hair loss / Minoxidil
Minoxidil is the generic form of the brand Rogaine®. Both medications work similarly in the body.
Minoxidil is a topical medication that is used to treat male pattern hair loss (androgenetic alopecia) in men and women. It comes in 2% and 5% strengths that should be applied directly to the scalp daily. Only the 2% formula should be used in women.
Disclaimer: The information provided on this page is not a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns about your health, please talk to a doctor.
The exact mechanism of action of minoxidil is not completely understood but it is known to increase blood flow, lengthen the growing phase of hair follicles (anagen), and increase the size of hair follicles.
Minoxidil is effective at preventing hair loss. In some, but not all, men, it may cause hair regrowth.
The most common side effects of minoxidil are irritation and itching of the scalp where the medication is applied. Contact your doctor if you experience more serious side effects.
What is Minoxidil?
Minoxidil is one of two FDA-approved treatments for male pattern hair loss (androgenetic alopecia). It was originally designed as an oral pill to treat hypertension. It was quickly abandoned as a primary treatment for hypertension because patients didn’t tolerate the oral (pill) form very well. It is still available in oral form, but it is rarely used. One of the side effects of oral minoxidil was unwanted hair growth. This prompted a study of minoxidil in topical form, which turned out to still have the positive effect of stopping hair loss and in some cases, even regrowing hair that was lost. The topical form is better tolerated and does not have the same effects as when it was taken by mouth.
How is Minoxidil Different from Rogaine®?
Rogaine® was the original brand name version of topical minoxidil that was FDA-approved for male pattern hair loss. After several years of Rogaine® being on the market, the FDA approved generic formulations of minoxidil. Rogaine® and generic minoxidil are both available in 2% and 5% strengths as a solution and as a foam. Minoxidil 5% has been found to be more effective in men, while the 2% and 5% are equally effective in women. Both strengths are FDA-approved for use in men and the 2% strength is also FDA-approved for use in women.
How does Minoxidil Work?
The exact mechanism of action of topical minoxidil is not completely understood. It increases the length of the growth phase of hair follicles (a process called ‘anagen’) and increases the size of hair follicles which dictates the thickness/diameter of the hair that comes out of the follicle. Minoxidil relaxes smooth muscle in blood vessel walls causing them to widen, increasing blood flow. This may be one of the ways that minoxidil works to prevent hair loss, and, in some cases, regrow hair.
Minoxidil tends to work best on younger men who have been experiencing progressive hair loss for fewer than 5 years. In fact, the earlier the better. However, even if started early, minoxidil is more likely to stop hair loss than to regrow hair. Hair regrowth can occur, but it is more common to stop or slow hair loss than it is to see hair regrowth. Minoxidil was studied and found to be effective at stopping or slowing down hair loss at the crown of the scalp. Interestingly, in the first few months of using minoxidil, loss of fine hairs may occur before they are replaced by thicker, more mature hairs. For some men, it can seem like it is getting a little worse before it improves.
How Effective is Minoxidil?
Topical minoxidil is one of only two FDA-approved treatments for hair loss. It was first approved for the treatment of male pattern hair loss in 1988, and there have been many studies showing its safety and effectiveness at preventing further hair loss. In some men, it is effective at regrowing hair as well. For example, a one-year study with minoxidil 5% solution showed that 62% of men had no increased hair loss. In addition, around 16% had significant hair regrowth and approximately 48% had moderate hair regrowth. When used topically, only around 2% of minoxidil is absorbed, and systemic side effects are rare.
Can Minoxidil Help with Hair Regrowth?
Minoxidil is better at stopping or slowing hair loss than regrowing hair; nevertheless, some men (and women) can experience some regrowth. A one-year study with minoxidil 5% solution showed that 62% of men had the same amount of hair at the end of the study as they had at the beginning of the year which means that they did not have any additional hair loss. In addition, around 16% had significant hair regrowth and approximately 48% had moderate hair regrowth. Another study showed that approximately 40% of men using 5% minoxidil, and approximately 22% of men using 2% minoxidil showed moderate or dense regrowth. It’s important to remember that daily use of minoxidil is essential to maintain results.
How do you Use/Apply Minoxidil?
The dose of topical minoxidil varies based on the individual. Below are general use instructions and the most common dosing.
1. You do not need to wash your hair before applying minoxidil; however, if you do wash your hair, your hair and scalp needs to be completely dry before applying minoxidil.
2. Apply the recommended amount to the affected areas of the scalp. Topical minoxidil is usually applied to the scalp twice daily, in the morning and at night.
3. Wash your hands after applying topical minoxidil.
4. Only use minoxidil on your scalp. Do not use on any other part of your body.
How to use topical minoxidil solution: Apply 1 mL topically to the affected area(s) of the scalp twice a day. The dose should not exceed 2 mL per day.
How to use topical minoxidil foam: Apply half a capful topically to the affected area(s) of the scalp twice per day.
How Soon Can You Wash Your Hair After Applying Minoxidil?
Wait 4 hours after applying minoxidil to your scalp before washing your hair. It’s a good idea to develop a routine of washing and drying your hair before applying minoxidil. Wash your hands immediately after applying minoxidil to your scalp.
What Should I Avoid While Using Minoxidil?
Avoid touching your clothes and other parts of your body after applying minoxidil. Wash your hands thoroughly and immediately after applying minoxidil to your scalp.
Minoxidil can stain clothes, linens, etc. That means the best time to apply it is not just before going to bed or in the morning just before putting on a hat. Instead, apply it 2 to 4 hours before going to bed and, if you apply minoxidil in the morning, let it dry before you put on a hat.
It’s also a good idea to avoid blow-drying your hair right after applying minoxidil as this can make the treatment less effective.
Side Effects of Topical Minoxidil
The most common side effects of topical minoxidil are irritation and itching of the scalp where the medication is applied. Unintended hair growth can occur if minoxidil comes in contact with areas other than your scalp. Other potential side effects of topical minoxidil that are more rare include:
- Acne at the application site
- Burning of scalp
- Increased hair loss
- Inflammation or soreness at root of hair
- Reddened skin
- Facial swelling or swelling of the face, hands, feet, or lower legs
- Blurred vision or other changes in vision
- Chest pain
- Fast or irregular heartbeat
- Numbness or tingling of hands, feet, or face
- Weight gain
You should contact your doctor immediately if you experience any of these side effects.
What Drugs Interact With Minoxidil?
When minoxidil is used topically, only about 2% of it is absorbed, which is why it has such a good side effect profile. Topical minoxidil does not interfere with any known drugs that are taken orally under normal circumstances. You should not use topical minoxidil over damaged skin because this will increase the amount that is absorbed systemically. Consult a dermatologist before using topical minoxidil if you are using other topical medications on your scalp.
Minoxidil Dosing Information
Minoxidil comes in two strengths, 2% and 5%. 5% minoxidil has been shown to be more effective than 2% in men but not in women. Both strengths are approved for hair loss in men, but only the 2% strength is approved in women.
For minoxidil solution: The dose should not exceed 2 mL per day.
For minoxidil foam: The dose should not exceed one capful per day.