Minoxidil Hair Treatment

Minoxidil was initially developed in the 1970s as an antihypertensive agent to treat high blood pressure. However, it attracted interest as a potential hair loss treatment when patients receiving this drug developed generalised hypertrichosis (excessive hair growth on the body).

This observation led to its topical formulation, which has since become the first-line treatment of male and female pattern hair loss (also called androgenetic alopecia). Dr Bonaros specialises in a variety of hair loss treatments and offers private prescriptions for oral minoxidil after a consultation at his professional hair transplant clinic in Glasgow.

Are you ready to restore your hair and boost your confidence? Contact Dr Bonaros and book a consultation to learn more about the different Minoxidil hair treatment options and find the solution that suits you best.

Table of Contents

How Minoxidil Works

Minoxidil’s exact mechanism of action is unknown. However, trials have shown that a topical minoxidil solution applied to the scalp can slow and reverse both male and female pattern baldness in several ways:

Minoxidil prolongs the anagen phase of the hair follicle
Reverses follicle miniaturisation
Enhances blood flow around the hair follicles
Stimulates follicle movement to the growth phase

According to other hypotheses, minoxidil may also have proliferative, anti-androgenic (the blocking of androgen hormones), and anti-inflammatory effects.

Minoxidil as a Hair Loss Treatment

Minoxidil is most commonly used as a topical hair loss treatment and, in some cases, is also taken orally as a prescription tablet. It’s important to understand that minoxidil cannot entirely reverse or prevent hair loss. However, it has been scientifically proven to slow down and lessen the effects of this process by strengthening hair follicles and promoting both hair regrowth and new hair growth.

Minoxidil Results

Several meta-analysis studies have confirmed the high quality of evidence for using minoxidil to treat androgenetic alopecia (AGA) in both men and women. Despite minoxidil’s effectiveness in hair regrowth, it doesn’t work for everyone and every type of hair loss.

In one study, dermatologists evaluated the effectiveness of minoxidil 5% topical solution in 984 men with hereditary hair loss. After one year, they reported that hair loss areas on the scalp had become smaller in 62% of the patients, unchanged in 35.1%, and more significant in 2.9%.

Regarding minoxidil’s effectiveness in stimulating hair regrowth, the investigators found it very effective in 15.9% of patients, effective in 47.8%, moderately effective in 20.6%, and ineffective in 15.7%. This means there was an overall efficacy rate of 84.3% for the minoxidil topical solution.

However, it’s key to note that patients should be treated for at least six months before being assessed by a hair restoration physician. Additionally, minoxidil hair loss treatment should be prolonged indefinitely to maintain the efficacy of positive results. Minoxidil discontinuation will cause acute hair shedding after three to four months.

Topical Minoxidil for Hair Follicle Stimulation & Growth

Topical minoxidil is one of the primary ways to treat hair loss. This FDA-approved and UK-licensed medication is available in two easy-to-use forms — a solution or foam. Users simply apply minoxidil topical solution to areas of the scalp where there is thinning hair or hair loss. A sulfotransferase enzyme found in hair follicles then works to activate and effectively absorb the minoxidil.

While this enzyme is always found in the liver, its presence in hair follicles differs from person to person. As such, topical minoxidil results differ between patients and, if there is little to no efficacy, a doctor may prescribe an oral minoxidil hair treatment instead.

Topical Minoxidil Dosage & Application

Dosages for topical minoxidil differ according to the sex of the patient and whether the minoxidil is a solution or foam. In men, the recommended dosage for minoxidil is 1ml twice daily for the 5% solution. The dosage for minoxidil 5% foam is half a capful twice daily. For women, the recommended dosage is 1ml of 2% minoxidil solution twice daily or half a capful of the 5% foam formulation once a day.

Both formulations should be applied on a dry scalp and left in place for at least four hours. Massaging the solution into the scalp is not needed. It is advisable to apply the minoxidil two hours before bed, as this will allow adequate time for drying and help prevent the foam or solution from spreading on the face during sleep or staining any linen. It is not recommended to use a hairdryer for this drying process, as it may impact the minoxidil’s effectiveness.

