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Minoxidil against hair loss (2021)

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Medically reviewed by Dr. Sternberg Written by David Stelzer on 1 Feb 2021

The progression of androgenetic hair loss can be prevented with medication. Minoxidil is one of a few medications whose effectiveness has been scientifically proven.

In a Nutshellsvg

Cost From 13 USD per month svg
Side Effects Itching (1%) etc. svg
Chances of success +18.6% Hair density/cm² svg

What is minoxidil?

Minoxidil is an antihypertensive drug that was originally used to treat high blood pressure. Under the name Lonolox, it is offered in tablet form to those with high blood pressure. The effect of minoxidil as a hair loss remedy was discovered by chance.

For hereditary hair loss, it is applied to the scalp in the form of a solution or foam called Regaine (Rogaine in the US) twice a day, morning and evening. It usually shows a controlled effect, namely on the areas where the solution is applied.

How do minoxidil and finasteride work?

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How does minoxidil work against hair loss?

For the best results, minoxidil must be used twice a day without pause. When it is applied, it dilates the blood vessels under the scalp, optimizing the supply of blood and nutrients to the hair. It is advised to start the medication as soon as the thinning of hair is noticed. The following table is an overview of clinical minoxidil studies and their results:

Study Results
Olsen et al (2002) 2% Minoxidil & Application 2 times a day: +12,7 hair density/cm2 5% Minoxidil & application 2 times a day: +18,6% hair density/cm2 Placebo group: +3.9 hair density/cm2 (male study participants only).
Berger et al (2003) 2% Minoxidil & Application 2 times a day: +12,7 hair density/cm2 5% Minoxidil & application 2 times a day: +18,6% hair density/cm2 Placebo group: +3.9 hair density/cm2 (male study participants only).
Lucky et al (2004) 2% Minoxidil & Application 2 times a day: +20,7 hair density/cm2 5% Minoxidil & application 2 times a day: +26,0% hair density/cm2 Placebo group: +9.4 hair density/cm2 (female study participants only).

As the overview shows, an improvement of hair loss with the use of minoxidil was found in each of the studies.

According to the manufacturer, minoxidil can stop hair loss in 70-80% of cases, and in 30% of cases new hair growth is even stimulated and the hair shaft diameters increase. If the drug is used consistently, the first signs of visible progress can be seen after only three to four months, while maximum efficiency is seen after twelve months. After these twelve months the hair is visibly denser in 30-42% of patients. Minoxidil is effective against receding hairline and hair loss at the crown.

In many cases, there is an initial increase in hair loss before progress is made, this is called the shedding effect. This means that the hair that has reached the end of its life cycle falls out and new hair can replace the atrophied hair. In an ideal scenario, a normal hair growth cycle is now established.

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For whom is minoxidil suitable?

The active ingredient minoxidil is suitable for both women and men and is equally well tolerated by both sexes. It should be noted that the 2% solution is more suitable for women and the 5% solution for men.

For people who suffer from androgenetic alopecia, i.e., congenital hair loss, the application of the drug is an extremely effective solution to stop the progression of pattern baldness, with women especially benefitting from the use of minoxidil. Minoxidil can usually only stop the hair loss however, and has not been proven to trigger new hair growth.

People who are already taking medication for psychosis, for example, should avoid taking minoxidil, which can lead to an increased reduction in blood pressure. Also, the effects of this medication on pregnant women and nursing mothers have only been analyzed to a limited extent. In general, when a patient has existing diseases or is pregnant, the intake of minoxidil should only be carried out under medical supervision.

Although hair loss medication such as Minoxidil is on of the few effective remedies against hair loss, only 15.6% of the patients who are interested in a hair transplant are treating their hair loss witch these medications according to the medihair hair transplant study:

Hair loss treated with Finasteride or Minoxidil

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How much does minoxidil cost?

At around 1.21 USD per daily dose, the drug minoxidil is not entirely inexpensive. For example, the cost of 60 ml Regaine dosed for women is about 30 USD and for men about 46 USD. The different price ranges result from the gender-specific dosages of the active ingredient. In addition, our cost study found that there are significant price differences between minoxidil suppliers.

