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Minoxidil Guide: Uses, Results & Side Effects
Dr Mir Malkani
Medically reviewed by
Dr Mir Malkani
Updated on September 26, 2023

Minoxidil is one of the most popular treatments for hair loss. It helps reduce hair fall and stimulate regrowth in a whole range of hair loss conditions, from male pattern baldness to traction alopecia.

Minoxidil is the second most recommended hair loss treatment by hair loss specialists, with 53% saying they always or often recommend it to their patients [1]. Minoxidil is generally well-tolerated and has minimal side effects. So if you’re looking for the right hair loss treatment for you, Minoxidil is an excellent option.

Learn more here about Minoxidil, its effectiveness, how it works to promote hair regrowth, and the side effects of daily usage.

Table of Contents

What is Minoxidil?

Minoxidil is a popular medication used to treat hair loss. It’s available in topical and oral forms, but Minoxidil topical solution is by far the most popular. Topical Minoxidil is applied directly to your scalp and can be used twice a day every day. It’s licensed for use in two strengths: Minoxidil 2% and Minoxidil 5%

Minoxidil also comes in a third strength – Minoxidil 10%. However, this is not approved by the FDA (US Food and Drug Administration) or MHRA (UK Medicines and Healthcare Products Regulatory Agency)

Minoxidil is most commonly found under the brand names Rogaine or Regaine. But you can also find off-brand versions that are normally cheaper.

How does Minoxidil work?

At the moment, there’s a lack of evidence to pin down exactly how Minoxidil works to increase hair growth. But one prominent theory is that applying Minoxidil regularly allows more blood to flow to the scalp, providing follicles with more nutrients and oxygen [2].

Minoxidil belongs to a family of medications known as vasodilators, which are designed to widen your blood vessels. By improving the blood flow, Minoxidil is thought to encourage the flow of nutrients to your hair follicles. This can stimulate them to enter the growth phase of the hair growth cycle. 

Minoxidil was actually discovered by accident after the medicine was given to severe refractory hypertension patients in the 1970s. It was only after these patients started to see abnormal hair growth around their bodies that experts realised Minoxidil could be an effective remedy to treat male pattern baldness and other forms of hair loss.

Does Minoxidil work?

Many studies have shown that Minoxidil is a very effective hair loss treatment [3-6]. It can work for several types of hair loss, including:

These before and after Minoxidil photos show how real patients have successfully used Minoxidil to regrow their hair:

Before and after oral Minoxidil photos for treatment of male pattern baldness
Male pattern baldness patient before and after Minoxidil treatment
Before and after photos of Minoxidil and corticosteroids treatment in an alopecia areata patient
Alopecia areata patient before and after Minoxidil treatment
  • In one four-month study, 773 men suffering from androgenetic alopecia were instructed to apply 1ml of Minoxidil 5% to the areas of their scalp where they were experiencing baldness, twice a day [3]. 453 participants agreed that Minoxidil was effective, and 74.2% of the 721 eligible subjects noticed an improvement in hair density.

  • In another study, nine men aged between 18 and 49 were given 5% Minoxidil topical foam to apply twice daily for eight weeks and four men were given a placebo solution [4]. By the end of the study, four out of the nine men using the Minoxidil solution had experienced hair growth.

  • A 2002 study of 393 men aged between 18 and 49, experts compared 5% topical minoxidil with 2% topical minoxidil and placebo in an eight-week trial [5]. Participants who used the 5% topical minoxidil experienced quicker results and up to 45% more hair growth than the group using 2% topical minoxidil.

  • A 2019 study assessed the effectiveness of Minoxidil for women with female pattern hair loss [6]. 20 patients were treated with a 2% topical Minoxidil solution for six months. Researchers noted a significant improvement between baseline hair and at the fourth and sixth-month intervals.

  • A study into the effectiveness of Minoxidil for treating alopecia areata induced by ocrelizumab medication found that all five patients responded well to conventional alopecia areata treatment, including corticosteroids and topical Minoxidil foam [7].

  • 36 women with chronic telogen effluvium were treated with 0.25-2.5mg oral Minoxidil over six months [8]. The average hair shedding score for participants was reduced at both six months and 12 months post-oral Minoxidil treatment.

  • A case report of a 31-year-old woman with traction alopecia found that daily treatment with 1.25mg oral Minoxidil (and a fluocinonide 0.05% topical steroid solution 2-3 times a week for the first 2 months) notably increased hair regrowth [9].

Does Minoxidil work for men and women?

Unlike some other hair loss treatments, Minoxidil can be used by both men and women. Finasteride and Dutasteride, which are hormone-blockers, can cause negative reactions in women. However, because Minoxidil is a topical treatment that doesn’t alter hormones, it’s perfectly safe for women who are experiencing hair loss to use.

