Minoxidil is an FDA-approved hair loss treatment. This topical solution was the first drug to be approved for androgenic alopecia. It’s able to stop hair loss and promote regrowth.
Yet, if you’ve ever looked at a minoxidil package label, the disclaimer is very specific. The label approved by the FDA specifically says that it’s “not for frontal baldness or a receding hairline”. Minoxidil is only meant to be applied to the crown of the head.
Is minoxidil hairline regrowth possible? Minoxidil works anywhere it’s applied, so it should certainly be able to help grow hair there. Yet, despite being sold for several decades and researched quite extensively, there aren’t many studies assessing minoxidil hairline regrowth.
What is minoxidil?
Minoxidil is a blood pressure reducer that was turned into a hair loss treatment in the late 1980s. This medication, which was originally an oral drug, is now available as a 2 percent and 5 percent serum and foam. The 5 percent version is thought to be the most effective.
Minoxidil is now approved for the treatment of male pattern hair loss (androgenic alopecia), but according to Statpearls Publishing, it’s also used off label for other hair issues, including:
- Alopecia areata
- Chemotherapy-induced alopecia
- Scarring alopecias
- Telogen effluvium (stress-related hair loss)
- Monilethrix (a rare brittle hair disorder that’s inherited)
Minoxidil is also used off-label to help reduce hair loss before and after hair transplantation procedures. It has minimal side effects and is even considered to be safe enough for off-label use in children.
How does minoxidil work?
Despite being the first FDA-approved treatment for androgenic alopecia, minoxidi’s mechanism of action isn’t completely understood. According to Statpearls Publishing and a review in the Journal of Dermatological Treatment, minoxidil works in a variety of different ways.
Minoxidil is thought to directly stimulate hair follicles and work as a:
- Anti-inflammatory agent
- Vasodilator, increasing circulation around the scalp, allowing more blood and nutrients to reach hair follicles.
- Activator of growth factors that can increase vascularization around hair follicles, which creates new routes where blood can flow.
- Activator of hair growth factors and the pathways they use to stimulate and prolong the hair growth cycle. Minoxidil is specifically thought to influence the length of the anagen (growth) and telogen (rest) phases of the hair growth cycle.
Minoxidil is an effective hair loss treatment that can regrow hair and help follicles produce thicker, healthier hair strands. It generally starts to work after about 8 weeks of use. This delay is primarily due to the hair growth cycle, and occurs in almost all hair loss treatments.
Like all drugs, minoxidil is not 100 percent effective. This medication may work better for some people than others. It’s also most suitable for people with mild to moderate hair loss. It won’t have a huge effect on someone who is already bald.
The Journal of Dermatological Treatment review says that minoxidil can regrow hair around both the temples and crown of the head. However, the FDA-approved label explicitly states that this medication should only be applied to the crown.
The question, then, is why limit this drug’s application? Does minoxidil not work as well on the temples and hairline? At the moment, only three studies seem to have assessed minoxidil’s effects on the temples and hairline. Yet, all of them have reported positive results.
Does minoxidil work for frontal baldness?
In androgenic alopecia, hair follicles shrink over time. This process, known as miniaturization, is what causes the follicles to produce increasingly thin, weak hair strands. Eventually, hair follicles stop producing hair altogether.
If a hair loss treatment isn’t started early enough, follicles that stop producing hair may never produce new hairs again. This is why minoxidil can’t do much for baldness of any type. Those hair follicles have been left dormant for far too long.
Unfortunately, this means that it’s unlikely to work well for frontal baldness, as well. The exception would be if you’d had a hair transplant to deal with your frontal baldness, and were using minoxidil to enhance or maintain the results.
However, this doesn’t mean that minoxidil can’t work at the front of the head. An article in the British Journal of Dermatology had men apply minoxidil to both their temples and the crowns of their heads. Biopsies, taken 8 weeks later, showed that this drug was able to work on both areas of the scalp. In both cases, minoxidil reduced inflammation and counteracted hair follicle miniaturization by reducing the expression of certain genes.
Minoxidil is best for mild to moderate hair loss
People who have patchy hairlines, thinning hair at their temples, and other similar mild to moderate hair loss symptoms are the most likely to benefit from minoxidil. A randomized, double-blind, 6 month clinical trial in the journal Skin Pharmacology and Physiology reported that 5 percent minoxidil was able to improve both hair density and hair thickness in men with moderate androgenic alopecia. These results could be seen at both the crown and the front of the head.
Another longer-term clinical trial, published in the Journal of the European Academy of Dermatology and Venereology, agreed. This 2 year study also reported improvements in hair strand diameter, hair density, and overall hair coverage across both the front, temples, and crown of the scalp. Notably, there were no major side effects from using minoxidil in this way.
