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

Treatment-induced hair shedding, or “dread shed,” is an often discussed yet poorly defined phenomenon in androgenetic alopecia (AGA) management. Shedding was most consistently reported with topical and oral minoxidil, attributed to premature anagen induction or stress-induced telogen effluvium. Evidence for shedding with antiandrogens is limited, while platelet-rich plasma with microneedling and light based therapies were rarely associated. Nutraceutical trials generally showed improved hair parameters without a clear shedding phase, though early shedding may be underrecognized due to delayed efficacy assessments. Despite its prevalence in social media, “dread shed” remains underrepresented in literature, highlighting the need for further research to guide patient counseling.