Minoxidil: What you need to know

Minoxidil, which is most commonly sold under the brand name Rogaine, is a well-established treatment for hair loss. Initially introduced as a medication for hypertension, its effectiveness in promoting hair growth led to its FDA approval as a topical treatment for hair loss in the late 20th century. This article aims to provide a comprehensive understanding of Minoxidil, including its benefits, limitations, and practical considerations.

What Is Minoxidil (Rogaine)?

Originally developed as an oral medication to treat high blood pressure, Minoxidil’s unintended side effect of excessive hair growth, spurred its use for alopecia. The FDA first approved the 2% topical solution for men in 1988, followed by approval for women in 1991. The more potent 5% solution was later introduced for enhanced efficacy. Available under brand names like Rogaine and Theroxidil, it also comes in generic formulations.

How Minoxidil Works

Hair growth follows a cycle consisting of four distinct phases; the anagen phase (active growth), catagen phase (transition), telogen phase (resting), and exogen phase (shedding). When even one phase is disrupted, it can lead to issues like hair thinning or loss.

Minoxidil helps to extend the anagen phase so that hair grows longer and thicker before entering into telogen phase. At the same time Minoxidil acts as a vasodilator, improving blood circulation to the scalp. This enlarges hair follicles, prolongs the growth phase, and stimulates hair regrowth. However, it does not directly counteract dihydrotestosterone (DHT), the hormone responsible for androgenetic alopecia.

Who Should Use Minoxidil?

Minoxidil is most effective for individuals experiencing androgenetic alopecia, especially those under 40 with early-stage hair thinning. However, it is not suitable for individuals with sudden hair loss, patchy baldness, or underlying scalp conditions. Pregnant and breastfeeding women should avoid its use. As minoxidil is a vasodilator, it is not suitable for those taking other vasodilators.

Benefits of Minoxidil

Clinical studies confirm Minoxidil’s ability to improve hair density and regrowth, particularly in the early stages of hair loss. Its over-the-counter availability makes it easily accessible. It works well for vertex baldness in men and general thinning on the crown in women. And also the 5% solution has shown superior results compared to the 2% formulation. Minoxidil is a noninvasive treatment option unlike the painful treatments of micro-needling and platelet-rich plasma therapy.

Limitations of Minoxidil

The effectiveness of Minoxidil varies among individuals. It is not a solution for receding hairlines or complete baldness, with approximately 40% of users reporting moderate improvement. It takes about 4–8 months for results to be appeared. And the continuous application is necessary to maintain regrowth. Stopping the treatment will again result in hair shedding. Applying Minoxidil can be inconvenient for some individuals as the scalp has to be completely dried before application and cannot wash the hair until several hours after application. Furthermore, Minoxidil is a temporary treatment whereas it does not address the underlying DHT hormonal causes of hair loss.

How to Use Minoxidil

Topical Minoxidil is available in both foam and liquid forms. It should be applied twice daily to a clean, dry scalp for best results. The hair should be sectioned before application such that the thinning areas are well exposed. Sometimes a one-time application is sufficient for women. Many people prefer to use Minoxidil in the morning and then again few hours before the bedtime.

The product should be gently massaged into the scalp using fingertips after application to ensure the targeted area is fully covered. Washing hands after application is necessary as minoxidil can cause hair growth in unwanted areas if it comes into contact. Since Minoxidil can stain the fabrics, wearing new or favorite clothes and high-quality bedding must be avoided when Minoxidil is applied. Visible improvements typically begin after 4–8 months of consistent use. Avoid application on irritated or sunburned skin, and keep the product out of reach of children.

Common Side Effects

Mild side effects of Minoxidil include scalp irritation, dryness, itching and flaking. If such experiences occur the use of minoxidil must be discontinued and consult the physician. In rare cases, it may cause systemic effects such as chest pain, weight gain, shortness of breath and swelling of hands, face, ankle and feet. Moreover, it is better to avoid exposure to direct sunlight while minoxidil is applied as it can make a person’s skin sensitive to sunlight.

Comparing Minoxidil with Other Treatments

Minoxidil and Finasteride are popular treatments for hair loss. Finasteride is a 5-alpha reductase inhibitor which is not usually recommended for women at childbearing age. That is because, finasteride can cause abnormalities in the developing male fetuses if a woman gets contacted with it during the pregnancy. However, Finasteride can cause side effects in men too such as sexual dysfunction. In such a situation Minoxidil becomes the only FDA approved topical treatment for hair loss which is suitable for both men and women! Over-the-counter alternatives often cannot be matched with the active ingredients and effectiveness of minoxidil. But however, combination therapies like minoxidil with finasteride or ketoconazole shampoos may offer enhanced results.

Setting Realistic Expectations

Most of the women than men experience varying levels of results with minoxidil. Some may notice an increase in hair density while some others find it nonresponsive. That’s because, the hair regrowth outcomes with Minoxidil depend on individual factors, including age, type of hair loss, and adherence to treatment. Although minoxidil isn’t a cure for hair loss, it is an effective management tool. And it might be the best practical option for women experiencing hair loss. Consulting a dermatologist can help the consumers in developing a personalized treatment plan avoiding the misconceptions.