Root Hair Institute


History & Background

Oral minoxidil is a medication that was developed for the treatment of high blood pressure. In patients taking the medication for high blood pressure, it was noticed that their scalp hair thickened and some grew more hair while on this medication. This eventually led to the development of topical minoxidil available as both solution and foam for the treatment of hair loss. Topical minoxidil was studied and found to be effective for many. It was eventually approved by the FDA for the treatment of male pattern and female pattern hair loss (also known as androgenetic alopecia which is the most common type of hair loss).

However, in some people, topical minoxidil is not effective. This can be due to a number of potential factors including the inability to penetrate the skin to reach the hair follicles, low levels of the enzyme that activates minoxidil to its active form in certain individuals, and/or low compliance with the topical application. Additionally, even in those in whom topical minoxidil is effective, many individuals become tired of having to apply it to their scalp and do not like the feeling, texture, appearance, and smell of the product in their hair. Thus, in recent years there has been growing interest in the option of low-dose oral minoxidil to allow individuals to take a pill by mouth for convenience rather than dealing with the topical.

Lower doses were used to decrease the risk of side effects that are more frequently seen with the higher doses used for high blood pressure. However, side effects are still possible, and it is important to consult with a physician experienced with low-dose oral minoxidil who can counsel you on the side effects of the medication. Of note, low-dose oral minoxidil for hair loss is an off-label treatment as the FDA has not approved oral minoxidil for hair loss.

This article will review the potential benefits and side effects of oral minoxidil. However, this article is not medical advice. Please always consult with your doctor prior to starting any new medications including minoxidil.

Benefits of oral minoxidil for hair loss

Compared to its topical counterpart, oral minoxidil is more convenient for some individuals and cheaper.

  • Less messy. The treatment is easier to take by mouth once daily than its topical counterpart, which can result in greasy hair and can require frequent washes.
  • More compliance. Many individuals find it easier to stay consistent with taking a single (or half depending on the dose) tablet per day rather than applying topical products to the scalp once or twice a day.
  • Reduced local side effects. The oral version causes less scalp irritation, redness, scaling, and itching and less hair dryness and breakage compared to the topical.
  • Affordable. Oral medication is generally cheaper than topical treatments.

Side effects of oral minoxidil for hair loss

Just like with any medication, there are potential side effects which include the following among many others:

  • Increased hair shedding. Similar to topical minoxidil, there can be increased hair shedding when starting the medication for up to 3 months.
  • Excess facial and body hair. You can see the thickening of the hair or increased hair growth on the face and body.
  • Reduced blood pressure. The medication can drop your blood pressure, especially at higher doses. This can lead to symptoms like dizziness and increased heart rate.
  • Rare serious side effects. There are rare but possible serious side effects including fluid retention, cardiac problems, and swelling around the heart or in the lungs. It is important to look out for any side effects including swelling of the body, swelling of the hands or feet, fatigue, increased or irregular heart rate, shortness of breath, cough, chest pain, or any other side effects.
  • Temporary solution. Your hair will stop growing once you discontinue taking minoxidil. This is also true of topical minoxidil and many other hair growth treatments including other medications, red light therapy, and many growth factor-based treatments.

It is important to only use minoxidil under the care of a physician experienced with using this medication. They will counsel you on if minoxidil is an appropriate choice in your case based on your hair and other medical conditions and medications. Always seek immediate medical attention if you develop any of the above side effects or any other symptoms.

Who can take oral minoxidil for hair growth?

Oral minoxidil is not for everyone. The type of hair loss you have, the severity of your hair loss, what other medical problems you have, and what other medications you are on are some of the factors that will determine if oral minoxidil is appropriate in your case.

Always consult with your doctor before taking any medications. We recommend seeing a hair loss specialist who commonly prescribes this medication if you are potentially interested in seeing if it is a good option for you.

Our doctors at Root Hair Institute have been prescribing this medication for many years. They also have experience combining low-dose oral minoxidil with other treatments such as hair restoration surgery, red light therapy, and injection-based therapies to maximize results. If this or another hair restoration treatment is something you are interested in, book a consult with us today.