Over 80% of men and just under 50% of women will experience hair loss as they age, according to NYU Langone Health. Women's hair thinning is also typical. Lotions, shampoos, oils, and gels are typical topical therapies that promise to encourage hair growth or stop additional harm.

Several medications frequently include minoxidil, also known more generically as topical minoxidil.

Minoxidil is widely regarded as safe and well-tolerated because of its lengthy history of use. The degree of success, according to Sandeep Sattur, MD, a hair restoration surgeon at Mumbai, India's HairRevive Centre for Hair Restoration and Skin Rejuvenation, varies. This sort of minoxidil may have unpleasant side effects in addition to other downsides.

Oral minoxidil is currently being prescribed by certain dermatologists to treat hair loss, which may be the best line of action. Even though the FDA has not approved these drugs for hair loss, doctors are permitted to prescribe oral minoxidil for this off-label use. Continue reading for additional details if you or a loved one is having hair loss and you're not sure whether minoxidil might be able to assist.

1. Although Topical Minoxidil Is Not Perfect, It Can Help Retain and Grow Hair

The FDA approved the first topical version of minoxidil to treat male pattern baldness in the late 1980s. Since then, the FDA has approved minoxidil's use as a treatment for female pattern hair loss, granted manufacturers permission to make it in higher quantities, and approved its over-the-counter sale without a prescription.

In a nutshell, topical minoxidil boosts hair growth or reduces balding when applied to the scalp once or twice a day.

These scalp treatments often contain minoxidil, which is either 2 or 5 percent. They are frequently accessible without a prescription and work best for recent hair loss in people under the age of 40, according to MedlinePlus.

Topical minoxidil has been demonstrated in numerous research trials to help increase hair thickness in regions where hair loss has been seen in both men and women, according to data from the Center for Drug Evaluation and Research (PDF). According to numerous studies, the extra-strength version performs better than the original formula with the 5% drug content (which uses a 2 percent concentration).

However, as was already indicated, topical minoxidil has disadvantages. For instance, it may take several months to see results, and stopping the medication would stop any additional hair growth.

Topical minoxidil doesn't work for all types of hair loss; for instance, people with pattern baldness are unlikely to see improvement after therapy, especially if they've been dealing with the problem for some time. According to the Mayo Clinic, it could also have unfavorable side effects including painful scalp stickiness, itching, rashes, and irritation.

2. The Original Indication for Oral Minoxidil Was High Blood Pressure

According to the Mayo Clinic, oral minoxidil, which came before topical minoxidil, was initially accepted as a prescription drug for severe hypertension, or high blood pressure. In the late 1970s, the FDA initially approved minoxidil tablets as a treatment for severe hypertension, or high blood pressure. However, they frequently resulted in excessive hair growth as a side effect. Drug makers rapidly released the possibility for this adverse effect, according to the American Academy of Dermatology Association, and repackaged minoxidil as a topical treatment for hair loss (AAD).

Minoxidil is no longer commonly used to manage hypertension, according to Dr. Juan Jimenez Cauhe, a trichologist at Grupo Pedro Jaen Clinic and a dermatologist at Ramon y Cajal University Hospital, both in Madrid. It is only recommended for severe hypertension cases when patients don't respond to other medications or when people have kidney failure, according to the American Heart Association.

It has been used increasingly frequently off-label for various types of hair loss at low doses over the past seven years, he says. After that, more on it.

3. Oral Minoxidil Is a "Off-Label" Hair Loss Treatment

The FDA states that the terms "off-label" or "unapproved" might apply to a variety of products. It could mean that doctors are utilising a drug in a different way, at a different dosage, or to treat a condition for which it has not yet gained FDA approval. An example of this would be using a drug orally rather than topically.

Currently, the FDA has approved minoxidil as an oral medication to treat high blood pressure as well as a topical hair loss treatment. Any prescription for treating hair loss when taken orally is nevertheless "off-label" because the medicine has not yet received FDA approval for this use.

4. There is a lack of research on using minoxidil orally to treat hair loss.

The use of oral minoxidil to treat hair loss is not yet backed by enough reliable studies. However, according to Dr. Sattur, a small number of studies show that oral minoxidil can help treat hair loss and, in some cases, may even be more effective for some people than topical remedies.

