Minoxidil For Hair Loss

  • Best Results4-6 months
  • Treatment RecoveryNA
  • Procedure TimeNA
  • Skin SpecialistPharmacy, dermatologist
  • Duration of ResultsDecades
  • AnaestheticNA
  • Back to WorkNA
  • Cost$

Minoxidil For Hair Loss

Minoxidil is one of the best studied treatments for male & female pattern hair loss. This medication can be applied topically as either a lotion or foam, compounded with other hair loss medications including hormone blockers or taken as a capsule orally. Minoxidil can be effective in up to 80% of cases, & can regrow hair in up to 40%. Early forms of androgenetic alopecia / hair loss respond best to this drug. This treatment is most effective when combined with medical therapy (discussed below).

FactsFacts on Minoxidil for Hair Loss

  • This over the counter topical is the first step in slowing down hair loss
  • The most commonly prescribed formulation is 5% minoxidil
  • It takes 4 to 6 months to see results
  • Minoxidil should be combined with medical therapy, lasers, PRP & other non-surgical procedures as early management of hair loss
  • Minoxidil compounded with topical finasteride gives a better outcome compared to monotherapy
  • Dermatologist also prescribe 1-2.5 mg minoxidil capsules for hair loss
  • Conversely minoxidil should be used post FUE to improve hair density at both donor & recipient sites

What is minoxidil?

Minoxidil is a readily available, over-the- counter hair loss treatment that comes as a lotion or foam. It is  applied to the scalp of men & women up to twice a day. This proven medical therapy can slow or stop the progression of male & female pattern baldness (a.k.a androgenetic alopecia).

Minoxidil tends to work best in the early stages of hair loss. To maintain results, it must be used continuously — if you stop using the medication, the new hair growth may reverse, and hair loss will continue. Essentially, the younger you are, and the sooner you start minoxidil, the better the results.

What types of hair loss responds to minoxidil?

Minoxidil works best for male & female pattern hair loss, also known as androgenetic alopecia. Your dermatologist may also consider this medication for cases of –

Telogen effluvium including Chronic Telogen Effluvium as well as-

*Disclaimer: I am a procedural dermatologist. For medical management of hair loss, please discuss with your dermatologist.

What percentage of minoxidil works best?

The stronger 5% topical formulation is most widely recommended by dermatologists. FDA approval for females is 2%, however research has shown that 5% works better.

Some dermatologists prefer to compound a bespoke formulation ranging from 5-7% minoxidil +/- 5 to 10% propylene glycol, 0.05 to 0.25 % retinoic acid +/- finasteride 0.2 to 0.9% in ETOH. Higher concentration of minoxidil coupled with increased absorption rates may increase efficacy at the expense of increased irritation & minoxidil effluvium.

Oral dose (as prescribed by dermatologists) ranges between 1-2% minoxidil.

*For patients with super sensitive skin or documented allergies to propylene glycol, the foam solution of minoxidil is advisable.

What is the difference between minoxidil lotion & minoxidil foam?

Even though both formulations contain 5% minoxidil the foam solution has several advantages over the lotion.

Foam is more convenient to use, it dries quicker & spreads less. It also has less irritation, as it does not contain propylene glycol. The main disadvantage of foam is that it costs more than lotion.

Davin’s Viewpoint on Minoxidil Lotion

Believe it or not, I have been using this lotion for the past 25 years! The price has come down from around $70 for one month supply to less than $15 in 2021.

Minoxidil should be one of the very first medical treatments for males & female pattern hair loss. This topical is most efficacious at preventing hair loss, especially if initiated early in the treatment. In 40% of cases (for males), regrowth can be obtained, however this is primarily in the vertex areas & not the frontal hairline.

Look for a 5% concentration of minoxidil as this is more effective than a 2% formulation. The latter was originally indicated for female pattern baldness. Initial reports suggest 1ml twice daily, however most hair specialists recommend once daily application. For higher concentrations (compounded), a rebound effluvium is often seen- namely paradoxical hair loss occurring at week 3-8 after initiating minoxidil. This is transient. On this basis my usual recommendation is 5%, rarely I do prescribe 7-8% sometimes with retinoic acid. Compounded retinoids topically markedly increase the skin irritation rate, titration is a must.

Minoxidil can also be prescribed orally in a capsule. In fact, oral ingestion over five decades ago was what led to the discovery of this ubiquitous treatment for hair loss. Fast forward half a century & the trend is back! Oral minoxidil is more convenient however side effects are more marked, including hypertrichosis, postural hypotension & peripheral edema (that is why I use topical lotions).

Minoxidil can also be compounded with other topical drugs including 5 alpha reductase inhibitors such as dutasteride & finasteride. Recent papers have supported combination therapy as this is more effective.

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