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Oral minoxidil for hair loss
Reviewed by Dr Epameinondas Bonaros
Low-dose oral minoxidil can be an alternative to topical minoxidil in the treatment of hair loss.
Disclaimer: This content is meant for informational purposes only and is not a substitute for professional medical advice. You should consult with a registered specialist before beginning any new treatment plan.
Minoxidil is a potent vasodilator that has been approved for use for severe hypertension. It can also be used topically for androgenetic alopecia, which is hair loss caused by genetics. Minoxidil was first developed in the 1970s as an antihypertensive medication. Early on, researchers noticed an unexpected side effect: some patients experienced hypertrichosis (excessive hair growth). Over time, they found that this side effect could be useful in treating male-pattern hair loss. The drug was first approved in 1988, and since then, it has become one of the most popular treatments for male and female pattern baldness. Oral minoxidil is an emerging treatment for hair loss for men and women.
When is oral minoxidil given for hair loss?
Even though topical minoxidil has been used for many years to treat hair disorders, some patients report poor compliance and side effects. Treatment with oral minoxidil can be considered in healthy men and women who cannot tolerate or comply with topical minoxidil. It is also considered for men who are concerned about or have already experienced sexual side effects from finasteride. In addition to its therapeutic benefits, practical advantages of oral minoxidil include improved convenience, comfort and cost. Oral minoxidil is not officially approved for male pattern baldness, so its use is off-label. Though additional studies in the form of large-scale, randomized clinical trials are needed, studies support the role of low-dose oral minoxidil in treating non-scarring alopecia.
Why would oral Minoxidil work when topical Minoxidil has not worked?
Oral minoxidil is an effective treatment option for patients who have not responded well to topical minoxidil. Minoxidil is a prodrug that is converted into minoxidil sulfate by the enzyme SULT1A1. In about half of the population, SULT1A1 activity is low, which indicates a weak response to topical minoxidil. On the other hand, oral minoxidil produces dose-dependent hair growth even in patients with low SULT1A1 activity.
How effective is oral minoxidil?
Oral minoxidil has been shown to be effective in the treatment of androgenetic alopecia, with 61–100% of patients demonstrating objective clinical improvement. This includes decreased hair shedding, increased hair density and length. Combining oral finasteride and minoxidil therapies may achieve superior results over minoxidil alone.
What are the side effects of low-dose oral minoxidil?
Side effects of low-dose oral minoxidil include unwanted hair growth on the face and other areas of the body, as well as lower limb oedema, postural hypotension, tachycardia and shedding.
Oral Minoxidil Dosage for hair loss
Different doses of oral minoxidil have been used to treat hair loss, ranging from 0.25 mg to 5 mg daily.
The dosage ranges from 1.25 to 5mg for men. The recommended daily dose for women is 0,25 to 2.5 mg.
When Minoxidil should be avoided
Oral minoxidil is not recommended for people with an allergy to the medication and people with a rare type of neuroendocrine tumour known as a pheochromocytoma.
It may also not be a viable treatment for elderly patients, those with hypertension, and cardiovascular or kidney problems.
Does Minoxidil cure hair loss for good?
Oral minoxidil is a medication that can help slow or stop hair loss, but it doesn’t cure hair loss. The effects of oral minoxidil last only as long as you are taking the medication, and stopping treatment means that you will likely lose any hair you have grown from the treatment.
In conclusion, low-dose oral minoxidil is an emerging therapy for alopecia, with a good safety profile and few contraindications that allow it to be prescribed for most patients.
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