From the Guidelines
Minoxidil is a medication that should be used under the guidance of a healthcare provider, particularly for the treatment of hair loss, and its use in hypertension is generally reserved for resistant cases. When considering minoxidil for hair loss, it is essential to understand that it comes in two common strengths: 2% (often recommended for women) and 5% (typically recommended for men), available as a topical solution or foam applied directly to the scalp twice daily 1. For best results, apply 1 ml of solution or half a capful of foam to dry scalp in the affected areas, gently massaging it in, and allow it to dry completely before styling hair. Consistent use for at least 4-6 months is necessary to see noticeable results, and continued application is required to maintain any new hair growth. Minoxidil works by widening blood vessels and opening potassium channels, which increases blood flow to hair follicles and extends their growth phase. Common side effects may include scalp irritation, unwanted hair growth in adjacent areas, and initial increased shedding in the first few weeks of treatment. If you experience chest pain, rapid heartbeat, dizziness, or severe scalp irritation, discontinue use and consult a healthcare provider. In the context of hypertension, minoxidil is considered for use in resistant hypertension, often after other treatments have been maximized, due to its potent vasodilatory effects 1. However, its use is associated with significant side effects, including hirsutism and fluid retention, necessitating the use of a loop diuretic and beta-blocker in conjunction with minoxidil 1. Given the potential for side effects and the availability of other treatments, minoxidil's use in hypertension is typically reserved for cases where other options have been exhausted. It's also worth noting that in the management of androgenetic alopecia, combining minoxidil with other treatments such as platelet-rich plasma (PRP) may offer enhanced benefits compared to monotherapy 1. Therefore, the decision to use minoxidil should be made under the guidance of a healthcare provider, considering the individual's specific condition, potential side effects, and the availability of alternative treatments.
From the FDA Drug Label
Minoxidil topical solution 5% is for use only by men. Minoxidil topical solution 5% may be appropriate for you if you are a male at least 18 years old and experiencing gradually thinning hair or gradual hair loss on the top of the scalp (vertex only, as shown below). Women should not use minoxidil topical solution 5% because studies have shown it works no better in women than minoxidil topical solution 2%. Minoxidil topical solution 5% should not be used on babies or for children under 18 years old
Key Points:
- Minoxidil topical solution 5% is only for men.
- It is intended for men with gradually thinning hair or gradual hair loss on the top of the scalp.
- Women and children under 18 should not use minoxidil topical solution 5% 2
From the Research
Minoxidil Overview
- Minoxidil is a medication used to treat hair loss, particularly androgenetic alopecia [(3,4,5,6,7)].
- It is available in topical and oral forms, with the topical form being FDA-approved for use in men and women [(4,6,7)].
Mechanism of Action
- Minoxidil acts through multiple pathways, including as a vasodilator, anti-inflammatory agent, inducer of the Wnt/β-catenin signaling pathway, and antiandrogen [(5,7)].
- It may also affect the length of the anagen and telogen phases 7.
Efficacy
- Topical minoxidil has been shown to be effective in promoting hair growth in both men and women with androgenetic alopecia [(3,4,6,7)].
- Oral minoxidil has also been shown to be effective in treating androgenetic alopecia, with some studies suggesting it may be more effective than topical minoxidil [(3,5,7)].
- Low-dose oral minoxidil (0.5-5 mg/day) may be safe and effective for female pattern hair loss and chronic telogen effluvium [(3,7)].
Safety and Side Effects
- Common side effects of minoxidil include hypertrichosis, postural hypotension, and cardiovascular symptoms [(3,5)].
- Topical minoxidil may cause irritation, particularly at higher concentrations 6.
- Oral minoxidil may cause sexual dysfunction and neuropsychiatric side effects, although these are less common 5.