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Minoxidil is one of two FDA-approved treatments for hair loss and has been approved for both men and women. Originally developed as an oral drug to treat high blood pressure, however, when patients started reporting unwanted hair regrowth after 3+ months of use, its manufacturers decided to reformulate it into a topical and begin testing it on men with androgenetic alopecia. Nowadays, minoxidil comes in both topical and oral forms, however, only the topical form is FDA-approved for hair loss.
Key insights:
- The in vitro evidence shows that minoxidil can affect hair growth in multiple ways: it is a vasodilator that increases blood flow to the scalp, as well as being a potassium channel opener which allows more oxygen, blood, and nutrients to reach the hair follicle.
- The clinical evidence shows that with topical minoxidil, peak hair regrowth occurs in the first year, with growth slowly declining in subsequent years. However, continuous usage maintained the number of non-vellus hairs – meaning that with continuous use, past 1 year, it is likely that the number of new hairs grown will be maintained..
- Minoxidil must be used as a continuous support for hair follicles, otherwise hair regrowth ceases and hair loss will start again a few months after treatment is stopped. Some studies have also shown that the efficacy of minoxidil ranges from 20-40%, causing discontinuity of treatment in a large number of patients.
- The usual dosage of topical minoxidil is either 2% or 5% and oral dosages are commonly started at 0.625mg per day for women and 1.25mg for men.
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