Minoxidil is one of the most frequently used hair loss medications in the world, and is often considered the first line of treatment for common types of alopecia. But when researching the treatment, you may discover Minoxidil warnings about certain side effects.
It can be difficult to sift through how common these are and whether your specific medication puts you at risk. Around 1.4% of topical Minoxidil is absorbed through your skin [1] — is this enough to cause side effects elsewhere in your body?
Minoxidil solutions are available at different strengths and it’s also available as an oral medication, making matters more confusing. We’re here to clear things up. In this article, we’ll explore:
Minoxidil is a drug that was originally used to treat high blood pressure [2]. But over time, researchers discovered it had the side effect of boosting hair growth. It’s mainly used to treat male and female pattern baldness (androgenetic alopecia), but may also be helpful for conditions like alopecia areata [3].
Scientists aren’t yet fully certain how Minoxidil works for hair growth, but they believe that it widens blood vessels and opens potassium channels in your scalp, so more oxygen, blood, and nutrients can reach the hair follicles [2]. This may help hair follicles in the resting phase of the hair growth cycle to start growing again.
There are two types of Minoxidil used as a hair growth treatment: topical Minoxidil and oral Minoxidil. Topical Minoxidil comes as a foam or liquid solution, and it’s licensed in the UK as a medication for hair loss.
Oral Minoxidil isn’t licensed as a hair loss treatment, but it’s often prescribed off-label for this purpose. However, topical Minoxidil and oral Minoxidil come with different precautions and warnings.
Research suggests that side effects from topical Minoxidil are generally mild. The only common side effect is contact dermatitis at the site of application, caused by either skin irritation or a mild allergic reaction [2].
However, manufacturers warn that unwanted effects are possible. These include:
Topical Minoxidil is usually available in solutions at a strength of 2% or 5%. A 2012 review warns that side effects like headaches, dermatitis, and hypertrichosis were more common with Minoxidil 5% [4].
Hypertrichosis is more likely to be an issue for women than men, so women are usually recommended to stick to Minoxidil 2% [4]. Two randomised controlled trials found that there was no evidence of systemic side effects when Minoxidil was used at a strength of 3% [4].
The National Institute for Health and Care Excellence (NICE) also shares the following warnings for topical Minoxidil [5]:
Researchers generally agree that oral Minoxidil has more potential side effects than topical Minoxidil. However, oral treatment does help you avoid the main side effect linked to topical Minoxidil — skin irritation and allergic contact dermatitis [6].
Be warned that symptoms associated with oral Minoxidil include [6]:
Hypertrichosis is the most common of these, and occurs in around 80% of people taking oral Minoxidil [6]. The other two most common warnings are postural hypotension (a sudden drop in blood pressure after standing up) and lower-limb swelling [7].
However, the authors of a review that analysed oral Minoxidil treatment across 19,270 patients described these side effects as mild, and noted that they generally improved with continued treatment [7]. Across all 19,270 patients, only one decided to stop treatment due to side effects (lower-limb swelling) [7].
NICE warns that oral Minoxidil is not suitable for people with certain rare blood disorders (acute porphyrias), or those recovering from a heart attack or with unstable chest pain (angina), until their condition is stable [5].
Despite the fact that serious reactions to oral Minoxidil are rare, manufacturers warn that serious side effects are possible. These include fluid buildup around the heart and chest pain, so it needs to be used carefully and usually with other medications to manage risks like a fast heart rate and fluid retention [8].
Minoxidil can interact with some other medications, meaning it may be unsafe to use when combined with them. Minoxidil is known to interact with 185 medications, and of these, five drugs have a major interaction with Minoxidil [9].
A major interaction means that the risk of combining these medications outweighs the benefit. The five drugs that have a major interaction with Minoxidil are [9]:
177 other medications have a moderate interaction with Minoxidil, meaning that you should usually avoid combining them, and can use them together only under special circumstances [9]. For this reason, it’s important to always speak to a healthcare professional before you start using Minoxidil for the first time.
Minoxidil isn’t suitable for everyone. Here are some reasons to avoid using Minoxidil [8]:
There are several reasons you may consider alternatives to Minoxidil. It may not be suitable for you, or you may be concerned about certain warnings.
Alternatively, you may have tried Minoxidil for several months but not achieved the results you were hoping for. You may also be eager to find a permanent solution because Minoxidil is temporary and hair loss returns when you stop taking it. Here are some alternative treatments that may be an option for you:
If you’re unsure whether Minoxidil is right for you, it’s best to ask an expert. Our team of specialist trichologists and hair transplant surgeons can identify the reason your hair is falling out and find the treatment plan that’s best for you.
Assessments may include diagnostic trichology tests, such as a hair pull test or blood tests for hair loss. Your hair doctor will also take a detailed medical history so treatment plans are fully personalised and safe.
You may even be a good candidate for a hair transplant, and if you are, you’ll receive treatment from some of the best hair transplant surgeons in the UK. Ready to learn how we can help you? Book a consultation at your nearest clinic location today.
People may stop using Minoxidil for several reasons. If you’re concerned about the warnings of Minoxidil, you’ve lost the will to keep up with the daily routine, or you don’t want to keep paying for the medicine long-term, it may be time to try something else.
Research suggests that Minoxidil is an effective treatment for male pattern baldness [10], female pattern hair loss [11-12], alopecia areata [13], and chronic telogen effluvium [14]. However, only research into the use of Minoxidil for androgenetic alopecia includes large numbers of participants, so further research on its use in other conditions is needed.
When used at the recommended dosage, Minoxidil shouldn’t be bad for your heart. However, an overdose of Minoxidil can cause serious heart and circulation problems, like dangerously low blood pressure, fluid buildup in the lungs, a fast heart rate that leads to heart failure, and reduced blood flow to the heart [15].
Further research is needed on the differences between rosemary oil for hair growth and Minoxidil. However, one study with 100 participants found that Minoxidil and rosemary oil offered similar improvements in hair growth for people with androgenetic alopecia — the main difference was that rosemary oil caused less scalp itching [16].
Simply fill in your details and we’ll get in touch with you shortly.
Δ
Simply fill in your details in the form below and we'll get in touch with you shortly.
