- FDA-approved for men and women
- Available as liquid or foam
- No prescription needed
What Is Minoxidil
What Is Minoxidil?
Minoxidil is a hair loss treatment that works as a vasodilator. It increases blood flow to the scalp, widening the blood vessels and increasing the size of the hair follicles. This allows thicker, healthier hair to grow. Minoxidil is also referred to by the popular brand name, Rogaine. (1)
Minoxidil was the first FDA-approved treatment for androgenic alopecia. The oral version of this drug was initially used to treat high blood pressure in the 1970s. After doctors noticed that one of its side effects was hair growth, it was explored as a hair loss treatment. (2)
Minoxidil is now most commonly used topically. It’s applied directly to the scalp as a solution or a foam. The topical solution is applied to the scalp in doses of 1 milliliter twice a day. In foam form, the standard amount is typically half a capful twice a day for men and once a day for women. (3)
Minoxidil is widely used as a treatment for hair loss. It’s proven to markedly improve hair growth in patients with androgenetic alopecia, the most common cause of balding. One review found that hair density and hair growth improves in minoxidil users, while hair loss decreases. (2)
What Is Minoxidil Used For?
Minoxidil is an FDA-approved hair loss treatment used to treat androgenic alopecia. Androgenic alopecia, also known as pattern hair loss, is the most common cause of balding. Minoxidil is a vasodilator, which means it increases blood flow to the scalp. This increases the size of hair follicles and encourages thicker hair to grow. (1)
Unlike some other treatments for pattern hair loss, topical minoxidil in 2 percent form is approved for both men and women. Minoxidil in 5 percent foam is approved for use in men and women. (4)
Minoxidil is also widely used off-label to treat most other types of hair loss. It has been used to treat (2):
- Alopecia areata, an autoimmune condition
- Frontal fibrosing alopecia, a scarring alopecia affecting the hairline
- Central centrifugal cicatricial alopecia, a scarring alopecia that spreads outwards from the top of the head
- Telogen effluvium, a form of alopecia triggered by stressful events
- Chemotherapy-induced alopecia
Minoxidil is sometimes used to treat hair shaft disorders, like monilethrix and loose anagen hair syndrome. Monilethrix is an inherited condition causing brittle hair. In loose anagen hair syndrome, hairs are not properly ‘anchored’ into the scalp, making them come loose easily.
Minoxidil for Body Hair Enhancement
Minoxidil is sometimes used for body hair enhancement, including to increase eyebrow and beard growth. This can be particularly useful for transgender individuals. (2) Hair is deeply linked to personal image and gender expression for many people, so recent research has looked at this topic in more detail.
It’s crucial that any treatment given to encourage hair growth doesn’t interact with the hormone treatment a transgender individual may be taking. A daily dose of 5 percent minoxidil has been found to be effective at increasing hair density on both the scalp and beard without interfering with hormone therapy. (23)
Oral minoxidil at doses ranging from 1.25 milligrams to 5 milligrams have proven to be a good option for some transgender patients who desire more widespread hair growth. (23) This is because oral minoxidil increases both scalp and body hair.
Feminine presenting transgender individuals may benefit from both oral and topical minoxidil to increase scalp hair growth and other desired feminine features. However, hair growing in undesired places is a risk that needs to be discussed with the patient so that they can make a choice about what’s best for them. (23)
Minoxidil isn’t yet officially approved for use in body hair enhancement, so it’s always best to check with your doctor before beginning treatment. Everyone’s goals for hair growth are individual to their ideal outward gender expression. When recommending minoxidil, doctors need to work with patients as individuals to determine a treatment plan that will best suit their needs. (23)
How Does Minoxidil Work?
Minoxidil is a topical, over-the-counter, FDA-approved treatment for hair loss that works as a vasodilator. It’s applied directly to the scalp twice a day to encourage hair growth.
Pattern hair loss is partially caused by an excess of the hormone dihydrotestosterone (DHT) binding to hair follicles. Over time, this binding can shrink the hair follicles, a process called miniaturization. This leads to thinner hair, and eventually, hair growth can stop altogether. (5)
Despite its widespread use, minoxidil’s exact mechanism of action is not fully understood. (2,6) However, we know that minoxidil works as a vasodilator, increasing blood flow to the scalp. It’s also thought to open potassium channels of the hair follicles. (1,2,6) Both of these actions encourage more blood flow, oxygen, and nutrients to reach the hair follicles. In turn, this allows thicker, healthier hair to grow.
