Treatment-Induced Hair Shedding (Dread Shed) Associated With Androgenetic Alopecia Therapies

November 2025 in “ SKIN The Journal of Cutaneous Medicine ”

Aysham Chaudry, Alexandra DeVries, Wilhelmina Lam, Alec Lawson, Spencer Hawkins, Matt Leavitt, Mark Nestor

androgenetic alopecia minoxidil topical minoxidil oral minoxidil anagen induction telogen effluvium antiandrogens platelet-rich plasma microneedling light-based therapies nutraceuticals AGA Rogaine PRP

TLDR "Dread shed" is common with minoxidil but less so with other hair loss treatments.

Treatment-induced hair shedding, known as "dread shed," is a poorly defined phenomenon in the management of androgenetic alopecia (AGA). It is most commonly reported with the use of topical and oral minoxidil, likely due to premature anagen induction or stress-induced telogen effluvium. There is limited evidence of shedding with antiandrogens, and it is rarely associated with platelet-rich plasma, microneedling, and light-based therapies. Nutraceutical trials generally show improved hair parameters without a clear shedding phase, although early shedding might be underrecognized. Despite its frequent mention on social media, "dread shed" is underrepresented in scientific literature, indicating a need for more research to better inform patient counseling.