When you are trying to overcome hair loss there are two primary components that you need to focus on: blocking DHT and regrowing hair. Treatments such as finasteride and dutasteride are great at blocking DHT and stopping the progression of hair loss.
Once hair loss is no longer progressing you then need to focus on promoting hair regrowth, and minoxidil is the most effective treatment that is currently available. There are two versions of minoxidil: topical and oral, although only topical minoxidil is available without a prescription, making it the more popular option.
Unfortunately topical minoxidil may not work for everyone, in fact studies have shown that it is only effective in about 60-70% of users (1). This has encouraged many hair loss sufferers around the globe to switch from topical to oral minoxidil, and if you are someone who hasn't seen the regrowth that you would have liked to on topical, it may be something to consider. But are there any risks involved?
In this article we are going to talk about the differences between topical and oral minoxidil and everything that you can expect if you decide to make the switch.
What is minoxidil?
Both the topical and oral versions work generally the same as they are both classified as minoxidil.
Minoxidil is a type of medication called a vasodilator. What this means is that it helps dilate (open) blood vessels to allow for improved blood flow. This is important because people who are suffering from androgenic alopecia (AGA; pattern hair loss) generally have lower blood flow to their hair and scalp (2).
Blood transports vital oxygen and nutrients to the hair follicles that they use to grow, but when there is less blood flow the follicles become malnourished and begin to wither away. The reason minoxidil is so effective is because it is very good at getting blood back to the hair follicles that need it and providing them with the nutrition that they need to regrow.
What is the difference between topical and oral minoxidil?
Again, both topical and oral minoxidil work similarly in the sense that their primary function is to improve blood flow, but there are a few key differences.
The first and most important difference is that topical minoxidil is FDA approved for the treatment of hair loss and oral minoxidil is not. This is not necessarily because one is more effective than the other (although studies have shown that oral minoxidil is potentially more effective), but instead because topical simply has more research behind it currently.
Another important difference is that oral minoxidil is more easily absorbed by the body. Since it is taken orally, the minoxidil is absorbed by the gastrointestinal tract versus when it is applied topically it needs to soak through the skin on the scalp to get to the hair follicles. This results in minoxidil levels in the blood being much higher in oral users compared to topical users, and while this usually isn't a problem for most people, it can cause side effects, which leads us to our next key difference.
The side effect profile for both topical and oral minoxidil is very similar, although the rate at which side effects occur is higher in oral minoxidil. Some of the side effects include:
-abnormal hair growth on the body
-fast or irregular heart beat
Don’t worry though, these side effects are rare, but it is important that you are aware of them. If you experienced any of these side effects when using topical minoxidil there is a good chance you may also experience them using oral.
What to expect when switching from topical to oral minoxidil
Now that you are aware of some of the key differences between the two types of minoxidil you may be wondering if anything drastic will happen when you switch. The honest answer is that we cannot say for sure because there haven't been any studies done on how the body reacts when switching from one type of minoxidil to the other, and clinical research on oral minoxidil in general is insufficient when compared to that of topical. But, several doctors have developed general expectations for what to expect based on patient observations and the nature of minoxidil.
One of the downfalls to minoxidil is that it creates minoxidil-dependent hairs. The hairs that you regrow on minoxidil are going to require a consistently elevated blood supply, which is why when people discontinue use they tend to lose most of the hair that they had regrown.
If you had some success when using topical minoxidil, switching to oral minoxidil may cause issues to arise. This is because your hair will have gotten used to the amount of blood flow that topical minoxidil was providing it and when you switch that amount may change, therefore impacting the minoxidil-dependent hairs. It could cause a shed, and until oral minoxidil dosage is adjusted to meet the needs of the individual, the hair may not grow back.
This will undoubtedly vary on a case-to-case basis, but once the proper dose of oral minoxidil is being administered the hair that you regrew with topical minoxidil should (in theory) return.
Keep in mind that there is always a chance that you may not respond to oral minoxidil.
Alternatively, if you used topical minoxidil and saw no results you might be better off. First of all, since there is no minoxidil-dependent hair that was grown, the likelihood of a shed occurring is low. Secondly, there is a good chance that you could respond to oral minoxidil and begin seeing hair regrowth, but it is important to remember that, just like with any hair loss treatment, it takes a lot of time. You can usually expect to wait at least three months or more (sometimes up to a year) before you start seeing results, so be patient!
As oral minoxidil becomes more commonplace, there will likely be more information that surfaces about what to expect from the transition from topical. For now it seems that what you should expect depends on how you previously responded to topical minoxidil.
If you had some regrowth using topical, there is a chance that you could experience a shed until the proper dose of oral minoxidil is found. On the other hand, if you had little-to-no regrowth using topical not only will you not experience a shed, but there is a chance that you may respond well and begin to experience the regrowth benefits that minoxidil has to offer.
Is there a major difference between topical and oral minoxidil? No, you just need to make sure you adjust accordingly if you decide to make the transition. But, early research has indicated that oral minoxidil may be more effective than topical (learn about it here), and if there is a chance that it could replace topical minoxidil in the future, that means that much more research will (hopefully) be conducted soon, so keep a watchful eye!