Topical Minoxidil Side Effects

Some patients notice a transitory increase in hair shedding at the beginning of this hair loss treatment. However, this usually only lasts for a few weeks and should not cause concern, as it is just a sign of minoxidil efficacy that indicates the telogen follicles are re-entering the anagen phase.

Minoxidil solution containing propylene glycol can cause skin irritation or an allergic reaction. If the affected area does become irritated, patients may switch to the minoxidil topical foam formulation. Unlike minoxidil solution, this foam does not contain propylene glycol and, therefore, will not trigger scalp irritation.

Other common adverse effects of minoxidil include:

Scalp dryness and dandruff.
Contact dermatitis and pruritus — a non-contagious but itchy and uncomfortable rash caused by contact with an allergen or irritant.
Erythema — redness of the skin resulting from increased dilation of the capillaries.
Facial hypertrichosis — unwanted hair growth on the face.

Hypertrichosis is reported more frequently in women than in men. However, it is unclear whether this occurs because it is genuinely more common or just more noticeable. This side effect usually resolves one to three months after drug discontinuation.

Topical minoxidil solution is the mainstay treatment for androgenic alopecia. Contact our clinic at 0141 340 9098 or info@drbonaros.com to find out more about minoxidil before and after treatment successes.

Oral Minoxidil for Hair Loss in Men & Women

Oral minoxidil is minoxidil in tablet form. This hair loss medicine is not officially approved to treat male pattern baldness, so its use is off-label. However, the results of small studies have shown positive results of minoxidil pills for hair loss and no inferiority to topical minoxidil. In fact, when prescribed appropriately, oral minoxidil tends to be more effective than its topical counterpart.

Oral minoxidil can be considered as an alternative treatment in healthy men and women who cannot tolerate or comply with topical minoxidil. It is also considered for men experiencing hair loss who are concerned about or have already experienced sexual side effects from finasteride medication for hair loss.

Oral Minoxidil Dosage & Consumption

When writing an oral minoxidil prescription, a medical professional will specify the exact dosage their patient should consume. For men, the recommended dosage ranges from 1.25 to 5mg. The minoxidil dose for female hair loss is lower and ranges from 0,25 to 2.5 mg daily.

Minoxidil tablets for hair loss are always prescribed as a low dose medication. These oral hair loss prescriptions are far below the 10 to 40mg average daily dosage (with a maximum of 100mg per day) used for hypertension. This means they can be prescribed for long-term usage — an essential part of maintaining the effects of hair loss treatment with minoxidil.

Oral Minoxidil Side Effects

As with its topical counterpart, common side effects of oral minoxidil are mild hair loss through shedding (usually within the first six weeks of treatment) and hypertrichosis — excessive amounts of hair growth. The higher the minoxidil dose for hair loss, the more likely hypertrichosis is to occur. However, as with topical minoxidil, this side effect will dissipate within one to three months after a patient stops using the oral treatment.

Other adverse effects of taking minoxidil in oral form include:

Lower limb oedema — fluid retention that causes the legs, ankles, and feet to swell.
Postural hypotension — low blood pressure that is caused by the transition from sitting or lying down to standing.
Tachycardia — a fast-paced heartbeat that exceeds 100 beats per minute.

Both postural hypertension and tachycardia can cause dizziness and lightheadedness. Tachycardia can also result in difficulty breathing due to shortness of breath.

If patients experience any of the above-mentioned side effects, they should contact a doctor as soon as possible.

Ready to try minoxidil for hair loss? Schedule a Zoom consultation to discuss your next steps with Dr Bonaros, Scotland’s only full member of the International Society of Hair Restoration Surgery (ISHRS).

Minoxidil for Hair Growth — Frequently Asked Questions

Can I use both topical and oral minoxidil?

No, you should not use topical and oral minoxidil at the same time. Both formulations of this hair loss medication have various side effects. Applying or consuming more than the recommended amount can increase the severity of or result in unwanted side effects. The same is true for the simultaneous usage of both topical and oral minoxidil.

However, non-simultaneous usage is possible. If your body does not respond well to topical minoxidil solution or foam (either through adverse side effects or minimal effectiveness), your doctor may write you a prescription for oral minoxidil instead. Switching from topical to oral minoxidil under the guidance of a medical professional is completely safe and can help improve the long-term success of your hair loss treatment process.