Minoxidil is also thought to shorten the resting phase of the hair cycle (known as the telogen phase) and increase the length of the growth phase (known as the anagen phase). Essentially, minoxidil encourages thicker, healthier growth and reduces hair loss. (1,2,6)
Does Minoxidil Work?
Minoxidil is an effective hair loss treatment with proven results. (2) Research shows that minoxidil can significantly increase hair density and hair growth for those with androgenic alopecia when using a 2 percent topical solution. Hair growth was even further improved when using a 5 percent topical solution. (2)
Minoxidil also shows great promise in treating a range of other hair loss conditions. A review on the topic found a marked increase in hair growth and reduction of hair loss in patients with various hair loss types, including androgenic alopecia. (2) Minoxidil is thought to be safe and effective, providing an excellent treatment option for both male and female pattern hair loss. (2)
How Long Does It Take Minoxidil to Work?
Minoxidil is usually applied topically to the scalp twice a day. Most patients start to see results after about 8 weeks. These results include a reduction in hair loss and the beginning of hair growth. Some initial shedding may occur, but this should pass, and healthier hair will start to regrow shortly after. (6)
After 4 months, the most significant effects of minoxidil should be seen, including thicker, healthier hair and significantly reduced hair loss. (6) A meta-analysis on patients taking minoxidil long-term found that the treatment reached its peak 1 year into treatment. (2) This means the most hair growth and prevention of hair loss were seen within this time frame.
How Effective Is Minoxidil?
Minoxidil is a very effective hair loss treatment. It’s available to purchase over the counter and is FDA-approved to treat androgenetic alopecia. It’s also commonly used off-label to treat a wide range of other hair loss conditions. (2)
A review found that when treating androgenetic alopecia, minoxidil increased hair growth significantly. One study discovered a mean increase of 8.11 hairs/cm² of hair growth in patients using a 2 percent minoxidil solution. Patients using the stronger 5 percent solution experienced an average hair growth of 14.90 hairs/cm². (2)
Another article found that over 48 weeks, increased hair growth and decreased hair loss can be expected in 4 out of 5 patients using minoxidil. (7) Research has shown minoxidil is effective at slowing hair loss and promoting thicker, healthier hair. It effectively treats many different hair loss conditions, improving disease outcomes over the long term. (2)
Can You Stop Taking Minoxidil?
If you stop taking minoxidil, hair loss may reoccur. (3,7) Minoxidil is effective, but it’s specifically a long-term treatment for hair loss. While you’re using this topical drug, it reduces hair loss and encourages healthier, thicker hair to grow. Consistency is key to see and maintain results.
You can stop taking minoxidil, but if you do, hair regrowth will likely stop and hair loss will reoccur. This happens in most patients within a few months of stopping treatment. (3,7)
Is Minoxidil for Beards Effective?
Minoxidil is an effective hair loss treatment. Some people use it off-label to enhance body hair growth, including eyebrow hair and beard growth with promising results. This isn’t approved or recommended, so it’s important to use it with caution.
A beard can be seen as a traditional indication of masculinity. This off-label treatment shows great promise as a treatment for men with a thinning beard, as well as for masculine-presenting transgender individuals who want to grow beards.
Research shows promising results when using a topical solution at a 0.5 milliliter dose twice a day for beard growth. Patients saw a significant increase in beard hair and experienced only mild side effects such as redness, itching, and skin irritation. (2)
A topical dose of 5 percent has shown to be effective at increasing beard growth without interacting with transgender patient’s hormone therapy. (23) Oral minoxidil has also shown promise as an option for masculine presenting individuals, typically starting at a low dose of 1.25 milligrams. This dose can be increased over time, rising as high as 2.5 milligrams until the patient achieves their desired results. (23)
There is a risk of hypertrichosis with both topical and oral minoxidil, meaning an excess of hair growth in undesired places on the body. This risk needs to be made clear to patients so they can make a choice about what’s best for them. (23) In general, lower doses of minoxidil cause less risk of hypertrichosis, but may not produce as effective results on hair growth. (23)
For many people, a minoxidil beard could be life-changing. A transgender individual should consult their doctor to work out a treatment plan that’s safe for them and that helps them to achieve their desired beard growth.
Topical vs. Oral Minoxidil
Topical minoxidil is an FDA-approved treatment for androgenic alopecia. It’s also widely used off-label to treat a variety of other hair loss conditions. Oral minoxidil is not yet sold or approved as a safe hair loss treatment.
