People commonly conclude minoxidil has stopped working and either double the dose or abandon it. True tolerance is not well established for topical minoxidil, and there are several more likely explanations to rule out first.
1. The Underlying Loss Has Progressed
Minoxidil does not stop androgenetic alopecia; it acts on the follicles it can still influence. Meanwhile the hormonal process continues. Maintaining the same appearance against a progressing condition is a result, even when it feels like standing still.
What to do: this is the strongest argument for adding finasteride, which addresses the mechanism rather than the symptom. Discuss it properly, including the MHRA's warnings.
2. You Are Applying Less Than You Think
Adherence decays quietly. A missed morning becomes a missed day becomes once-daily use of a twice-daily product.
What to do: track it honestly for a fortnight. Most "it stopped working" is this.
3. Technique Has Drifted
Applying to damp hair, applying to the hair rather than the scalp, or not letting it dry before bed all reduce how much reaches the follicle.
What to do: dry scalp, part the hair, target the skin, let it dry fully.
4. You Changed Format or Supplier
Switching from solution to foam changes the vehicle and the amount applied per use. Neither is inferior, but the transition can feel like a loss of effect.
What to do: give any change three months before judging it.
5. Something Else Started Causing Loss
Androgenetic alopecia can coexist with other causes. Iron deficiency, thyroid disease, significant rapid weight loss, a new medication or a period of severe stress all cause shedding independently.
What to do: if the pattern changed — diffuse shedding rather than patterned thinning, or loss elsewhere on the body — see a GP and get ferritin and thyroid function checked. Treating a deficiency is cheaper and more effective than any topical.
6. You Are Judging It Wrong
Day-to-day perception of hair density is unreliable. Lighting, styling, whether it is wet, and mood all affect it more than a month of growth does.
What to do: fixed-angle photographs in consistent light, compared at three-month intervals.
What Not to Do
- Do not apply more than the recommended amount. It increases absorption and side effects without improving response.
- Do not stop and restart repeatedly. Intermittent use gives you the inconvenience without stable benefit, and hair lost in the gaps may not come back.
- Do not jump to compounded high-strength products on the strength of a forum post. They are unlicensed, variable, and absorbed.
When It Genuinely Has Not Worked
If you have used it correctly and consistently for twelve months with no effect, that is a real finding. The productive next steps are a conversation about finasteride, a check for other causes, and — if the loss is established and stable — an assessment of whether transplantation is appropriate. "Nothing works" is very rarely the actual answer.