If you’re looking into hair loss treatments, chances are you’ve stumbled upon the name minoxidil. This topical treatment comes in various concentrations and product types, and several are FDA-approved for the treatment of hair loss.
Minoxidil is unique because it’s the only topical treatment currently available. It also has minimal side effects and is known for being affordable. If you’re interested in finding out more about minoxidil and its effects on your body, you’ve come to the right place.
Minoxidil: The first treatment for hair loss
The 1950s and 1960s were huge for drugs in the United States. From valium to the creation of the first oral contraceptive, the USA was on a huge drug development boom.
Around the same time, an oral blood pressure reducer was also being assessed in clinical trials. The medication worked. But when people took it for more than a few weeks, up to 80 percent reported a strange, but harmless side effect: They were seeing an increased amount of hair growth (also known as hypertrichosis).
At this point and time, there weren’t any medications for hair loss. In fact, many clinics were offering snake oil treatments that caused incredibly unpleasant side effects and didn’t do anything to help boost hair growth. Given the lack of alternatives, this strange antihypertensive, hair-growth inducing drug was suddenly the recipient of a lot of attention.
According to a publication from The Pharmaceutical Journal, it wasn’t until 1978 that this drug – minoxidil – started being assessed in clinical trials for hair loss. It was tested in both androgenic alopecia (male pattern baldness), a type of hair loss caused by a mixture of genetic and hormonal factors, and alopecia areata, an autoimmune condition that triggers hair loss.
After these trials, researchers were able to confirm that minoxidil at 1 and 2 percent concentrations were able to induce clinically relevant improvements in hair growth. In 1986, topical 2 percent minoxidil solution became the first hair loss treatment available to the public, and topical 5 percent solution became available a few years later. Today, minoxidil remains as the only topical, FDA-approved treatment for hair loss.
How minoxidil prevents hair loss
These days, topical 2 percent minoxidil isn’t the only minoxidil product on the market. You’ll find a range of different items, including minoxidil creams, minoxidil shampoos, minoxidil foams, and minoxidil serums. Concentrations of these products can range between 1 and 15 percent. However, only the 2 and 5 percent foam and serum are FDA-approved treatments for hair loss.
When you apply minoxidil serum or foam to your scalp, it’s absorbed into your body. According to a study in the journal Drug Design, Development and Therapy, once the medication is absorbed, it directly affects your follicular cells – which are the cells in and around your hair follicles. However, the exact way minoxidil works after this point isn’t fully established. According to this study and another study in the Drugs Journal, minoxidil is thought to potentially:
- Stimulate hair growth by increasing blood flow to the scalp
- Stimulate hair follicle cell proliferation and differentiation
- Increase hair follicle size
- Increase levels of hair-related growth factors
- Prompt follicles to stay in anagen phase, which is the active, growing phase of the hair growth cycle
- Mediate the body’s inflammatory response
Other topical minoxidil products technically work the same way. However, they might be more or less effective depending on other factors, like the concentration of the product and how long they’re left on your scalp.
Which minoxidil should I use?
If you’re trying to grow hair back after hair loss, you should probably try one of the FDA-approved hair loss treatments: 2 or 5 percent minoxidil serum or foam. A lot of the other minoxidil products on the market, like minoxidil shampoo or minoxidil cream, can come in much lower concentrations and may consequently be less effective.
If you’re trying to choose between 2 and 5 percent minoxidil solutions, you should be aware that the 5 percent products are also the ones typically recommended for men with androgenic alopecia. The Drug Design, Development and Therapy study mentioned that the 5 percent formula produces better results, so choosing either 5 percent minoxidil foam or 5 percent minoxidil serum might be your best bet.
Is there any benefit to high concentration minoxidil?
Minoxidil products can be sold in concentrations as high as 15 percent. So why not use the highest possible concentration of minoxidil, you might ask? Well, for most people, it’s just not necessary.
