Hair loss comes in many different shapes and sizes, and so do the treatments for it. There are oral treatments, topical treatments, surgery options… pretty much anything that you can think of has probably been used by someone somewhere to try to beat hair loss.
Out of all the different hair loss remedies that are available there are a few that outshine the others, one of which is minoxidil (commonly sold under the brand name Rogaine).
Minoxidil gained popularity as an effective topical hair loss treatment, in fact it is the only topical treatment that is FDA approved. Whether you prefer the liquid or the foam version, many scientific studies have time and time again proven minoxidil as one of the most effective treatments available on the market.
What most people don’t know though is that minoxidil was originally sold as a tablet that was taken orally to treat high blood pressure before a topical version was developed. And yes, in case you were wondering, the oral version of minoxidil can also be used to combat hair loss, in fact many people prefer it over the topical solution. But, the oral version is not FDA approved, meaning it is still relatively obscurely used throughout the hair loss community. But there are questions that need answering!
In this article, we are going to have a look at what oral minoxidil is, how effective it is based on current research, and ultimately if it is worth considering as a substitute for the more sought-after topical version.
Firstly, a brief overview of how minoxidil works. \
What is minoxidil?
Minoxidil is a type of drug called a vasodilator. Vasodilators work to improve blood flow, hence why it was originally made for high blood pressure, by dilating (opening) blood vessels.
Blood flow is extremely important for promoting hair regrowth. Blood is responsible for delivering vital oxygen and nutrients to the hair follicles that they then use to complete healthy growth cycles. If the follicles are not receiving enough blood, the growth cycles may get shortened which can cause miniaturization. This is why low blood flow has been shown to be linked with the early onset of pattern hair loss (1).
Even though the topical version is very well-studied, and the oral version less so, there is still some promising research surrounding oral minoxidil.
What the research says about oral minoxidil
There are many different reasons why people may want to opt for oral instead of topical minoxidil. It’s certainly easier to use, undeniably more convenient, but is it as effective? Let’s take a look.
This study from 2019 followed 41 male participants with androgenic alopecia (AGA; pattern hair loss). Each participant was administered either 2.5 or 5mg daily oral minoxidil for a minimum of 6 months.
When the study concluded it was found that 37 of the 41 participants showed clinical improvement in their hair loss (that’s 90.2 percent!). The other four participants showed stabilization of their hair loss, which is profound because that means that none of the patient’s AGA worsened throughout the duration of the study.
Although the researchers claimed that oral minoxidil has an “acceptable safety profile”, there were still some adverse side effects that were recorded, notably: hypertrichosis (body hair growth) in 24.3% if patients, lower limb edema in 4.8%, and shedding in 2.4%.
The sample size of this study was small, but nonetheless achieving such a high percentage of response to the medication is pretty remarkable.
The second study from January 2020 included 25 male patients with a mean age of 36.7 years.
Before the study began they were grouped into two categories: those with mild-to-moderate AGA (2-3 on the Norwood scale, 40% of participants) and those with severe AGA (IV-VI on the Norwood scale, 60% of participants). Each participant was given 0.25mg oral minoxidil daily for 24 weeks.
There were four parameters measured at the end of the study for both the frontal hairline and the vertex independently: total hair density, density of terminal hair, new hair, and new terminal hair. It was found that 60%, 40%, 52%, and 48% of participants showed improvement in each category respectively in the frontal region and 40%, 44%, 40%, and 44% respectively in the vertex. The researchers also noted that there was a statistical trend in favor of those with more mild AGA responding better to treatments.
Similar side effects to the study above were also recorded.
As you can see, the results of this study were nowhere near as statistically significant as the above study. But, as I just mentioned, the people with less severe AGA responded better to the oral minoxidil, and the researchers in this study mentioned that similar results were uncovered when topical minoxidil was tested. Although it is not certain, there is a good chance that the data from this study may have been skewed due to a disproportionate number of participants with severe AGA.
The last study that we are going to look at, again from 2020, looked at low-dose oral minoxidil for female pattern hair loss (FPHL).
It was conducted on 148 women who had all been clinically diagnosed with FPHL. Each was administered doses of oral minoxidil between 0.25 and 2mg for a mean time of 9 months (although the range was 6-27 months). The results were pretty staggering.
It was found that 30 patients (20.3%) has stabilization of their FPHL, while the other 118 (79.7%) patients showed improvement: 95 showed slight improvement and 23 has a distinct improvement. Those are incredible results.
Again, hypertrichosis was the main side effect that was observed in 19% of patients.
These are the three most prominent studies that have been conducted on oral minoxidil, although there are several more that have been done as well.
Based on these findings it seems that, granted your hair loss has not progressed past a Norwood 3, oral minoxidil may be a very viable option. Two of the studies revealed that it, at the very least, stabilized hair loss or improved it in 100% of the participants, and while the other study may have been skewed the results were still significant.
There is a risk of experiencing side effects, but they are seemingly rare and mild compared to some other hair loss treatments on the market.
For now, topical minoxidil still has more research to back it and is likely still the better option, but if you don’t respond to it oral minoxidil makes a strong case for being a viable alternative.
Always talk to your doctor before beginning any hair loss treatment, especially one that is not FDA approved.