Medically reviewed by Mary Lucas, RN
Written by Our Editorial Team
Last updated 2/12/2021
If you live with hair loss, minoxidil is a name you're going to want to remember. Although, with topical minoxidil and finasteride being currently the only FDA approved treatments for hair loss, that shouldn't prove too hard to do.
For decades, minoxidil has repeatedly proven to be an effective treatment against hair loss in both men and women. But what amount of this medication is suitable to manage your hair loss needs?
We'll be answering this question by looking into the dosage recommendations of minoxidil, how it works, and the potential side effects you should be aware of when using this medication.
How does minoxidil work?
Before we get into the science-heavy mechanics of how minoxidil operates, let's break the ice with a story about its origins.
Minoxidil was originally discovered in the ‘70s as a treatment for severe refractory hypertension. In fact, oral minoxidil is still in use as a potent antihypertensive agent.
From the onset, patients who were being treated with minoxidil for severe refractory hypertension got a little more than they bargained for in their therapy — the abnormal growth of hair on different body parts.
This accidental discovery of minoxidil’s ability to promote hair growth brings us to the breakdown of how this medication may work.
Minoxidil is known to promote hair growth by shortening the telogen phase of the follicle growth cycle.
When the telogen phase is shortened, your hair follicles are forced to enter into a premature growth phase.
This typically causes the excessive shedding of telogen hairs. It is otherwise known as the last thing you want to see happen when attempting to control hair loss.
But don't sweat it, this process will only allow room for the growth of new hairs, especially because minoxidil is able to extend the anagen phase of the hair cycle. Even better, this medication is known to increase hair length and diameter.
Topical minoxidil is available as an over-the-counter medication for the treatment of male pattern baldness.
You can find it in 5% and 2% dosages. To improve your hair loss, you're probably hoping for a dosage that can offer quick and efficient results — perhaps even overnight improvements where possible.
However, while nothing can offer next day results, the 5% dosage of minoxidil may be the preferred option in managing hair loss.
In a 48-week clinical trial carried out on 393 men to compare the 5% and 2% dosages, 157 applied the 5% topical minoxidil dosage. Among the patients, 158 men were given the 2% formulation while 78 were given placebo to apply t two times a day.
The effectiveness of either dosage was determined by scalp target area counts, as well as patient and investigator assessments of hair growth and treatment benefits.
At the end of 48 weeks of therapy, 5% topical minoxidil was found to be more effective than the 2% option or a placebo in increasing hair re-growth.
Those on the 5% treatment also had an earlier response to treatment. The men studied left with improved perceptions of themselves following minoxidil use.
A similar study carried out on women with female pattern hair loss produced the same end results.
It's important to note that results can be varied, speak to your healthcare provider for the best option for you.
For effective results from your recommended dosage, remember to apply it twice daily and follow the instructions to to keep the applied amount at 1ml for the liquid form.
Topical minoxidil is available in liquid and foam.
As an alternate option, while oral minoxidil is yet to receive FDA approval for use in treating hair loss, in low doses, it has been shown to be an effective remedy for androgenic alopecia at a dose of 0.25mg-5mg daily.
However, caution is needed especially for people with high blood pressure or other cardiovascular issues.
On paper, minoxidil appears to be a perfectly suited treatment for male pattern hair loss. But how does it hold up in actual practice?
In a study to determine this, 5% minoxidil foam was tested against a placebo in 16 healthy men between the ages of 18 to 49 who were experiencing thinning hair on the frontal and vertex regions of the scalp.
The subjects of the study were to apply either the topical solution, or the placebo twice daily for eight weeks.
To make sure results were accurately documented, scalp photographs were taken at the start and finish of the study. Likewise, scalp biopsies were done before and after treatment.
While 16 men began the study, only 13 completed it, this number consisted of nine in the active group and four on placebo.
By week eight of the study, four out of the nine participants on topical minoxidil had already begun to experience hair growth. It is believed that topical minoxidil stimulated production of “keratin associated proteins” to achieve this. However, the remaining five were non-responders to the treatment.
Those that responded to the treatment displayed growth in the frontal and vertex scalp.
Another example is a four-month study to test the effectiveness of topical minoxidil in androgenetic alopecia. 733 men with the condition were evaluated.
These subjects included 150 physicians who knew a thing or two about the right use of minoxidil and how to assess its effects.
The subjects were to apply 1ml of the solution twice a day to the affected areas of their scalp.
Subsequently, this number dropped to 725 eligible patients.
By the fourth month, 488 of the 725 subjects noticed that the affected area of their scalp had become smaller. Although, 231 men didn't notice any changes in their hair loss, and six subjects reported an increase in the affected area.
On hair growth, 54 of the 725 subjects found topical minoxidil to be very effective, 399 found it effective, 227 moderately effective and 45 users didn't find it to be effective at all.
In determining hair density, 74.2 percent of the 721 eligible subjects reported improvements, while 24.3 percent claimed to remain unchanged and with 1.5 percent reported worsened conditions.
In total, around 60 percent of users found topical minoxidil effective in managing their hair loss after only two months of use.
Oral minoxidil also passes the effectiveness test.
In a study carried out on 30 men aged between 24 to 59 years with androgenetic alopecia, 5mg of oral minoxidil was administered once daily for 24 weeks.
Forty-three percent of participants showed excellent improvement in their hair loss.
However, hypertrichosis (more than normal hair growth) was a common issue observed in 93 percent of participants following oral minoxidil use.
Minoxidil is a largely well-tolerated medication. However, like any drug, it isn't without a fair share of side-effects. This medication may cause unintended hair loss via telogen effluvium, as well as other adverse effects, including:
Skin irritation such as: erythema (skin reddening) and a burning sensation on the skin surface.
Scalp irritation or the worsening of seborrheic dermatitis
Allergic contact dermatitis
Isolated pruritus — itchy skin without an accompanying rash
Localized or generalized hypertrichosis, which is commonly observed after the use of oral minoxidil.
Hair loss can be one of life's big curve balls, but with medications like minoxidil to help with managing it, you could get the last laugh, and a noticeably improved head of hair to boot.
In its approved form, minoxidil can be applied topically as a liquid formulation or as a foam. It is available in 2% or 5% formulations, and should be used once daily, at a 1ml amount.
Minoxidil also comes as an oral tablet. While yet to be approved for use for hair loss, it has been proven effective in 0.25mg to 5mg doses, to be used once a day.
To make sure you're getting the right care in the right doses however, have a chat with your healthcare provider on what doses of minoxidil will work best for your hair loss.
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