A study in the Journal of Dermatological Treatment says that 5 percent minoxidil solution is actually more effective, even when compared to higher concentrations like the 10 percent solution. People who tried the higher concentration version of minoxidil actually experienced an increase in side effects, and no real difference in hair growth compared to the people using the 5 percent solution.
It’s only in very select cases that high concentration minoxidil products can be helpful. As you might remember, about 80 percent of people respond to the standard concentrations of minoxidil – which essentially means that not everyone does. According to the Drug Design, Development and Therapy study, people who are non-responsive to the standard concentrations of minoxidil are the ones who might benefit from higher concentration products, like those sold at 10 or 15 percent. This is still being researched, though.
Oral vs. topical minoxidil
Even though it was developed first, oral minoxidil isn’t very common these days. However, if you have very sensitive skin, your doctor might recommend it as an alternative to the FDA-recommended minoxidil treatments. According to a publication in the Journal of the American Academy of Dermatology, low doses of oral minoxidil can be just as effective as topical minoxidil. Just be aware that oral and topical minoxidil have very different side effects.
How long does minoxidil take to work?
Back in the 1960s, it only took a few weeks for oral minoxidil to start inducing hair growth. Unfortunately, topical minoxidil doesn’t work that quickly. Most men using topical minoxidil see results after a few months of using this hair loss treatment. It’s certainly possible to see promising effects within a few weeks, but the majority of people will only start to see a noticeable increase in hair growth or thicker hairs later on.
The Pharmaceutical Journal study recommends giving minoxidil three months before making a judgement on whether or not it’s working for you. This is because it takes time for wispy, vellus hairs (like the peach fuzz on other parts of your body) to turn into the dark, terminal hairs that typically grow on your head.
How to use minoxidil solution correctly
Minoxidil is a hair loss treatment, but it doesn’t need to be applied to your hair. If you’ve never used minoxidil before, here’s the main thing you need to know: Minoxidil needs to be applied onto your scalp in order to work. You should specifically apply it to the area or areas where you’d like to see hair regrowth.
Most people need to apply minoxidil twice a day: once in the morning and once in the evening. It’s most effective when left on your hair for several hours at a time, so it’s best to apply it before you go to work in the morning or an hour or two before you head to bed at night. Make sure to repeat this routine each day; otherwise minoxidil might not have any effect.
What results can I expect?
Once you begin to see the initial signs of hair regrowth, you can expect better results in time, too. After an entire year of using minoxidil, 84 percent of participants from the Journal of the American Academy of Dermatology study had improved hair growth. By the end of the study:
- 62 percent of participants had smaller patches of hair loss on their heads
- 15.9 percent of participants found minoxidil to be very effective
- 47.8 percent of participants found minoxidil to be effective
- 20.6 percent of participants found minoxidil to be moderately effective
Generally, men see a vast improvement within the first year of using minoxidil.
“Many people benefit even with a bald patch at the back and regression at the front and, unless someone is completely bald, it’s worth a go for three months.”
A second study from the Journal of the American Academy of Dermatology that followed minoxidil users for a period of five years reported significant hair regrowth over the first year. They experienced slower results and fewer notable changes after that.
That doesn’t mean you should stop taking minoxidil after a year, though. Your hair regrowth is dependent on continuously applying this treatment. If you stop, your hair will eventually go back to its original state.
Possible side effects of using minoxidil for men
Many different side effects that have been reported for minoxidil. Fortunately, most of them are pretty rare.
According to the Journal of the American Academy of Dermatology study and publications in the Journal of the American Academy of Dermatology and Recent Patents on Inflammation & Allergy Drug Discovery minoxidil side effects include:
- Stinging or burning sensations after applying the product
- Redness and irritation
- Inflammation
- Itchiness
- Dandruff (or a scaly scalp)
- Dermatitis
- Hypertrichosis
Out of all of these, the most common reported side effects are mild symptoms, like irritation, dandruff, or an itchy scalp. Other side effects, like hypertrichosis, are uncommon with topical minoxidil. However, this side effect is much more common if you’re taking an oral version of minoxidil, even when it’s taken in low doses.