Originally, oral minoxidil was used before the topical form. Potential side effects include fluid retention, increased heart rate, low blood pressure, skin rashes, hair growth in places other than the desired site, and more. (21) However, recent studies show it could be a viable treatment option at lower doses. (6)
Clinical trials have shown that patients taking oral minoxidil at a dose of 0.25 milligrams to 2.5 milligrams daily can experience a reduction of hair loss and improved hair growth. (6) A 2021 review of recent research on oral minoxidil concluded that the treatment was effective and well-tolerated. The review also suggested that this could be a good option for people who find topical minoxidil impractical. (8)
Topical minoxidil is applied directly to the scalp, so adverse side effects are minimal and localized. Side effects can include scalp irritation, rashes, and a burning sensation. However, since oral minoxidil is ingested and processed by the liver, it can produce systemic side effects including hair growth in undesired areas, swelling, water retention, and more. Research also suggests the rate of side effects may be higher. (2)
Other Types of Minoxidil
Minoxidil is an effective topical treatment for hair loss. It’s usually applied twice daily as a liquid or a foam. In these forms, it’s FDA-approved to treat androgenic alopecia. Other formulations of minoxidil, including pill, lotions, and shampoos, are available but still being tested.
Minoxidil solution is a clear liquid in a dropper containing propylene glycol, while minoxidil foam doesn’t contain propylene glycol and is aerosolized. Propylene glycol is a liquid used in minoxidil solution which is sometimes associated with skin irritation like redness, itching, and burning, and allergic contact dermatitis. (22) One 2020 study tested a propylene glycol-free 5 percent minoxidil lotion. They concluded that the lotion was generally well tolerated and efficient at treating androgenic alopecia. (9)
A double-blind clinical trial was conducted in 2015 using minoxidil shampoo. There was no significant difference in hair growth between users of minoxidil shampoo and the placebo. (10) These results, along with other research, suggested that minoxidil shampoo may not be the optimal treatment option for hair regrowth.
Clinical trials are ongoing, testing minoxidil lotions, shampoos, and even gels, in a variety of strengths and along with other ingredients. Higher concentrations of topical minoxidil are also being tested.
Concentrations up to 15 percent have been trialed, which are significantly higher than the approved doses of 2 percent or 5 percent. Higher concentrations may produce increased side effects and don’t seem to have increased positive results. (11) More research is needed to determine the long-term safety and efficacy of these minoxidil formulations.
How Do You Use Minoxidil?
Minoxidil is an effective topical hair loss treatment that’s fairly simple to use. It’s applied to the scalp twice a day at the site of your thinning hair on the top of your scalp.
It’s important you follow the instructions exactly and apply the correct amount of minoxidil to ensure efficacy and safety. Minoxidil solution is applied at a dosage of 1 milliliter twice a day, while half a cap of the foam version should be applied two times a day. (3) Adverse effects, such as skin irritation, undesired hair growth, rashes, and other effects may be seen if instructions aren’t followed exactly.
How To Apply Minoxidil
Minoxidil is applied to the scalp as a topical solution or foam twice a day. Topical minoxidil should be applied in a 1 milliliter dose, twice a day. The same applies to minoxidil foam, but at a half cap dose, two times each day. Try to space your doses out: they should ideally be 8 to 12 hours apart. (3)
To apply minoxidil correctly, you should (3):
- Ensure your hair and scalp are dry.
- Part your hair into sections to make it easier to apply.
- Use the applicator to apply the correct dosage to the scalp. The applicator will be different depending on whether you’re using the solution or foam. The solution will typically be a dropper that indicates clearly 1 milliliter. The foam will be in an aerosol can that you dispense the foam from directly, typically 6 sprays is 1 milliliter.
- Spread the solution or foam over the thinning area of your scalp with your fingers. If you’re using foam, gently massage it in.
- Wash your hands immediately after application. Don’t spread the minoxidil to other areas of your body, as this could cause an adverse reaction such as hair growth in undesired areas.
- Don’t shampoo or get your hair wet for four hours after using minoxidil. It’s important you give it time to dry and penetrate your scalp fully. This allows the medication to work optimally. Resting your head on items such as pillows can remove product before it has time to dry, or cause staining.
How To Take Minoxidil Orally
Oral minoxidil is taken once a day in pill form. Minoxidil is most commonly used topically as a treatment for hair loss.
Both foam and liquid minoxidil have been approved by the FDA as androgenic alopecia treatments. Recent studies have assessed oral minoxidil for hair loss, but it’s not yet FDA-approved in pill form for hair loss.
