Does Minoxidil Really Work for Hair Growth?

Hair loss is an incredibly common concern. In one form or another, it can affect men and women across all age groups and races. There are many different treatments for hair loss, each promising to prevent shedding and promote regrowth. Amongst these, minoxidil is one of the most common and easiest to get treatments for hair growth. However, how effective is it really? In this article, we explore the science behind minoxidil. We assess how well it works, what results to expect, and the best strengths and ways to use it.

What is Minoxidil?

Minoxidil was initially developed as an oral medicine in the 1960s to treat ulcers. However, the trials showed that, although it didn’t treat ulcers, it was a powerful vasodilator that could treat high blood pressure. Even more surprising was that during clinical trials, researchers observed another unexpected side effect. Minoxidil seemed to increase hair growth. This discovery led to the development of topical minoxidil as a treatment for hair loss, which received FDA approval in the 1980s. Fast forward to today, and minoxidil treats certain types of hair loss alone or in combination with other medicines. It comes in various forms, including topical solutions and foams as well as oral tablets. It is available over the counter in lower strengths, and by prescription for higher ones, in the UK.

How Does Minoxidil Promote Hair Growth?

The effectiveness of minoxidil lies in its ability to stimulate hair follicles and extend the anagen phase (growth phase) of the hair cycle. There are three main ways it works:

• Vasodilation: minoxidil widens blood vessels, improving blood flow to the hair follicles. This delivers more oxygen, nutrients and growth factors to the follicles, promoting healthier, thicker hair growth.
• Prolongs the growth phase: minoxidil opens potassium channels, which may help prolong the anagen phase. This allows hair to grow longer and stronger before it enters the shedding phase.
• Cellular effects: minoxidil increases the activity of dermal papilla cells, which are crucial to hair follicle development and growth. By boosting these cells, minoxidil helps rejuvenate shrinking follicles. This leads to thicker, more robust hair strands.

Who Can Use Minoxidil?

Minoxidil is suitable for both men and women experiencing various types of hair loss. However, its effectiveness can vary depending on the cause and extent of the loss. Minoxidil is most effective for androgenetic alopecia (male or female pattern hair loss). This appears as thinning hair and a receding hairline in men, and diffuse thinning over the crown in women. It can also help those with other forms of alopecia, such as alopecia areata or telogen effluvium, although results may vary.

In general, minoxidil is safe for adults over the age of 18. However, before starting, it’s important to consider any underlying health conditions (especially anything affecting the blood vessels) that might make it unsuitable. Additionally, people with scalp conditions such as eczema or psoriasis should consult a healthcare provider, as minoxidil may aggravate these conditions. Minoxidil should also not be used during pregnancy or breastfeeding.

How to Use Minoxidil for Hair Growth

As a general rule, minoxidil is mainly used as a topical treatment these days. It is effective, acts directly on the scalp and carries a lower risk of side effects. Topical minoxidil is available as Regaine in the UK over the counter, in concentrations of 2% (for women) and 5% (for men). It is mostly used as a foam, though a solution is also available. Higher concentrations are available in prescription treatments, which may also include other hair growth ingredients like finasteride or tretinoin. In the UK, you can get minoxidil for hair loss online through regulated clinics, often combined with other actives in a single formula. Most people need to apply minoxidil twice daily and use it consistently for 6 to 12 months to achieve the best results. After that, it may be possible to maintain results with a lower frequency, though your doctor will advise on this.

Oral minoxidil is less commonly used, but some healthcare providers may prescribe it off-label for hair growth. This option is usually only considered for people who haven’t seen results with topical forms, or who experience irritation from them.

What Results to Expect from Minoxidil

One of the most common questions about minoxidil is how long it takes to see results. It’s a complex question, as it varies from person to person and depends on the cause of your hair loss and your overall health. That said, here’s a realistic timeline based on the average user’s experience:

• Initial shedding: this is shocking for a lot of people. In the first few weeks of using minoxidil, you may notice increased hair shedding. However, this is a normal part of the process, as old hairs make way for new growth.
• Early growth (3 to 6 months): most users begin to see initial signs of regrowth within this period. New hairs may appear finer and lighter in colour at first.
• Visible growth (6 to 12 months): continued use leads to more noticeable improvements. Hair becomes thicker and fuller as the growth cycle progresses.
• Peak growth (12 months and beyond): you typically see maximum results after one year of consistent use. Hair regrowth stabilises, and many people experience a significant improvement in density and coverage.

It’s crucial to understand that minoxidil is a maintenance treatment. To sustain the benefits and prevent hair loss from recurring, you need to keep using it. Stopping minoxidil will likely lead to the gradual loss of any regrowth. Your hair then returns to the state it was in before treatment.