A daily pill containing 0.25 mg of minoxidil and 25 mg of spironolactone was found to be both safe and effective for treating female pattern hair loss in a short observational trial of 100 women. It is difficult to say whether the medication is to blame for these results because there was no control group in the study.

The Journal of the American Academy of Dermatology presented a follow-up analysis with 634 individuals and 17 studies in July 2020. The study showed that oral minoxidil was a usually successful and well-tolerated alternative to topical minoxidil, however experts emphasise that larger, controlled studies are needed.

5. The dosage for oral minoxidil is not standardized

Even while the effects are effective, it will take time to demonstrate them. Do you know what is the Right Time To Take Minoxidil? For many people, hair loss can be a major issue, but it can be controlled with the aid of drugs that work similarly to minoxidil. It aids in enhancing hair growth.

The majority of this research, according to Sattur, looked at doses between 0.25 mg and 5 mg, which are lower than those employed to treat hypertension. (The normal dosage range for treating hypertension in adults and children over the age of 12 is 5 to 40 mg.)

All over-the-counter drugs have the following drawback: Sattur claims that there is no agreement on the ideal dose among the published small sample studies. It is uncertain how much minoxidil is safe to consume while using it off-label because there is no suggested dose for it.

6. Minoxidil Pill Side Effects Can Be Serious

When compared to systemic medication, like pills, which affects the entire body, the side effects of topical treatments are typically less problematic.

The Mayo Clinic lists some of the more uncommon side effects of topical minoxidil as chest pain, edoema, inflammation, acne, and blurred vision. The most frequent negative effects on the scalp are rashes or itching.

The safety picture is considerably less clear for oral minoxidil because it hasn't undergone the kind of extensive clinical study required for FDA approval.

For instance, Sattur queries if taking oral minoxidil in modest doses to treat hair loss would have a negative impact on blood pressure in people who do not already have hypertension. According to Sattur, each patient will require a different treatment plan based on changes in their blood pressure and cardiovascular system.

According to the Mayo Clinic, minoxidil pills have a black box FDA warning (PDF) because there's a chance they can raise your risk of developing pericardial effusion, which is the medical word for an excessive buildup of fluid around the heart.

Dr. Jiménez Cauhé claims that other side effects in some patients taking oral minoxidil at lower doses for hair loss include dizziness, heart palpitations, and fluid retention. Although these side effects should go away once patients stop taking the medication, Jimenez-Cauhe points out that "the likelihood of these difficulties is one reason why patients should get them prescribed by a clinician who has a thorough awareness of patients' existing diseases."

7. Using Minoxidil While Pregnant Is Dangerous

Dr. Jiménez Cauhé claims that other side effects in some patients taking oral minoxidil at lower doses for hair loss include dizziness, heart palpitations, and fluid retention. The likelihood of these issues is one reason why patients should have medications prescribed by a doctor who has a thorough understanding of their current medical conditions and medical history, according to Jiminez-Cauhe, even though these side effects should go away once patients stop taking the medication.

8. Minoxidil Isn't Your Only Hair Loss Treatment Option

• According to the AAD, persons with pattern hair loss have a variety of other therapy options besides minoxidil. Because certain procedures can leave men with facial hair and others are not recommended for women who are pregnant or breastfeeding, men and women have different treatment options.
• In addition to minoxidil, the AAD asserts that there are further treatments available for pattern baldness.
• Most men who take the prescription medication finasteride do so to stop hair loss.
• Artificial hair Hair plugs are transferred from one region of the scalp to another using a procedure known as platelet-rich plasma.
• a procedure that uses blood plasma injections into the scalp, either separately or in conjunction with hair transplants,

9. Topical Minoxidil Is Still the Gold Standard in Hair Loss Treatment

Dermatologists advise people who are first thinking about taking minoxidil tablets to start with FDA-approved alternatives. This includes topical minoxidil, which is offered under various brand and generic names, including Rogaine.

Finding a dermatologist knowledgeable in identifying hair difficulties should be the first step for a patient considering using low dose oral minoxidil, suggests Dmitri Wall, MD, a consultant dermatology and hair transplant surgeon at St. James' Hospital in Dublin.

According to Sattur, the risk-benefit ratio of oral minoxidil in comparison to topical minoxidil and the low quality of the evidence that is now available for oral minoxidil do not support routine usage of the drug to treat pattern hair loss. The mainstay of treatment remains topical minoxidil.