Initial clinical trials have shown that oral minoxidil can effectively reduce hair loss and promote hair growth. These trials have focused on an oral minoxidil dose of 0.25 milligrams to 2.5 milligrams daily. (6) Lower doses were found to be less effective, while doses of 2.5 to 5 milligrams were found to be more effective. (8)
Since oral minoxidil acts systemically rather than directly, it can cause more side effects. These include issues like fluid retention, increased heart rate, low blood pressure, and hair growth in places other than the desired site. (2)
It’s important to remember oral minoxidil is not approved by the FDA for hair loss. Little research has been done into its safety when used to treat hair loss. It’s always best to do your research and talk to your doctor before starting any new medication.
Can Minoxidil Be Combined With Other Hair Loss Treatments?
Minoxidil can be combined with other hair loss treatments, although these combinations are not yet approved as safe for use. Both oral and topical minoxidil have been tested with other ingredients to treat a wide variety of hair loss conditions. (2)
Finasteride is another FDA-approved treatment for androgenetic alopecia when used orally. This drug is a dihydrotestosterone (DHT) blocker. An excess of DHT binding to hair follicles is one of the main causes of androgenetic alopecia. Finasteride works to lower levels of DHT in the body, reducing the amount of DHT binding to the hair follicles.
Using oral finasteride and topical minoxidil simultaneously is not officially recommended. However, recent research has shown this combination to be effective. In fact, it may be 94 percent more effective than either treatment alone. (12,24)
Topical finasteride is not yet FDA-approved. However, this alternative formulation shows promise as a hair loss treatment. Combinations of topical finasteride and minoxidil have also shown potential. Recent studies tested a combination of 5 percent minoxidil and 0.1 percent finasteride. They found that 80 percent of patients using the solution experienced increased hair growth or maintained hair density. (13)
Minoxidil has also been combined with other hair loss treatments, like dutasteride and platelet-rich plasma (PRP). PRP involves plasma which is high in platelets being injected into the scalp to promote increased hair growth and healing. Dutasteride is another DHT blocker that works similarly to finasteride. Combining monthly PRP treatments with biweekly 0.5 milligrams of oral dutasteride and daily minoxidil 5 percent lotion also improved hair growth. (14)
Minoxidil has also been used before and after hair transplants to improve outcomes. When used this way, it’s proven to minimize hair loss and make treatment more effective. (6)
Minoxidil has been tested with a variety of other medications, including (2,15-17):
- Corticosteroids to treat scarring alopecia, which slowed disease progression
- Pyrithione zinc shampoo, for general hair growth with results showing sustained improvement in hair growth
- Mesotherapy, a topical injection procedure tested for treatment of female pattern alopecia, with results showing an increase in hair density
- Spironolactone, a medication that is used off-label to treat female pattern hair loss, with results showing reduced hair shedding and improved hair growth
Outcomes have generally been positive, although more research is needed. It’s important to mention that these combinations are not all well researched or approved as safe. Therefore, it’s important to consider your options carefully and check with your doctor to ensure your chosen medication is safe for you.
Minoxidil Safety and Side Effects
Does Minoxidil Have Side Effects?
Like all medications, minoxidil has potential side effects. This topical drug is usually applied directly to the scalp. Common side effects include itching, tingling, or a rash at the application site. (3)
Oral minoxidil, which is not yet approved by the FDA, works systemically. It can cause more serious side effects and potentially a higher incidence of side effects. (2) Side effects may include cardiac issues, sodium and fluid retention, a shortened menstrual cycle (known as polymenorrhea), headaches, skin rashes, and more. (2)
Depending on the dose, both oral and topical minoxidil may also cause hypertrichosis, an excessive growth of hair. In some patients, minoxidil may cause a temporary increase in hair shedding. This side effect is thought to be because minoxidil shortens the resting phase of the hair growth cycle. (6)
Does Topical Minoxidil Have Side Effects?
Topical minoxidil can cause some localized side effects. Systemic side effects are rare and only occur if too much minoxidil is absorbed into the body or if the application is not correctly carried out. (3) Common side effects from topical minoxidil include skin irritation, rash, and itching at the application site. (3) In general, higher doses of both topical and oral versions of this drug are likely to cause increased risks of minoxidil side effects. (2,11)
Some patients are specifically worried about minoxidil sexual side effects, since other hair loss treatments, like finasteride, have been associated with symptoms like erectile dysfunction and loss of libido. Minoxidil isn’t known to cause adverse sexual effects. However, there is a single case report of sexual dysfunction in a patient on topical minoxidil. (18)
Most medications have the potential to cause some sort of side effect. It’s always important to do your research and talk to your doctor, so you can make an informed decision about what’s best for your health.
What Is Minoxidil Shedding?
Minoxidil shedding refers to increased hair shedding, which can occur when you start using this topical hair loss treatment. (1) Minoxidil is FDA-approved for people with androgenic alopecia. With consistent use, minoxidil can help to reduce hair loss and improve hair growth.
