Can Oral Minoxidil Help Treat Hair Loss?
Key takeaways:
Hair loss is a health condition that affects both men and women. However, it’s much more common in men.
There are different ways to treat hair loss, including medications and surgery. Minoxidil foam and minoxidil topical solution are commonly recommended medications for hair loss.
Minoxidil also comes as an oral tablet, which is FDA approved to treat high blood pressure. But it’s sometimes prescribed off-label at low doses for the treatment of hair loss.
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Androgenetic alopecia is the most common cause of hair loss in men and women. Also called male- or female-pattern hair loss, it’s especially common among men. But regardless of who it happens to, hair loss can be deeply distressing. The good news is that many treatments are available for hair loss.
One medication, minoxidil, is a go-to treatment for many people searching for a convenient hair-loss remedy. Topical forms of minoxidil that are applied to the scalp are especially popular. An oral form of minoxidil is also available, and these tablets are being used frequently by people looking to start a new chapter on their hair loss journey.
What is minoxidil?
Minoxidil is a medication that treats multiple health conditions, and it comes in a variety of forms.
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One type of minoxidil is topical minoxidil, and it can be purchased over the counter. It commonly goes by the name Rogaine and comes in two main forms: a foam and topical solution. Both are applied directly to the scalp. And since these medications have been around for a while, generic formulations are also available.
Another type of minoxidil is oral minoxidil. It’s a prescription-only tablet that’s FDA approved to treat high blood pressure. But many healthcare providers prescribe it off-label to treat hair loss. An “off-label use” is when a medication is used in a way that’s not officially approved.
How does minoxidil work?
The way minoxidil works for hair loss is not fully understood. But current evidence suggests a few theories.
Hair grows in a number of stages, including a growing phase and a resting phase. Minoxidil is thought to extend the length of the growing phase and shorten the duration of the resting phase.
There’s another layer, too. Topical minoxidil doesn’t start working right away. An enzyme (protein) on the scalp — scalp sulfotransferase — has to change minoxidil into its active form, minoxidil sulfate.
Not everyone has the same amount of this enzyme on their scalp. Some people have more of it, and some people have less. If you don’t have much of it, topical minoxidil may not turn into its active form. This is one reason why some people find it to be not-so-effective for hair loss. When topical minoxidil fails, some healthcare providers turn to oral minoxidil.
How is oral minoxidil dosed for hair loss?
Oral minoxidil is FDA approved to treat high blood pressure. Since oral minoxidil is used off-label for hair loss, there’s not an officially established dose for this purpose. But healthcare providers tend to prescribe low-dose oral minoxidil for hair loss.
According to a study published in the Journal of American Academy of Dermatology, an oral minoxidil dose between 0.5 mg to 5 mg per day can safely treat hair loss. This is much lower than the dose used to treat high blood pressure.
How effective is oral minoxidil for hair loss?
When starting a new medication, many people wonder how effective their medication will be for treating their condition. When it comes to oral minoxidil, there’s good news. It appears to be an effective option for regrowing hair.
According to one small study of 30 male participants, an expert panel reported that 100% of study participants had some improvement in hair density around their crown area after about 3 to 6 months of use. What’s more, about 43% of study participants showed “excellent improvement.” Other studies have also found that it’s an effective and well-tolerated alternative to topical minoxidil.
However, keep in mind that these results come from studies that are still ongoing. We’re still learning about oral minoxidil’s effectiveness for hair loss.
Is oral minoxidil better than topical minoxidil for hair loss?
There aren’t many head-to-head studies looking at whether oral or topical minoxidil works better for hair loss. One small study showed that oral and topical minoxidil were similarly effective for female-pattern hair loss.
But one clear benefit of oral minoxidil is that it doesn’t cause side effects like scalp irritation, burning or redness. These are common side effects that some people may have with topical minoxidil. If you’re experiencing these symptoms while using topical minoxidil, talk to your healthcare provider. They may recommend trying oral minoxidil instead.
How does oral minoxidil compare to finasteride for hair loss?
Finasteride (Propecia) is a medication that’s FDA approved to treat hair loss. It stops your body from converting testosterone into DHT, which is a hormone that can contribute to scalp hair loss. Because it works in a different way, some people take it in combination with topical or oral minoxidil.
When comparing the two head-to-head, finasteride was found to be more effective than oral minoxidil when given in a similar dose in a large meta-analysis. It increased scalp hair count more than oral minoxidil.
What are the side effects of oral minoxidil?
As mentioned, oral minoxidil is given at a lower dose for hair loss than for high blood pressure. At lower doses, you’re less likely to experience side effects. However, low-dose oral minoxidil still has some possible side effects to be aware of. These includes:
Hair growth in other areas of the body
Puffiness around the eyes
Lightheadedness
Increased heart rate
Headache
Lower blood pressure
Although rare, oral minoxidil can also cause serious side effects. There have been reports of serious heart-related events, primarily when given at higher doses. If you have a history of heart disease, oral minoxidil might not be right for you. If you experience sudden chest pain or shortness of breath, you should seek immediate medical attention.
The bottom line
Oral minoxidil is a medication that’s used off-label for the treatment of hair loss. It’s an alternative option to topical minoxidil, and it’s been shown to help improve hair growth in several studies. If you’re interested in trying oral minoxidil tablets for hair loss, make sure to speak to your healthcare provider.
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References
Badri, T., et al. (2021). Minoxidil. StatPearls.
Gupta, A. K., et al. (2022). Relative efficacy of minoxidil and the 5-α reductase Inhibitors in androgenetic alopecia treatment of male patients a Network Meta-analysis. JAMA.
Johnson & Johnson Consumer, Inc. (2022). Men’s rogaine minoxidil [package insert].
Organon LLC. (2022). Propecia [package insert].
Pal, S., et al. (2022). Low-dose oral minoxidil deemed safe for hair growth. Physician’s Weekly.
Panchaprateep, R., et al. (2020). Efficacy and safety of oral minoxidil 5 mg once daily in the treatment of male patients with androgenetic alopecia: An open-label and global photographic assessment. Dermatology and Therapy.
Ramos, P. M., et al. (2020). Minoxidil 1 mg oral versus minoxidil 5% topical solution for the treatment of female-pattern hair loss: A randomized clinical trial. Journal of the American Academy of Dermatology.
Randolph, M., et al. (2021). Oral minoxidil treatment for hair loss: A review of efficacy and safety. Journal of the American Academy of Dermatology.
Vañó-Galván, S., et al. (2021). Safety of low-dose oral minoxidil for hair loss: A multicenter study of 1404 patients. Journal of the American Academy of Dermatology.
