Highlights
- Minoxidil is approved by the FDA as a topical medication to treat female pattern hair loss and as an oral medication to treat high blood pressure.
- Oral minoxidil can be used off-label to treat hair loss in women.
- Sometimes providers will prescribe both oral and topical minoxidil to support hair growth in women.
- The best treatment plan for you depends on a variety of factors, such as the extent of your hair thinning, cause of hair loss, and your preference for oral or topical medication.
- You can order minoxidil and other hair loss treatments at eDrugstore.com.
Topical minoxidil has been used for decades for treating hair loss. More recently, oral minoxidil has become a popular treatment for hair loss among dermatologists. Learn why a panel of hair loss experts supports minoxidil for hair loss in women.
What is minoxidil?
Minoxidil is a medication that can be used to treat hair loss in both men and women. The Food and Drug Administration (FDA) has approved minoxidil as a topical medication to treat hair loss and as an oral medication to treat high blood pressure. Topical minoxidil is available over the counter (OTC), but oral minoxidil requires a prescription.
In recent years, oral minoxidil has been used as an off-label prescription for treating hair loss. A recent New York Times article detailed how low doses of oral minoxidil offer a cost-effective solution to hair loss. Minoxidil has been used for decades and is safe for most people to use, making it an attractive option for many people.
We asked a panel of hair loss experts to weigh in on the benefits of using minoxidil to treat hair loss in women. See what they have to say below.
Can women take oral or topical Minoxidil for hair loss?
Hair loss experts from a variety of practices agree that Minoxidil is a safe and effective treatment for hair loss in most women.
Dermatologist Dr. Hyemin Pomerantz of VivaSkin Dermatology and Aesthetics has prescribed oral minoxidil for several years. She says, “Minoxidil is not a hormone-based treatment, and both men and women can take oral and topical minoxidil.”
Dr. Brandon Kirsch, a board-certified dermatologist, enthusiastically promotes the use of both oral and topical minoxidil for treating hair loss. He states, “Absolutely! Women can use either oral or topical minoxidil, or both at the same time. Minoxidil works remarkably well for treating hair loss in women.”
He also explains why it works so well for hair growth. “It is a vasodilator, meaning it opens up the blood vessels. This increases blood flow and nutrient delivery to the hair follicles. Oral and topical minoxidil encourage more hair follicles to enter the growth phase, and increase follicle weight and density.”
Oral vs. topical minoxidil: Which is better?
Our experts across the board support the use of both oral and topical minoxidil. However, several experts commented that some clients gravitate toward oral minoxidil. This is largely due to the convenience of a daily pill compared to daily application of a topical solution.
Dr. Crystal Dinopol, a clinical dermatologist with My Psoriasis Team, explains that convenience is a key factor for many women. “Oral minoxidil has the same effects as topical minoxidil with the advantage of convenience since the application of topical minoxidil can be time-consuming, especially for large areas (alopecia universalis).”
Ghanima Abdullah, a cosmetologist and hair loss expert with The Right Hairstyles, agrees that many women prefer the oral minoxidil. She adds, “Women can take minoxidil orally at low doses instead of using the topical minoxidil, which some find distasteful as it has to stay on the scalp.”
At the end of the day, the decision to use oral or topical minoxidil depends on the extent of hair loss, the client’s health history, and the client’s personal preferences.
Dr. Ryan Welter, Founder and Chief Surgeon of the New England Center for Hair Restoration, summarizes, “It is not that one is better than the other. The area affected and the extent of involvement help dictate the better course of action. Generally topically is universally safe. Because there can be systemic effects on the cardiovascular system with the oral preparation, a full history and exam by your doctor and careful follow-up is necessary, but even still the safety profile is very high for most people.”
Dr. Kirsch expresses a similar viewpoint. He comments, “Whether oral or topical minoxidil is better, or whether using both would be best, depends on the individual. Some patients prefer the convenience of a once-a-day oral medication, while others prefer to avoid oral medications altogether.”
What is the optimal minoxidil dose for women?
The optimal dose for women will depend on the extent of their condition, their personal risk factors, and how long they’ve been taking minoxidil. The prescribed dose of oral and topical minoxidil varies, but several experts shared the same recommended dosages for women.
Optimal dose for oral minoxidil
There isn’t a standard prescribed dose for oral minoxidil, but providers typically begin with a low dose. Starting at a low dose can help women acclimate to the medication and adjust to any side effects that appear. For example, Dr. Pomerantz advises starting at a low dose and increasing dosage slowly, as long as it’s tolerated by the individual.
Alexia Donovan, Director of Client Services at the Barber Surgeons Guild, shares, “Clinical studies show us that low dose oral minoxidil (LDOM) of 0.5 milligrams taken once daily has a very good effect without the common adverse effects of the higher doses that are readily available.”