Minoxidil shedding occurs because minoxidil shortens the telogen (or resting) phase of hair growth. However, minoxidil also extends the anagen phase, known as the growth phase. In most patients, some increased shedding at the beginning of the treatment is to be expected. New, healthy hair growth soon replaces the lost hair. (1)
Many people wonder: ‘what does minoxidil do to healthy hair?’. Minoxidil is meant to be used on thinning hair and isn’t recommended for use on healthy hair. If you have a thin patch of hair, apply minoxidil directly to that spot and not to the rest of your healthy hair.
Fundamentally, minoxidil is a safe and effective treatment for hair loss when used correctly. Some shedding is normal during use, but healthier, thicker hair should replace the lost hair in the long term. If excessive shedding occurs for months, it’s best to consult your doctor to see if continuing minoxidil treatment is right for you. (6)
Can Women Use Minoxidil?
It’s safe for women to use minoxidil. Unlike some other hair loss treatments, like finasteride and dutasteride, minoxidil is approved for women with pattern hair loss. A 2 percent or 5 percent topical dosage is applied directly to the scalp twice a day. (4)
Research shows that minoxidil for women is a very effective treatment. One review found that a 2 percent minoxidil solution helped reduce hair loss and helped healthy, thicker hair regrow in female participants. Their hair growth reached a peak 1 year into treatment, meaning they had experienced optimal hair growth and decreased hair loss. (2)
5 percent topical minoxidil is being tested as a treatment for women to be applied once a day. A single-blind trial found that using a 5 percent minoxidil foam once daily was just as effective as using a 2 percent minoxidil solution twice daily. (19)
Using minoxidil once a day may be more practical for female patients, allowing them to style their hair more freely. (19) It’s important to consider that while higher concentrations of minoxidil may produce quicker, more effective results, they can also result in more side effects, including undesirable hair growth in other places, skin irritation, redness, and swelling. (2)
Is Minoxidil Dangerous for Pets or Kids?
Minoxidil should be kept out of reach of children for their safety. Incorrect use is likely to cause adverse side effects. (3) Minoxidil currently isn’t approved for use in children. However, it may be used off-label. It’s generally understood to be safe for use in children as long as it’s used correctly and with supervision. (6) Minoxidil may be used in children in the case of alopecia areata or telogen effluvium, typically occurring after acute illness, stress, or major surgery. (6)
Minoxidil is not safe for pets and should be kept out of their reach. Don’t allow your pet to lick or touch any area that has minoxidil on it. Both ingestion and dermal absorption are dangerous for cats and dogs in particular and can cause a range of serious health issues. These include diarrhea, vomiting, tremors, lethargy, seizures, heart problems, breathing difficulties and death. (20)
How Much Does Minoxidil Cost?
Minoxidil is available as an over-the-counter treatment for hair loss. The cost will vary depending on your location, where you purchase minoxidil, the concentration you choose, and whether you buy a brand name.
The following prices for 60 milliliters or 60 grams are roughly a 1 month supply of minoxidil.
United Kingdom: 2 percent minoxidil solution averages £15.43. For the 5 percent solution, the average price is £21.63. Both Regaine for Men Extra Strength 5 percent scalp foam and Regaine for Women Once a Day 5 percent scalp foam average £23.33 per 60 grams.
United States of America: Minoxidil 2 percent solution averages at $16.29. The 5 percent solution costs around $27.14. Minoxidil 5 percent foam averages $25.78.
Canada: Both 5 percent foam and solution average CA$24.99. Minoxidil 2 percent solution for women averages CA$11.65.
Asia: Prices vary hugely depending on where you purchase and the deals used.
You may be able to find reduced prices in sales or with coupons. Bulk buying is often better value overall. This can be particularly important because minoxidil is a long-term treatment.
Minoxidil Name Brands: Are They Better?
You might see minoxidil available under a range of brand names. This can be confusing, but they’re all essentially the same medicine. Minoxidil is the generic name and is the active ingredient in all brand-name medicines. Different minoxidil brands might have slightly different inactive ingredients, but they all work in essentially the same way.
Different countries and shops have their own brand names. In America, Kirkland is a popular Costco brand. You might also see Equate minoxidil. In Canada, a range of brands are available, including Apo-Gain, Gen-Minoxidol, and Hairgro.
Rogaine is one of the most popular minoxidil brands and is widely available. In Europe, Asia, and Australia, the well-known Rogaine is called Regaine.
It’s always best to check the ingredients of any brand-name medication and double-check with your doctor before starting treatment.
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Last updated July 2021