In a 2004 study, 381 women aged 18-49 with female pattern hair loss compared the efficacy and safety of 5% topical minoxidil with 2% topical minoxidil and placebo [10]. After 48 weeks, it was found that 5% topical minoxidil was superior, and could improve psychological perceptions of hair loss in participants.

Women’s hair loss is often much more complicated than men’s hair loss. There are many potential causes, so it’s important to get an accurate diagnosis with female hair loss blood tests. These can help you determine whether Minoxidil or another female hair loss treatment is best for you. 

Does Minoxidil work for facial hair?

Minoxidil shows some very promising results for those who are also struggling to grow facial hair. There is evidence to suggest that Minoxidil can also stimulate hair growth for beards and moustaches.

One study discovered the effectiveness of Minoxidil for beard hair in a 16-week randomised, placebo-controlled trial of 48 men aged between 20 and 60 years [11]. Participants were instructed to apply 0.5 ml of 3% Minoxidil to their chin and jawline twice daily. The hair count for men in the Minoxidil group was significantly higher than those using a placebo solution.

Other studies have also detailed the application of Minoxidil for eyebrows. In one particular study, it was found that Minoxidil 2% lotion was effective at promoting eyebrow hair growth [12].

low dose oral Minoxidil

Types of Minoxidil

There are several types of Minoxidil available:

Topical Minoxidil isn’t available on the NHS, but you don’t need a prescription. Minoxidil foams, solutions, and shampoos are available to buy over the counter in the UK. Regaine is one of the most popular UK brands for Minoxidil foam and solutions.

Oral Minoxidil, meanwhile, is usually used to treat other health conditions such as high blood pressure. It can be used for hair loss, but you’ll need a prescription from a private hair loss clinic.

What dosage do I need?

Minoxidil is available in two concentrations: 2% and 5%. Regaine sells 5% foams and solutions in its men’s range, while both concentrations are available in its range for women.

The 5% dosage is generally more effective, but it’s also associated with a higher risk of side effects [13]. Many people start at a lower concentration. If you don’t see the results you want after a few months, you can try a higher dose.

Adults should apply 1ml (spray or solution) or half a capful (foam) to their balding areas twice a day. Children should apply Minoxidil in line with their doctor’s guidance. Don’t double up if you miss a dose. Instead, just continue using it, as usual, the following day.

If you’re unsure which dose is most appropriate for you, speak to a hair loss specialist for advice.

How to apply Minoxidil

This hair loss treatment should be applied twice a day to areas of the scalp that are visible through your thinning hair.

Most people will apply topical Minoxidil in the morning and evening, a few hours before they go to bed. It’s best to use 1ml during each application in the areas where you’re experiencing hair loss.

See a step-by-step guide to how to apply Minoxidil for more information.

How long does it take Minoxidil to work?

For most people, it will take around eight weeks before you start to notice any improvements after using Minoxidil. It will only be after the four-month mark that you’ll experience the real results, as long as you’ve kept up with consistent use [2].

If you want to benefit from the full results of taking Minoxidil, it’s important that you take the treatment as instructed in the product’s guidelines. In most cases, this means using 1ml of the solution twice daily (although some people are advised to use Minoxidil once a day to reduce the risk of unwanted side effects).

You may be tempted to use more than the recommended dosage, but we’d strongly recommend against doing this. It will not help to encourage hair to grow quicker and could instead cause a range of side effects like skin irritation.

Minoxidil side effects: is Minoxidil safe?

Minoxidil is a generally well-tolerated hair loss treatment with a good safety profile. However, some Minoxidil users do report side effects. These include:

These Minoxidil side effects will normally go away after the first few weeks of use. If you notice that your side effects don’t clear up, or you’re having a severe reaction or allergic reaction, it’s best to speak to your GP.

Concerned about the sexual side effects of Minoxidil? Fortunately Minoxidil is one of the safer hair loss drugs, as it doesn’t impact your hormones.

Is there a way to reduce Minoxidil side effects?

Although it’s not possible to completely eliminate the chance of side effects, there are a few things you can do to reduce your risk, such as the following:

  • Only use the recommended dosage of Minoxidil
  • Washing your hands with soap and water after every application
  • Only applying the product in areas where you’re experiencing hair loss
  • Check the shelf life of your product before using it.

What are the alternatives to Minoxidil?

Minoxidil is an effective treatment to counteract the first signs of hair loss and balding. However, it’s not a cure for baldness.