Can minoxidil treat all parts of the scalp?

Since minoxidil’s overarching effects relate to the stimulation of hair follicles and the promotion of hair growth, it makes sense that this medication would be able to treat different parts of the scalp.

Most studies have been focused on the effectiveness of minoxidil on the crown, but recent studies have shown positive results that minoxidil may be just as effective in treating hair loss along the hairline. So, while it is most commonly prescribed for hair loss on the crown of the head, minoxidil can also be used to treat a receding hairline.

Where can I get minoxidil?

Minoxidil is the generic name given to the active ingredient found in products that stimulate hair growth, such as Rogaine. Topical hair loss products containing minoxidil, such as an alopecia topical solution, can be bought as over-the-counter medication without a prescription. However, oral minoxidil can only be purchased with a medical consultation and prescription.

For your own safety, it is always best to check with a health professional before taking a new medication. Both topical and oral minoxidil should only be used under the guidance and instructions of a trained doctor.

Dr Bonaros provides private prescriptions for oral minoxidil. Book an appointment today — either at our clinic in Glasgow or through a consultation over Zoom.

What to avoid when using minoxidil to treat hair loss?

To ensure your hair loss treatment is as effective as possible, there are certain precautions you should take when using minoxidil.

Using other skin products on the same skin area that is undergoing minoxidil treatment should be avoided. Perming, relaxing, and colouring the hair is safe during a minoxidil hair treatment, as long as you ensure your scalp is washed just before you apply the products. However, you should not use minoxidil 24 hours before or after your hair treatment procedure.

Who cannot use minoxidil?

While oral minoxidil requires a prescription, topical minoxidil is available over the counter. However, this does not mean you should begin using it before checking with a doctor. Both forms of minoxidil have various potential side effects and, depending on the patient, can be unsuitable for usage.

Minoxidil can be especially unsafe for patients with:

A history of heart problems such as heart disease or failure
Existing hepatic (related to the kidneys) or renal (relating to the liver) conditions
Very low blood pressure
Pheochromocytoma (an adrenal gland tumour)

Usage of minoxidil in patients over the age of 60 should be carefully regulated and monitored by a medical professional, as these individuals are generally more at risk of experiencing side effects.

Minoxidil is a vasodilator that increases blood flow by dilating blood vessels. It is therefore not recommended for patients who are taking other vasodilators, such as erectile dysfunction or antihypertensive (high blood pressure) medication.

Minoxidil is also not advised for women who are pregnant or actively trying to fall pregnant. Since minoxidil is excreted into breast milk in very low concentrations and no adverse effects have been reported in infants, the American Academy of Pediatrics considers topical minoxidil in lactation to pose little to no threat. Please note that this only applies to topical (not oral) minoxidil.

What should I do if I accidentally miss a dose of minoxidil?

In the case of a missed dose of minoxidil, there are two ways to proceed. If it is not very long after the original time you were supposed to have your minoxidil, you can still take it. However, if it is close to the scheduled time for your next dose, you should skip the previous one entirely. It is essential that you do not double your next dosage to compensate for a missed dose, as doing so could lead to several unwanted side effects.

How do I choose between topical and oral minoxidil?

It is essential to note that topical and oral minoxidil are the same medication — just in different forms. This means they are both effective as hair loss treatments. Topical minoxidil is usually recommended before its oral counterpart. However, this is mostly due to the fact that it is more easily available and in no way indicates that it is somehow better than oral minoxidil.

Your doctor will guide you in finding the best course of action to treat your hair loss. It’s vital to ensure you disclose all of your health conditions, allergies, and the current medications you are taking during your initial medical consultation, as this will impact your hair loss treatment plan. For example, if you are allergic to propylene glycol, you will be unable to use a topical minoxidil solution and your doctor may recommend a topical foam instead.

Additionally, if you have minimal positive results or experience severe side effects from topical minoxidil solution or foam, your doctor may recommend you switch to oral minoxidil. Each person’s body is different and, as such, responds differently to medication.

