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The user experienced increased hair shedding after adding tretinoin to their regimen of finasteride, minoxidil, and dermarolling, but noticed new vellus hairs appearing. They plan to restart tretinoin more gently, as some users suggest shedding indicates treatment effectiveness, while others warn it may cause severe thinning for a minority.

The conversation is about whether vellus hair should be included in hair fall counts, with data showing daily hair loss. The consensus is that shedding, including vellus hair, is normal and within physiological limits.

Beard hair grown with minoxidil can become permanent because it is not sensitive to DHT, unlike scalp hair, which requires ongoing minoxidil use even with DHT blockers like finasteride or dutasteride. Dutasteride reduces scalp DHT significantly but not completely, which may explain why scalp hair still needs minoxidil for maintenance.

The user observed new tiny white hairs after 12 days of using minoxidil, finasteride, microneedling, and biotin, hoping they will become terminal hairs. Others advise that while some hairs may not fully grow, consistent treatment, patience, and scalp massages could enhance results.

The conversation discusses difficulty in distinguishing between new hair growth and thinning hair at the temples after using microneedling and a rosemary peppermint topical for four weeks. The advice given is to wait a few months to see if the hairs grow out to determine their nature.