Sorry for the late reply, she said that the side effects were only seen by 3% of the people, I don't believe her, regardless I am not interested in taking a medicine. However I have bought minoxidil spray recently and was wondering if you know anything about it, one of my friend has recently started taking it and he is saying that he is experiencing accelerated hair fall with it which worries me. I thought minoxidil only sheds the hair it re grows other than the hair that are already ok :/
Each hair follicle on your scalp grows a hair (growth phase), and eventually sheds it to regrow a new one. The shedding isn't synchronized, so at any given time, the %age of hair in the shedding phase is quite small.
In androgenetic alopecia, a hormone called DHT (dihydrotestosterone) gradually destroys your hair follicles. The hair follicles get smaller, the hair they produce get smaller and thinner, until the follicle is destroyed to the point where it cant produce hair anymore.
The exact mechanism of how minoxidil increases hair growth is unknown, but amongst its actions are an increase in local blood flow, which helps hair grow. It also shifts hair from the shedding phase to the growth phase, but this involves simultaneous shedding of all hair that is close to the shedding phase. Hence its normal to experience increased hair loss when you first start minoxidil. All the hair lost will regrow, and more, and it'll be stronger than before.
However, minoxidil doesnt do anything to the DHT attacking the hair follicles. Eventually, follicles become damaged to the point where they cant grow hair even with minoxidil, ie, minoxidil will eventually stop working.
If your friend quits minoxidil at any point, he's going to very rapidly lose all the hair that was there due to minoxidil.
Otherwise minoxidil is generally a very safe drug with minimal side effects.
Finasteride is the drug that prevents the formation of DHT. DHT is an incredibly important hormone for men. While the 3% incidence is correct, the side effects are of a very serious nature (mainly sexual and neuropsychiatric), and for around 25% of people, side effects are permanent / long lasting even after discontinuing the drug.
The best bet is, imo, a hair transplant.