Can Minoxidil regrow your hair?

A popular product many use to regrow their hair is Minoxidil – it comes in both a topical and oral form. But how exactly does it work? Who are good candidates to use it? Dermatologist Dr. Oyetewa Asempa explains and answers questions about the topic.

First, it’s important to understand how hair loss occurs, as there are many different types, the most common being androgenetic alopecia.

“This happens due to a combination of hormonal changes as well as genetic factors,” Asempa said. “Other types of hair loss can happen due to autoimmune disease, medications, vitamin deficiencies, traumatic hair care practices and more.”

Question: How does Minoxidil work?
Answer: The exact way that Minoxidil works to regrow hair is still being figured out, but so far, we know that it increases blood flow, oxygen and the delivery of nutrients to the hair follicles. This leads to the follicles staying in the growth phase for longer.

Q: Is the topical form of Minoxidil better than the oral form? Does it matter?
A: Neither is better nor worse. In fact, a meta-analysis of four studies and more than 270 patients found no significant difference in hair density between oral and topical Minoxidil. However, this may vary in real life, since the topical form can be compounded into higher strengths than those available over the counter, and the pill can also be taken at higher doses.

There are also some practical differences:

• Oral: Many people find it easier to take a pill than apply a medication to the entire scalp daily. The pill is cheaper. It does not cause skin irritation. However, it has a higher rate of facial or other undesired hair growth and requires monitoring for cardiac side effects.
• Topical: It is FDA approved for the treatment of hair loss, available over the counter, but a bit more challenging to do long term because many people feel it causes scalp irritation or weighs down the hair.

Q: How often should someone use Minoxidil? When can someone start seeing results?
A: Minoxidil can be applied to the scalp daily or twice a day. As a pill, it is often taken daily or split into two and taken twice daily. This varies depending on the specific patient. To see results, it typically takes between 4 and 6 months. Unfortunately, continuous use is required to maintain the results. People will notice shedding of the new hairs after stopping for 3 months.

Q: Speaking of shedding, are there any side effects or risks to using Minoxidil?
A: Transient shedding happens in up to 25% of patients after 1-2 months of taking the medicine. This resolves on its own in four weeks and is considered a positive sign that the medicine is working!

Another side effect is hypertrichosis – the medical term for unwanted hair growth. This can happen in up to one-third of women taking the pill and is a bit less frequent with topical use.

Scalp irritation is most common with topical formulations, often due to preservatives in the formulations.

Cardiovascular side effects can happen with the oral medication, such as hypotension, leg or face swelling or heart palpitations. These are rare overall.

Q: Who are good candidates for Minoxidil?
A: Topical Minoxidil is FDA-approved for the treatment of androgenetic alopecia in men and women. Dermatologists also use it off label to treat many different types of hair loss.

Topically, it should be avoided by people who are irritated by the formulation or have itching/burning with application. Orally (taken as a pill), it should be avoided in patients with heart problems unless approved by their doctor, because Minoxidil is actually a blood pressure pill at a low dose. It can lower blood pressure.

Minoxidil should not be used in someone with uncontrolled heart disease or pregnancy.

By Taylor Barnes