Updated: Feb 12
Minoxidil, most commonly sold under the brand name Rogaine, is a time-tested hair loss remedy and one of the most popular treatments available. If you have been dealing with hair loss for some time now there is a good chance you have heard of it, if you’re new to this whole hair loss thing, welcome, minoxidil is probably going to be one of your new best friends.
What is Minoxidil?
Minoxidil was given the FDA approval for treating hair loss on February 12, 1996. It is one of the only FDA approved treatments for hair loss, and there’s a reason for that. To be approved, a drug must undergo extensive research and testing to prove its efficacy, most drugs don’t show consistent enough results, but minoxidil did.
Minoxidil is a vasodilator. What’s that? A vasodilator is a medication that opens blood vessels by preventing the muscles in your arteries and veins from tightening, which results in better blood flow. Increasing blood flow is minoxidil’s main mechanism for combatting hair loss, more explained later.
It is available in liquid, foam, and as oral tablets, although the tablet form is not FDA approved for hair loss.
(This study shows oral minoxidils effectiveness. Several clinical studies have been done, but not enough for approval by the FDA)
How does it work?
Just as I said earlier, minoxidil increases blood flow, specifically to the areas where it is applied topically. Blood flow plays a vital role in hair growth and while it often may not be the main contributor to hair loss, they are inexorably linked. This is because blood flow brings vital oxygen and nutrients to the scalp that your hair uses to undergo a healthy growth cycle. In one study, it was found that balding scalps have 2.6 times less blood flow than someone with a normal head of hair.
For someone experiencing androgenic alopecia (pattern hair loss) the hair typically undergoes a process called miniaturization. What happens during miniaturization is that the anagen, or growth phase, progressively gets shorter and shorter. A shorter growth phase means the hair is not growing to its full size (width and length) and eventually it disappears. But, if you catch the hair before its completely gone minoxidil could be your saving grace.
If you still have those short, thin, unpigmented hairs (vellus hair) where your hair used to be, you’ve still got time. This is due to a few key things that happen from the moment you start minoxidil treatments:
• Firstly, follicles are stimulated to move into the early stages of the growth phase, so any hairs that are currently in the telogen (resting) phase will be prompted to start growing
• Secondly, and probably most importantly, the growth phase begins to extend. This kick starts the reversal of miniaturization because as the growth phase lengthens, the hair will be able to continue to grow longer and thicker through each cycle
• Lastly, blood flow is increased which supplies the hair with the nutrients it needs to rebuild itself and sustain a healthy growth cycle
(Note: the mechanism by which minoxidil uses to stimulate hair growth is still not fully understood)
Will minoxidil work for me?
Just like most hair loss treatments, it is different for everybody.
Everyone responds differently to hair loss treatments. Depending on how far along you are in your hair loss and how much regrowth you are expecting will determine how effective minoxidil will be for you. Although the statistics are on your side.
According to WebMD, minoxidil works for about every 2 in 3 men. Like I said earlier, to get FDA approved the results need to be strong enough and supported by a lot of data. This alone is definitely a good indicator that there is a high degree of success with minoxidil.
One observational study of 984 men showed a high degree of success. Some if the findings included:
• Hair loss areas of the scalp had become smaller in 62% of patients and unchanged in 35%
• Treatment was ineffective in only 15.7% with it being either very effective, effective, or moderately effective in all other patients
•Hairs lost during washing was a mean 69.7 at the start of the study and 33.8 by the end of it
There are many studies that have similar findings meaning that the odds of some degree of success are likely higher than having no success at all. It’s worth trying.
One common misconception in the hair loss world is that minoxidil only works on the crown and will not have any effect on the hair line. This is likely false.
The reason that this rumor came about is because technically minoxidil is not FDA approved to treat frontal hair loss. During the clinical studies for FDA approval, the majority of tests were only conducted on the crown, meaning the FDA could not make claims about the hairline.
The truth of the matter is that the hair on the front of the head is very similar to hair on the crown and likely reacts to minoxidil in the same way. Studies have been able to back this claim, though more scientific evidence is needed. Best advice, use minoxidil on both the crown and the hairline and expect results from the crown and possible results from the hairline.
•When starting minoxidil, expect a shedding phase. Since minoxidil encourages follicles to move into the start of the anagen phase many of the hairs need to go through the rest of the hair cycle to get there, which includes falling out
•Remember to be patient. Hairs growth phase can last up to 5 years and oftentimes people don’t start seeing good results until 6 months in
•Consistency is key. Just like with any hair loss treatment you need to stick with it. It is often advised to use minoxidil twice a day, if you don’t your hair loss will likely continue. If you’re not ready to commit don’t waste your money
•Using minoxidil in conjunction with Finasteride can likely yield better results. Finasteride targets DHT, the main culprit in pattern hair loss, and protects your hair against it
•Derma rolling can increase minoxidils effectiveness by increasing the rate of absorption in the scalp