removal treatments may be used.

Once the treatment is stopped, this hair growth is not permanent. Vellus hairs don’t have big, strong follicles so once they stop being stimulated, the hair returns to its original thickness - this is naturally quite fine and short.

It is important to know that certain medical conditions can also contribute to hypertrichosis. In women, this could be PCOS, for example, but in men potential causes of hypertrichosis include hormone imbalances, conditions such as hyperthyroidism or anorexia, cancer and side effects of certain medications, besides minoxidil. These include acetazolamide, cyclosporine, phenytoin and diazoxide.

Should the hypertrichosis be solely related to minoxidil use, it should wear off once you discontinue use. Permanent side effects from minoxidil have not been reported.

If you decide to stop using minoxidil, there are alternative male hair loss treatment options you could consider. These include finasteride 1mg, an oral DHT inhibitor, and hair growth supporting products such as the FDA-cleared LaserBand, which uses medical grade lasers to stimulate accelerated hair growth.