Does Oral Minoxidil Work for Hair Loss?

Are you wondering if oral minoxidil for hair loss is right for you? Dermatologists may recommend minoxidil, an FDA-approved topical drug, for people with hair loss. Another form of minoxidil, high-dose minoxidil pills, has FDA approval for high blood pressure treatment. However, the pills have been researched regarding their off-label use, or when a medication is prescribed for a use other than what the FDA approved it for.

Some providers have prescribed low-dose oral minoxidil for the off-label treatment of hair loss, and research has found the treatment has generally been effective. Here's what to know about using minoxidil orally for hair loss—and how to bring it up to a dermatologist.

Oral Minoxidil Use for Hair Loss

Using low-dose oral minoxidil for hair loss began after noticing the side effects of the high-dose version of the drug used to treat high blood pressure. In clinical trials for Loniten (oral minoxidil for blood pressure), about 80% of patients experienced hypertrichosis—longer, thicker body hair with more color. During the trial, the hair growth typically developed three to six weeks after beginning treatment.

Some researchers indicated that oral minoxidil might be used in cases where people:

• Find it easier and more convenient to take the medication orally
• May be able to save money with an oral minoxidil prescription
• Prefer not to have residue on their hair

How Effective Is Oral Minoxidil?

Larger studies will be needed to further support oral minoxidil's effectiveness for hair loss treatment. Still, some researchers have generally found oral minoxidil to be helpful.

One study followed the treatment results of 51 participants with androgenetic alopecia (AGA) for three years. AGA is commonly known as female- or male-pattern hair loss. The results indicated that 65% of the individuals had scalp hair growth, and 27% experienced a decrease in how much their hair shed.

In another study, participants with AGA were assigned to receive topical or oral minoxidil treatment. After six months of use, the researchers found that the pills were as effective as the topical version of the medication.

Potential Risks and Side Effects

Because oral minoxidil helps with hair growth, it may lead to hair growth everywhere, specifically on your face and temples. You may also experience any fine body hair becoming darker and thicker.

Hair growth can also be temporary. In the oral minoxidil clinical trial, the patient's hair growth stopped within one to six months after stopping treatment, and their appearances were restored to what they looked like before treatment.

Other side effects can include breast tenderness, headache, and nausea or vomiting. However, seek immediate medical care for the following:

• Difficulty breathing or shortness of breath
• Dizziness or fainting
• Fast heartbeat
• Rash
• Swollen ankles or feet
• Unexplained weight gain

Who Should Avoid Using Oral Minoxidil?

Minoxidil pills may not be an appropriate treatment for everyone. People who should avoid taking this drug include individuals with:

• High blood pressure with mitral stenosis, a condition that restricts blood flow due to a partially-opening valve in the heart
• Hypersensitivity to the drug and its ingredients
• Pheochromocytoma, a type of tumor that affects neurotransmitter-receiving cells used to send hormones into the bloodstream
• Severe liver dysfunction
  

Other FDA-Approved Treatments for Hair Loss

There are two main hair loss treatments that are FDA-approved for AGA: minoxidil and finasteride.

Minoxidil (Topical)

This treatment is found in products like Rogaine and many other hair loss replacement foams, creams, and shampoos. Minoxidil is a vasodilator, or a medication that opens blood vessels. For this reason, in oral form, it was first introduced to treat high blood pressure.

However, the drug had an unexpected side effect: It increased hair growth, leading to its topical formulation and FDA approval. Research has shown that topical minoxidil—mainly in concentrations of 5%—was most effective in regrowing hair in all genders.

Finasteride (Oral)

This medication, which is sold under the brand name Propecia, is FDA-approved to treat hair loss, specifically in men with androgenetic alopecia. Propecia is taken as one 1-milligram tablet once a day. Results typically show up after three months of treatment.

The medication, though effective, does come with side effects like decreased libido, erectile dysfunction, and ejaculation disorder. Propecia should also not be handled or come into contact with people who are, or who may become pregnant, due to risks associated with fetal development.

Other Treatments

Other potential treatments for hair loss might be part of your treatment plan. They include:

• Hair transplants: The process of removing small pieces of scalp still able to grow hair and transplanting them onto balding or thinning areas of the scalp
• Laser caps and combs: The use of laser devices to stimulate hair growth, resulting in thicker, fuller hair
• Platelet-rich plasma (PRP) injections: A procedure where a patient's blood is taken, red blood cells are filtered out, then injected back into the body

What To Ask Your Healthcare Provider

If you're interested in trying oral minoxidil, talk to a dermatologist. They should be able to counsel you on the medication and may recommend other treatments that can also help. You'll also want to ask a dermatologist about:

• How long it may take any treatments to work and for your hair to grow back
• How your hair will grow back—for example, if it will be the same or have the same texture
• If it's best to change your hairstyle
• If there are any precautions you need to follow with hair loss treatments
• If you can do anything to make your hair appear fuller
• What may be causing your hair loss

A Quick Review

Oral minoxidil has been used off-label for hair loss treatment, and research shows that this medication is beneficial for hair growth. However, it does come with side effects, like headaches or nausea, and not everyone can use it.

Still, typical treatments are topical minoxidil and oral finasteride, though your treatment plan might include other treatments like hair transplants or PRP injections. Talk with a dermatologist to determine if oral minoxidil is an appropriate treatment for you.