Combat frontal baldness early on
Your best chance of using minoxidil to combat frontal baldness is to start your treatment before you’ve gone bald. Ideally, you should start using minoxidil or another treatment as soon as you start to see changes around your hairline and temples.
Start a hair loss treatment before it’s too late.
According to a study in the Journal of Cutaneous and Aesthetic Surgery, a receding hairline is one of the very first signs of male pattern hair loss. If you’re not sure if you have a receding hairline, keep a lookout for any hairline irregularities, a larger than normal amount of thin hairs or baby hairs framing your face, and an increase in your forehead size.
Oral minoxidil for hairline restoration
From higher dose topical minoxidil to oral minoxidil, different minoxidil concentrations and formulations are constantly being tested. Recently, a study in the Dermatology and Therapy journal tested how well low doses of oral minoxidil could work on different parts of the scalp.
This study found that oral minoxidil was able to act across the entire scalp, at both the crown and frontal regions. While positive effects were seen across both areas, minoxidil had more of an effect at the crown than it did at the hairline and temples. And this version of the drug, unlike topical minoxidil, caused more side effects, like swelling and hypertrichosis (excessive, random, unwanted hair growth across other areas of the body).
Hair transplantation for hairline restoration
If you’ve tried using minoxidil on your hairline and temples for a few months and haven’t seen much effect, you’ll likely want to consider a different hair loss treatment. Although you can certainly try using another FDA-approved solution, like finasteride or low level laser therapy, the best and most foolproof way to fix a receded hairline is a hair transplant.
According to a study in the Journal of Maxillofacial and Oral Surgery, two main hair loss transplants are currently performed: follicular unit extraction (FUE) and follicular unit transplantation (FUT). Ironically, minoxidil is usually used before and after both of these surgeries to enhance their results.
If your hairline has receded substantially and your temples are also affected, your doctor will likely recommend FUT. This surgery involves a strip of skin being removed from the back of the head, where no hair loss has occurred. Hair follicles are then extracted from the strip of skin and transplanted to the areas of the scalp affected by hair loss. The main downside to this procedure is the large scar that it leaves at the back of the head.
If your hairline hasn’t receded a great deal, your doctor will likely recommend that you have FUE. This is a less invasive procedure where healthy follicular units are extracted from your scalp and transplanted into the areas with hair loss. This procedure is often more appealing to people as it doesn’t leave as large a scar as FUT. However, it’s not usually an option for people with extensive hair loss. If that’s you, your doctor might actually recommend that you get both FUT and FUE done.
Combining scalp micropigmentation and hair transplantation
According to a study in the Journal of Cutaneous and Aesthetic Surgery, both FUE and FUT can cause scarring. FUT’s scar, at the back of the head, is practically guaranteed. However, both procedures can cause circular post-surgical scars and pigmentation changes to the areas of the scalp where the follicles were transplanted. Obviously, these marks can draw attention to the hairline in an undesirable way.
An article in the Hair Transplant Forum International journal recommended combining a tattooing procedure known as scalp micropigmentation with hair loss transplants. This scalp tattoo isn’t like a regular tattoo, as it only lasts a few years. However, it’s still ideal as it can both enhance the appearance of the transplant and hide any post-surgical scars.
You can get micropigmentation done multiple times to maintain your look. Alternatively, if you don’t want to repeat the process, you can always just grow your hair out in order to hide your scars in a more natural way.
Does minoxidil work for hairline regrowth?
Minoxidil for frontal baldness is not recommended by the FDA. As the package states, minoxidil is intended to treat hair loss at the crown of the head.
However, this topical hair loss treatment should technically work where it’s applied. If you’ve bought some of this product and are wondering if you can also apply minoxidil to a receding hairline, you’re not the only one. Whether or not minoxidil will have any effect will largely be based on how long you’ve been experiencing hair loss symptoms.
Although it’s not recommended, you can apply minoxidil to the hairline and temples. Studies have shown that this topical drug can produce positive effects related to both hair regrowth and the production of thicker, healthier hair in these parts of the scalp.
Oral minoxidil has also been assessed for its ability to promote frontotemporal regrowth. It doesn’t work as well as on the crown, but this alternative formulation is still able to counteract hair loss at the hairline and temples. Unfortunately, it does seem to cause more side effects.
If you’ve been experiencing miniaturization for a while, your hair follicles may be dormant and unable to produce hair. In this case, a hair transplant will likely be your best bet for hairline restoration. Your doctor will likely recommend using minoxidil before and after your transplant in order to enhance your transplants results.