Risks & Side Effects

Like any medication, minoxidil can cause side effects. Understanding these potential risks and how to manage them is crucial for safe and effective use. They include the following:

• Scalp irritation: redness, itching and dryness may occur with topical minoxidil, especially the solution form. Switching to the foam or using a moisturiser can help ease these symptoms.
• Unwanted facial hair: minoxidil can cause hair growth on the face if used orally, or if it touches facial skin when applied topically. Careful application can reduce this risk.
• Allergic reactions: severe allergic reactions are rare but possible. Symptoms include rash, swelling and difficulty breathing. Seek immediate medical attention if these occur.
• Heart palpitations: minoxidil can affect heart rate and blood pressure, especially (but not exclusively) when used orally. If you experience palpitations or dizziness, stop using it and consult a healthcare provider.

In addition to the side effects in people, minoxidil can also be toxic to pets. Even tiny amounts licked from your skin, hair or bedding may cause serious, potentially life-threatening toxicity, especially in cats and dogs. So if you have a pet or are in regular contact with animals, let your doctor know.

Tips for Getting Started on Minoxidil

There are no magical cures for hair loss and, like anything in life, consistency is key. Here are some of our best tips to help you start on the right footing:

• Stick to a schedule: set reminders or build minoxidil application into your daily routine so you don’t miss a dose.
• Be patient: hair regrowth takes time. It’s important to use minoxidil consistently for at least 4 to 6 months before expecting visible results. Unless you have side effects, don’t give up.
• Avoid contact with eyes and face: minoxidil can cause irritation if it reaches sensitive areas, so wash your hands thoroughly after application.
• Apply onto a clean scalp: this helps with penetration.
• Limit application to the scalp: minoxidil can cause unwanted facial hair. So avoid transferring it beyond the scalp, whether with your fingers or through pillows and towels.

Combining Minoxidil with Other Hair Growth Treatments

Hair loss is complex, and in some cases combining minoxidil with other treatments can enhance results. This usually means combining it with other medicines, though professional treatments can also work. Here are the most common hair growth treatments to combine with minoxidil:

• Finasteride: available as either an oral or topical medication, finasteride works by blocking the hormone DHT, which contributes to hair loss. Using it alongside minoxidil targets hair loss from two different angles. Finasteride is normally only for use in men and postmenopausal women.
• Dutasteride: similar to finasteride, dutasteride is also available as an oral or topical medication. It inhibits DHT but does so more comprehensively than finasteride. Combining it with minoxidil can offer potent results. However, due to the risks, it is often reserved for men and postmenopausal women who do not respond adequately to other treatments.
• Spironolactone: another medication available in oral or topical form, spironolactone can treat hair loss by blocking androgen receptors. This reduces the effect of the hormones that contribute to it. Combining it with minoxidil can be especially effective for women with androgenetic alopecia.
• Hydrocortisone: for those experiencing scalp inflammation or irritation, topical hydrocortisone can help soothe these symptoms. Using it alongside minoxidil can allow higher strengths to be tolerated and help maintain a healthy scalp.
• Tretinoin: combining tretinoin with minoxidil can enhance how well minoxidil penetrates the scalp, potentially improving its results.
• Microneedling: this involves creating tiny punctures in the scalp with fine needles, which can boost the absorption and effectiveness of topical treatments like minoxidil. Microneedling also stimulates the hair follicles directly.
• Laser therapy: low-level laser therapy (LLLT) devices, such as laser combs and helmets, can stimulate follicles and improve density. Combining LLLT with minoxidil may offer added benefits, as the laser improves the overall environment for hair growth.
• Hair transplants: minoxidil is sometimes used before and after hair transplant surgery to support the success of the procedure and new growth. It helps maintain the health of existing hair and helps the newly transplanted hair thrive.

Minoxidil offers a scientifically backed option for those struggling with certain types of hair loss. It has a long, established safety record and can be effective when used correctly in the right people. However, like anything in life, everyone responds differently, and minoxidil hair growth results are no different. It’s worth knowing from the outset that you will need months of consistency and patience before you even start to see results. A number of other treatments can also enhance the effects of minoxidil. So if it isn’t working, or you want help from the start, it’s worth seeing a healthcare professional. Finally, like most hair loss treatments, minoxidil requires a long-term commitment to maintain your results. It’s vital to consider this before embarking on your hair regrowth journey.

At City Skin Clinic, we understand that hair loss is a deeply personal journey. This is why our doctors create personalised hair loss treatments for women and men through our online clinic. We use actives like minoxidil, spironolactone, finasteride and dutasteride where appropriate, in bespoke compounded treatments designed around you. To start your personalised plan, book a virtual video consultation or use our online consultation form. The journey towards great skin and hair starts here.

This article is intended for general informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Always consult a qualified medical provider for any health concerns or questions you might have.