What is the efficacy of oral Minoxidil for treating alopecia?

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From the Guidelines

Oral Minoxidil is not effective for treating alopecia, as the provided evidence discusses the efficacy of topical Minoxidil, not oral Minoxidil.

Efficacy of Topical Minoxidil

  • The efficacy of topical Minoxidil for treating alopecia areata is limited, with response rates ranging from 32-33% in patients with extensive alopecia areata 1.
  • A double-blind study reported a significantly greater frequency of hair regrowth in patchy alopecia areata in patients treated with topical 1% minoxidil compared with placebo, but subsequent controlled trials failed to confirm these results 1.
  • In children with severe alopecia areata, a similar short-term response was found, but less than 10% experienced sustained benefit 1.

Oral Minoxidil

  • There is no mention of oral Minoxidil in the provided evidence, and therefore, its efficacy for treating alopecia cannot be determined based on this study 1.

From the Research

Efficacy of Oral Minoxidil for Treating Alopecia

  • The efficacy of oral minoxidil for treating alopecia has been demonstrated in several studies, with response rates ranging from 61-100% for androgenetic alopecia and 18-82.4% for alopecia areata 2, 3, 4.
  • Low-dose oral minoxidil (LDOM) has been shown to be a safe and effective treatment for both male and female androgenetic alopecia, with a favorable efficacy and safety profile 2, 5.
  • The usual starting dose for LDOM is 1-5 mg/day for male androgenetic alopecia and 0.5-1 mg/day for female-pattern hair loss, with a maximum dose of 5 mg/day 2.
  • Oral minoxidil has also been used to treat other forms of hair loss, including telogen effluvium, tractional alopecia, and postchemotherapy-induced alopecia 3, 6.

Safety and Side Effects

  • The most common side effects of oral minoxidil are hypertrichosis and cardiovascular symptoms, with females being more prone to hypertrichosis than males 2, 3.
  • The side effects of LDOM can be categorized as dose-dependent type A side effects (hypertrichosis and cardiovascular symptoms) and idiosyncratic type B side effects (pericardial effusion) 2.
  • Postural hypotension is also a common adverse effect of oral minoxidil 3.

Dosage and Treatment Duration

  • Different dosing regimens have been utilized in scarring and non-scarring alopecia, varying from 0.25 to 5 mg daily 6.
  • Women may require lower doses of oral minoxidil, from 0.25 to 2.5 mg daily, while men may require higher doses for maximal efficacy, from 1.25 to 5 mg a day 6.
  • The mean time of treatment with oral minoxidil has ranged from 2 to 60 weeks, with a mean of 27 weeks 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Review of oral minoxidil as treatment of hair disorders: in search of the perfect dose.

Journal of the European Academy of Dermatology and Venereology : JEADV, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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