Many patients have been inquiring at the Gabel Center in Portland Oregon about changing from topical minoxidil to oral minoxidil to help treat their hair loss. The use of oral minoxidil has been receiving a lot of attention since the New York Times published the article1, “An Old Medicine Grows New Hair for Pennies a Day, Doctors say.” Our patients say that they do not like to put the topical solution on their scalps twice a day as it messes up their hair, it causes discoloration of their clothes and pillows, or they forget. They also don’t like to carry around the solution when they travel. They want to know if changing from the topical solution to the oral tablets will work. The short answer is yes, for both men and women. The real answer lies with studies to confirm this, and more studies are coming out about the efficacy of oral minoxidil, and the safety of it. This first blog will cover the efficacy of oral minoxidil.
What is Oral Minoxidil?
Oral minoxidil is a very potent antihypertensive medication that was developed in the 1970’s. It was prescribed for patients with severe hypertension at doses of 10 mg/day to 40 mg/day. However, the patients that used it reported not only a benefit for their blood pressure, but also, they were noticing increased growth of the hair on their scalp and other parts of their body.2 The medication was subsequently formulated as a topical solution and approved by the FDA for male pattern baldness in 1988 and for female pattern baldness for women in 1991. Since the side effects of the oral medication showed increased hair growth, researchers began to study the effects of low dose oral minoxidil (LDOM) on hair growth.
The Efficacy of Oral Minoxidil
There are many studies to show the efficacy of oral minoxidil. In one study, Panchaprateep3 in 2020 studied 30 men, ages 24 – 59. She studied area hair counts, hair diameter, performed photographic assessments, a self-administered questionnaire, and the safety profile of the medication. She found that oral minoxidil improved hair growth in all of the study parameters. She found total hair counts increased by 14.25% at 12 weeks at the vertex, and 19.23% at 24 weeks. Total hair counts were increased by 40.7 hairs/cm2 in younger patients, and 25.4 hairs/ cm2 in older patients. The photographic assessment showed a 100% improvement at the vertex at 24 weeks.
The most common complication was increased hair growth in other areas of the body (93%) and swelling of the ankle (10%). In a study by Jha4, they studied 32 men, ages 18-45, and found that at 24 weeks of LDOM at 1.25 mg/day showed a 43.8% marked and mild improvement. Clearly, there is a dose dependent improvement in clinical outcomes.
For women, LDOM was also found to be effective. In 2020, Rodrigues-Barata, et al5 performed a retrospective study of 148 women with female pattern hair loss taking LDOM between 0.25 and 2 mg daily. She found that 20% stabilized their hair loss and 79.7% had clinical improvement of which 15.5% had marked improvement. The most common side effect was hypertrichosis or unwanted hair in other parts of the body in 17%, and 1 patient experienced ankle swelling, a fast heart rate, and general malaise.
How Oral Minoxidil is Prescribed
Overall, LDOM is showing great efficacy for patients being treated for both male and female pattern hair loss. There are many studies out to verify this, and more studies are being performed to figure out the best dosage for both men and women. At the Gabel Center, for our hair restoration patients, we typically will treat men at a dosage of 2.5 mg/day, and women at 1.25 mg/day. This has been very well tolerated by our patients, and to date, no patients have had any issues where they needed to discontinue it. Although LDOM is well tolerated and showing great efficacy, patients also need to be cognizant of the potential side effects which will be discussed in a future blog.
Where to Find Trustworthy Hair Restoration Treatments
If you are suffering from hair loss, Dr. Gabel at the Gabel Hair Restoration Center is equipped with the latest technology to evaluate and diagnose your hair loss condition and recommend treatment options to restore your hair. These options may include nonsurgical therapy with or without hair transplants. Patients can schedule a consultation online or call 503-693-1118 to start their comprehensive hair restoration treatment plan.
1. Kolata, G. An Old Medicine Grows New Hair for Pennies a Day, Doctors Say. New York Times. August 23, 2022.
2. Burton JL, Marshall A. Hypertrichosis due to minoxidil. Br J Dermatol. 1979;101(5):593–5.
3. Panchaprateep, R., et al. Efficacy and Safety of Oral Minoxidil 5 mg Once Daily in the Treatment of Male Patients with Androgenetic Alopecia: An Open-Label and Global Photographic Assessment. Dermatol Ther (Heidelb) (2020) 10:1345–1357.
4. Jha, A., et al. Efficacy and safety of very-low-dose oral minoxidil 1.25 mg in male androgenetic alopecia. J Am Acad Dermatol, Volume 83 (5); pg 1491 – 1493.
5. Rodrigues-Barata et al. Low-Dose Oral Minoxidil for Female Pattern Hair Loss: A Unicenter Descriptive Study of 148 Women. Skin Appendage Disord. 2020 Jun;6(3):175-176.