Taking minoxidil tablets instead of applying topical minoxidil may be more effective for certain individuals. This could be a result of their physiological make-up. Minoxidil needs to be activated by the sulfotransferase enzyme (found in both hair follicles and the liver). However, this enzyme is not always present in everyone’s hair follicles, meaning certain patients may only be able to effectively absorb minoxidil in an oral form.

What alternative medications are there to minoxidil?

Besides minoxidil, there are two other drugs predominantly used to treat male pattern baldness and hair loss — finasteride and dutasteride.

Originally developed to combat benign prostatic hyperplasia (an enlarged prostate), these medicines function by preventing the conversion of testosterone into dihydrotestosterone (DHT) — a male hormone that shrinks hair follicles and results in the prevention of hair growth.

While both medications have been shown to yield positive results as hair loss treatments, dutasteride has a slightly higher efficacy rate than finasteride. This is because it has the ability to block higher levels of testosterone and is slightly more successful in promoting new hair growth. However, dutasteride is not currently a UK-licensed hair loss medication (despite common off-label usage for this purpose).

Given that their mechanisms of action directly relate to hormone production, the side effects of both finasteride and dutasteride are generally related to hormones and sexual functionality and organs. Cross-examples of this include mood disturbances, gynecomastia (the growth of male breast tissue) and differing forms of sexual dysfunction.

Can minoxidil topical be used on other parts of the body?

No. Even though it can sometimes cause hypertrichosis on the body or face, minoxidil topical solution for hair loss should only be used on the scalp in the exact amount prescribed by your doctor.

Using a higher concentration of minoxidil foam or cream, using it too often, or using it on other parts of the body increases the chances of it being absorbed through the skin and affecting your heart and blood vessels with unwanted effects.

Read more about the uses of minoxidil for beard growth and body hair growth.

What are the side effects of minoxidil hair loss treatments?

While minoxidil offers the positive effect of stimulating new hair growth, it may also cause some unwanted side effects, such as swelling of the face, reddened skin, rapid weight gain, fainting, continuous itching, or a skin rash.

Please note that not all minoxidil side effects for women and men are mentioned above, so you should contact a medical professional if you experience any adverse reactions after beginning the treatment.

How long does minoxidil take to work?

For some, minoxidil hair regrowth results have appeared in as little as eight weeks following a regular dosing schedule. However, others might have to wait a few months — up to 16 weeks — before they start seeing results.

During the first six weeks of use, you may still experience thinning hair and hair loss, but this should subside. If you are still seeing hair shedding after four months, there may be a separate, underlying medical problem. Minoxidil results after 1 year differ for everyone, but will usually include noticeable hair growth.

It’s important to note that, if you decide to stop treatment, any positive effects the minoxidil treatment had will be reversed as your hair growth returns to its normal cycle. However, this process is not immediate, and will usually take place over the course of three to four months after you stop using minoxidil medication.

Considering crown and hairline hair restoration using minoxidil and want to speak to a professional? Book an appointment at our clinic to find out how we can help.

Dr Bonaros: Trusted Hair Loss & Restoration Specialist, UK

If you are looking into hair restoration solutions, contact our state-of-the-art hair transplant clinic in Glasgow. Our clinic is led by Dr Bonaros, a highly experienced and trained hair transplant surgeon and hair loss specialist in Scotland. We aim to treat hair loss in a safe, effective, and personalised manner, with the overall goal of helping patients regain their confidence through long-term solutions.

As a full member of the British Association of Hair Restoration Surgery (BAHRS) and Scotland’s only full member of the International Society of Hair Restoration Surgery (ISHRS), Dr Bonaros is one of the most qualified hair restoration experts in the UK.

Using a patient-centred approach, Dr Bonaros can assess your case, perform a reliable diagnosis, and provide you with a realistic and comprehensive treatment plan tailored specifically to your needs. He will also monitor the effectiveness of the medical therapy clinically and suggest other treatments, such as medical and surgical options to augment the benefits of minoxidil.

Are you ready for a minoxidil hair treatment from a trusted hair loss treatment specialist in Scotland? Book an appointment with Dr Epameinondas Bonaros to start your hair restoration journey today. You can also schedule a Zoom consultation below or fill out our free online assessment form to get advice sent directly to your inbox.