Minoxidil is known under different trade names like Regaine (also Rogaine in the US), Lonolox, Neocapil, Alopexy or Loniten.

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How to use minoxidil

Minoxidil is applied under the name Regaine in the form of tonic or foam to the thinning areas. Doctors recommend that the solution be applied twice a day to the affected areas using an applicator. The prescribed dosage must be adhered to and should ideally be applied in the morning and evening.

The hair should be dry and one should wait about four hours after applying the foam before taking a shower or bath. If the product accidentally spreads to unwanted areas during application, it is important to clean them in order to prevent unwanted hair growth.

After about eight weeks a visible change should have occurred. If this is not the case, you should seek advice again and stop using minoxidil. However, if the drug does have a positive effect, it is important to continue to take it consistently. Otherwise, the progression of hair loss will resume within three to four months.

svgOur tip

Minoxidil is not suitable for every individual suffering from hair loss. Therefore, it is important to thoroughly analyze all hair loss treatment options before deciding to take minoxidil. Our hair loss experts will help you to choose the right hair loss treatment: Do your hair loss analysis now

What are the side effects of minoxidil?

Compared to the hair loss medication finasteride, the side effects of minoxidil are much less severe. However, as with any medical drug, minoxidil may also have side effects, such as:

  • Allergic reactions
  • Irritation or drying of the scalp

In exceptional cases, hair growth in undesirable places and blood pressure reduction with dizziness and palpitations may occur. Since minoxidil is applied topically to the scalp in the form of foam or tonic, only a small amount of the active ingredient can be absorbed into the bloodstream. Therefore, the side effects are often harmless in the form of skin irritation or dry scalp. The following table shows a study overview of the possible side effects and their frequency:

Study Results
Olsen et al (2002) Itching: 1% Headaches: 0.6%. (Male study participants only).
Berger et al (2003) Local intolerance (itching): 7%. (Male study participants only).
Lucky et al (2004) Itching: 0.6% Headaches: 2% (Male study participants only).

How to get minoxidil

Minoxidil in the form of solutions and foams is available without a prescription but it must be purchased in a pharmacy. However, minoxidil for the treatment of high blood pressure is available only with a prescription.

There are also many ways to purchase a minoxidil solution online. Companies such as Hims and Keeps are online businesses which specialize in hair care or skincare and offer minoxidil solutions. However, it is generally recommended that the best places to purchase minoxidil online are through well-established large retailers such as, Target, Walmart, Amazon etc.

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What happens when you stop taking minoxidil?

Once the patient has started taking minoxidil for hair loss, sudden discontinuation of the medication is not recommended. The effects of minoxidil are not permanent, and discontinuation of the medicine will lead to the previous hair loss resuming within three to four months.

However, one should generally distinguish between two types of hair loss. If a patient suffers from seasonal hair loss, then they should use minoxidil for approximately three months to prevent hair loss. In this case, minoxidil can be discontinued without hesitation after three months and the positive effects of the medication will remain as the body becomes able to regulate hair growth. However, if the hair loss is due to a genetic predisposition, discontinuing the medication will lead to visible hair loss.

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Alternatives to Minoxidil

According to the evidence-based, S3-guideline of dermatologists for the treatment of androgenetic alopecia, there are two alternative options to minoxidil that have a scientifically proven effectiveness in halting hereditary hair loss:

The prescription drug finasteride is, along with surgical hair transplantation, one of the most effective alternatives to minoxidil. Unlike minoxidil, finasteride is taken orally. However, in order to achieve optimal results, finasteride should be taken regularly and permanently, just like minoxidil. Also, the hair transplant cost are relatively high compared to the hair loss medication.

The three forms of therapy can also be combined. For example, it can be useful to transplant hair to the bald areas with hair transplantation and stop future hair loss with a combination of minoxidil and finasteride.

Frequently Asked Questions

How long does it take for minoxidil to take effect?

How dangerous is minoxidil?

Can minoxidil stop hair loss?

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