If you’ve found that Minoxidil has not worked for you, there are several alternatives to Minoxidil for hair loss, including:

Each of these Minoxidil alternatives is designed to treat a different condition. So it’s best to get advice from a hair loss specialist if you’re unsure which treatment to try.

If Minoxidil doesn’t work, an FUE hair transplant or FUT hair transplant might be a viable option. At the Wimpole Clinic, we specialise in both of these surgical procedures. However, a hair transplant can’t protect you from continuing hair loss. In these cases, Minoxidil can help prevent ongoing hair loss and help you maintain hair density for longer.

Book a hair loss consultation with Wimpole Clinic

To learn more about Minoxidil or discuss your hair loss treatment options, get in touch with the team at the Wimpole Clinic.

You can book a no-obligation consultation call with one of our experts where we’ll take you through everything and advise on whether this procedure could be right for you.

 

Minoxidil Guide: Uses, Results & Side Effects, Wimpole Clinic

Research suggests side effects like dermatitis, headaches, and hypertrichosis are more common in those who use 5% Minoxidil solutions, rather than lower concentrations [13].

Oral Minoxidil is more likely to cause hypertrichosis or any other unwanted hair growth than topical Minoxidil (although this is usually mild). Topical solutions are more likely to cause itchiness and skin irritation [14].

Minoxidil side effects are relatively uncommon. In one study of 102 participants, just six instances of adverse effects were recorded (all of them mild) [15]. More research is needed to establish the risk factors for experiencing Minoxidil side effects.

Minoxidil is known to interact with some other medications, including:

  • Benadryl (diphenhydramine)
  • Xanax (alprazolam)
  • Cyclosporine

Benadryl and Xanax can lead to low blood pressure if taken alongside Minoxidil. Minoxidil may also cause excess hair growth if taken alongside cyclosporine (a drug used to prevent organ rejection after a transplant). This list isn’t exhaustive, so it’s a good idea to check if Minoxidil is safe for you to use if you’re taking other medications. 

Ischemic heart disease patients and those on dialysis are advised to avoid using Minoxidil.

It’s generally accepted that topical Minoxidil is one of the safer hair loss treatment options.

But some studies show that long-term chronic use can lead to cardiovascular symptoms in rare cases, including tachycardia (an unusually fast heart rate) [16]. Patients with coronary artery disease are at particular risk.

No. Minoxidil can be absorbed through the skin and into your breastmilk, so it’s not safe to use Minoxidil while breastfeeding [17].

Yes. Research suggests using Finasteride and Minoxidil in combination can produce better results than just using one or the other [18-19].

Some brands now sell Minoxidil fortified with topical Finasteride, which can give you good results.

Sources:

 

  1. ISHRS Practice Census 2022
  2. Minoxidil | NLM
  3. Rapid onset of action of minoxidil 5% topical solution in a 4-month German observational study on both patients and physicians
  4. Similar Response Patterns to 5%Topical Minoxidil Foam in Frontal and Vertex Scalp of Men with Androgenetic Alopecia: A Microarray Analysis
  5. A randomised clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men
  6. Trichogenic effect of topical ketoconazole versus minoxidil 2% in female pattern hair loss: a clinical and trichoscopic evaluation
  7. Ocrelizumab-induced alopecia areata—A series of five patients from Ontario, Canada: A case report
  8. Treatment of chronic telogen effluvium with oral minoxidil: A retrospective study
  9. Treatment of traction alopecia with oral minoxidil
  10. A randomized, placebo-controlled trial of 5% and 2% topical minoxidil solutions in the treatment of female pattern hair loss
  11. Efficacy and safety of minoxidil 3% lotion for beard enhancement: A randomized, double-masked, placebo-controlled study
  12. Minoxidil 2% lotion for eyebrow enhancement: a randomized, double-blind, placebo-controlled, split-face comparative study
  13. Minoxidil and its use in hair disorders: a review
  14. Minoxidil 1 mg oral versus minoxidil 5% topical solution for the treatment of female-pattern hair loss: A randomized clinical trial
  15. Safety and efficacy of topical minoxidil in the management of androgenetic alopecia
  16. Could Topical Minoxidil Cause Non-Arteritic Anterior Ischemic Optic Neuropathy?
  17. Minoxidil | Drugs and Lactation Database
  18. Comparing the therapeutic efficacy of topical minoxidil and finasteride with topical minoxidil and oral finasteride in androgenetic alopecia: a randomized trial
  19. Topical minoxidil fortified with finasteride: An account of maintenance of hair density after replacing oral finasteride
Dr Mir Malkani
Medically reviewed by Dr Mir MalkaniUpdated on September 26, 2023
The Wimpole Clinic offers FUE Hair, Beard & Eyebrow Transplants & Trichology.
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