Ghanima Abdullah explains, “Men are typically prescribed 2.5 milligrams to 5 milligrams a day, but women are given less than half of that. Most women are given 1.25 milligrams a day or less. If they develop side effects with that dosage, they are moved down to 0.625 milligrams for a few weeks before moving up to 1.25 milligrams. After six months, the hair growth isn’t satisfactory, they might increase to 1.875 milligrams, but not more than that. Most women stay with the 1.25 milligrams dosage.”
Optimal dose for topical minoxidil
Several strengths of topical minoxidil are available. For example, Dr. Kirsch clarifies that topical minoxidil is most often applied at between two percent and seven percent strength. However, several experts recommended a five percent strength or higher.
Dr. Welter shares, “I generally recommend 5% over 2.5% twice a day. If the hair loss extends beyond the hair line, then applying topically to the entire scalp can be difficult so I generally recommend moving to an oral regimen.” He also comments that in severe cases, he recommends both topical and oral minoxidil.
Dr. Kirsch shares that many of his clients have had better results when using both topical and oral minoxidil. “For women, I have observed the best results, with the least side effects, at 6% topically and 1 milligram orally (both daily).”
For anyone using topical minoxidil, Dr. Dinopol reminds you to “make sure to wash your hands before and after application to avoid accidental hair growth in unwanted areas.”
What are the risks for women taking Minoxidil?
As with many medications, side effects can vary from person to person. The experts we talked with emphasize the importance of discussing your risk of side effects with your provider.
It’s especially important that you discuss these treatments with your provider if you’re pregnant or trying to become pregnant. Donovan advises, “While there are no known instances of birth defects with pregnant women using minoxidil orally or topically, due to a lack of clinical data on this subject, it should be avoided in this circumstance.”
Topical minoxidil risks
The most common side effects of topical minoxidil include irritation, inflammation, itching, and swelling on the scalp. Dr. Sean Byers, a medical advisor at Health Report Live, points out, “The topical form tends to be more irritating to the skin due to increased scalp contact with the medication.” It can also cause facial hair growth.
Dr. Pomerantz cautions that people with a sensitive scalp may be more likely to experience a burning sensation when using topical minoxidil. She adds, “If the medication gets on the pillow or bedding and is transferred on the face, then hair growth in an unwanted area can be seen.”
Dr. Kirsch explains that some women may experience initial shedding when taking minoxidil. “The shedding is the result of dormant hair follicles transitioning from the resting phase to the growth phase. The short-term introduction of an over-the-counter topical steroid solution can be helpful for any scalp irritation, which otherwise usually resolves with time or decreased frequency of application.”
Though research on the use of oral minoxidil for hair loss is relatively limited, the current evidence is promising. For example, a review published in the Journal of the American Academy of Dermatology shows that oral minoxidil is generally well tolerated and effective in treating hair loss. Women who experience uncomfortable side effects while using a topical solution may prefer to take oral minoxidil.
Oral minoxidil risks
Most people can take oral minoxidil without serious side effects. Many of the same side effects with topical minoxidil can occur when taking oral minoxidil. However, anyone with a pre-existing cardiovascular condition may be at greater risk for side effects.
Dr. Welter comments, “If you have preexisting heart or cardiovascular issues, you may not be a candidate for oral minoxidil.” Abdullah adds, “Women can develop an erratic heartbeat from taking too much minoxidil, along with dizziness and fluid retention.”
Despite this, risks of cardiovascular side effects are relatively low for most women. Dr. Pomerantz clarifies: “Oral minoxidil is used to lower blood pressure. The dose we use to treat hair loss is usually not high enough to lower blood pressure, but dizziness or headache can happen with blood pressure fluctuation.”
Women should stop taking minoxidil and speak with their provider right away if they experience serious side effects. Dr. Kirsch cautions, “Rare but more serious side effects that warrant pausing treatment and contacting your doctor include swelling, shortness of breath, lightheadedness, dizziness, headaches, chest pain, or heart palpitations.”
Not everyone responds to minoxidil
Despite minoxidil’s promising success rate, some people don’t respond to it. If you’re one of those people, a hair growth supplement made for women might be the right option for you. Peak Body Hair Growth Support for Women is an over-the-counter dietary supplement containing vitamins and minerals that are scientifically associated with hair loss, including vitamin C, B vitamins, biotin, and zinc.
We offer a free consultation with a physician licensed to practice in your state to help you decide if this option is right for you.
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Shelby is a public health professional with research and field experience in sexual and reproductive health. She holds a Master of Public Health (MPH) and is a Certified Health Education Specialist (CHES).