Allergic reactions to minoxidil
Like all other FDA-approved drugs, minoxidil was tested extensively before it entered the pharmaceutical product market. This means that adverse reactions to this medication are rare. For example, a study in the Journal of the American Academy of Dermatology that looked at minoxidil users over the course of a year reported that less than 4 percent of participants experienced negative side effects. That being said, it is possible to be allergic to minoxidil.
Different symptoms, like swelling around your hands and feet, feeling faint or dizzy, or chest pain, are indicative of a minoxidil allergy. If you experience symptoms like these, the FDA says you should talk to your doctor immediately. Even if they’re not signs of a minoxidil allergy, they could indicate that you’re experiencing a more serious health problem.
Got a minoxidil allergy? Here’s what to do next
If you’ve previously experienced a minoxidil allergy, there’s a good chance that you’re actually allergic to a specific ingredient commonly used in minoxidil products: propylene glycol. If you already know that you’re allergic to propylene glycol and still want to use minoxidil, there’s an easy solution to this problem: Try foaming minoxidil products instead of minoxidil serums.
This is one of the perks of minoxidil compared to other hair loss treatments. If you’re allergic or have had an unpleasant reaction, you can usually just switch to a different formula, concentration, or product type.
Alternatives to minoxidil for men
If switching to a different minoxidil product hasn’t helped resolve side effects or allergic reactions, you might want to consider a different hair loss treatment. The FDA has also approved an oral hair loss treatment, called finasteride, which works by blocking the production of an androgen called DHT (dihydrotestosterone).
Another alternative, which works for both men and women, is low-level laser therapy (LLLT). This is one of the newest FDA-approved treatments for hair loss, and works by using laser light to induce hair follicle activity and prompt hair regrowth.
What happens if I stop taking minoxidil?
Minoxidil is a long-term hair loss treatment. Essentially, as long as you continue taking it, it will maintain healthy hair growth on your head, and prevent you from losing hair.
Of course, if you forgot to put on minoxidil this morning, or decide that you can’t apply it while you’re camping over the weekend, it’s probably not a big deal. That’s assuming that you usually apply minoxidil regularly on all the other days, though.
That being said, if you stop taking minoxidil for more than a few days, you might start to experience side effects, like hair shedding. The study in the Drug Design, Development and Therapy journal reported that ending minoxidil treatment would result in the return of hair loss. If you were to stop applying minoxidil altogether, you’d likely see progressive hair loss within 3 to 6 months.
“Termination of [minoxidil] treatment results in progressive hair loss within 12 and 24 weeks.”
What if minoxidil doesn’t seem to be working?
If minoxidil doesn’t seem to be working, it’s understandable that you might not want to keep using it. But before you stop trying it altogether, remember that some people are non-responsive to the standard concentrations of minoxidil. You may want to try a higher concentration of minoxidil or test out a different product.
It’s also sensible to talk to your doctor about a combination treatment. Sometimes, they’ll recommend trying two hair loss treatments simultaneously, like minoxidil and finasteride. They might also recommend you check out a clinical trial or assess other factors that might be affecting your hair loss. Men with androgenic alopecia sometimes have additional issues affecting them, like skin conditions or nutrient deficiencies. Treating these secondary problems is key to helping them resolve their hair loss.
Takeaway
Minoxidil is the only topical treatment currently available for androgenic alopecia. In order for it to work, it needs to be applied to your scalp each day. It generally takes about 3 months to see results, but some people may see hair regrowth even sooner than that.
If you’re a man who has never tried minoxidil before, it’s likely best to start with the 5 percent foam or serum. There are other minoxidil products available, but out of all of them, the 5 percent solution produces the best results!
