By Steven Gabel, MD, FACS – Gabel Hair Restoration Center, Portland, Oregon
Minoxidil has long been a foundational treatment for male and female pattern hair loss. Most patients know it as a topical foam or liquid, and some use low-dose oral tablets which we have written about in the past. Recently, another form has started to attract attention: sublingual minoxidil, a version that dissolves under the tongue. A published case series provides early insight into how this option may work for androgenetic alopecia.
This blog reviews the study by Dr. Sinclair titled “Treatment of male and female pattern hair loss with sublingual minoxidil: a retrospective case-series of 64 patients” and shows what it may mean for patients at the Gabel Hair Restoration Center.
Why Sublingual Minoxidil Is Being Studied
While topical minoxidil is effective, many patients struggle with irritation, residue, or inconsistent use. Low-dose oral minoxidil can help, but because it relies on systemic absorption, some patients experience more noticeable side effects.
Sublingual minoxidil offers a potential middle ground. By dissolving under the tongue, it may be absorbed more efficiently, which could allow for lower doses with fewer systemic effects. It also avoids the cosmetic challenges of applying a topical product daily.
What the Study Found
In the case series, men and women with pattern hair loss took sublingual minoxidil daily for at least six months. Treatment was given alone—without additional medications—allowing investigators to observe its independent effect.
Overall, most patients experienced steady improvement. Hair density and coverage gradually increased, and shedding decreased over time. These changes occurred slowly, as expected with all forms of minoxidil, but the trend was consistently positive.
The treatment was also generally well tolerated. A few patients experienced mild side effects such as light facial hair growth, brief dizziness, or minimal swelling. No serious complications were reported, and the overall side-effect profile appeared milder than what has been documented with low-dose oral minoxidil.
Important Clarification: Sublingual Minoxidil Is Not Currently Available
Although the early findings are encouraging, sublingual minoxidil is not yet commercially available or FDA-approved. At this time, it cannot be prescribed in a standardized, widely accessible form, and any use would require specialized compounding. As with all non-approved therapies, careful clinical oversight and strong evidence are essential before widespread adoption.
At the Gabel Hair Restoration Center, we are monitoring this area closely. If future studies confirm its safety and effectiveness—and if a reliable, medically sound formulation becomes available—we will be at the forefront of offering it to our patients. Our priority is to provide treatments that are well-researched, safe, and truly beneficial.
How This Fits Into Hair Loss Care
Minoxidil remains one of the most rigorously studied and consistently effective medications for androgenetic alopecia, with decades of high-quality research supporting its benefit. The only FDA-approved form today is topical minoxidil, which continues to be a safe and reliable first-line treatment.
However, oral minoxidil is gaining popularity due to its convenience and predictable absorption, and many patients benefit from it under proper medical supervision. Looking ahead, sublingual minoxidil may eventually become another viable option, offering easier use and potentially fewer systemic effects—though more research is required before it can be recommended broadly.
As with all hair loss treatments, the best outcomes come from a comprehensive, individualized plan. As evidence evolves, Dr. Gabel remains committed to offering the most effective, science-based therapies available to his patients here in Portland, Oregon.
Take the First Step Toward Fuller, Healthier Hair
If you’re considering treatment options for hair thinning or pattern hair loss, the Gabel Hair Restoration Center is here to help. We offer comprehensive evaluations and personalized plans tailored to your specific goals. To schedule a consultation with Dr. Gabel or learn more about the most current, research-backed hair restoration options, contact our Portland office today.
Reference
Sinclair R, Trindade de Carvalho L, Ferial Ismail F, Meah N. Treatment of male and female pattern hair loss with sublingual minoxidil: a retrospective case-series of 64 patients. J Eur Acad Dermatol Venereol. 2020 Dec;34(12):e795-e796. doi: 10.1111/jdv.16616. Epub 2020 Jul 28. PMID: 32386429.
