Dr. Bauman explains what to expect from using oral minoxidil and answers questions including if you can use it with other hair loss treatments.
(Video Transcript)
Hey everybody! It’s Dr. Alan Bauman from Bauman Medical Hair Transplant and Hair Loss Treatment Center, coming to you today on behalf of Strut.
And, we’re going to talk today about what’s old and what’s new about Minoxidil for hair loss.
So, we’re going to cover some of the most frequently asked questions like; How does Minoxidil work, should you be using oral Minoxidil in conjunction with topicals (or instead of), what are the common risks and concerns, and what are some pro-tips to get the best results from oral Minoxidil?
Stay tuned, you’re gonna find out.
So, for those of us in the world of hair restoration, we’ve known about oral Minoxidil for many, many years. But, the general public seemed to have gained more interest after the New York Times story that was front page news about oral Minoxidil and how it could regrow hair at a relatively low cost.
Well, there are some concerns, and we’re gonna go over some of those today. Like, should you be using oral Minoxidil in conjunction with topical medication, and some pro-tips, and some warnings and concerns.
So, the first one: Does oral Minoxidil work for hair loss?
Well, actually, oral Minoxidil, many of you might hear the name Minoxidil, be familiar with Minoxidil from the ingredient in topical medications. Typically, either over-the-counter like Rogaine or generics, as well as prescription topical Minoxidils.
But, Minoxidil originally was a blood pressure medication. And, back in the early 1970s, they used Minoxidil to treat blood pressure.
And, they saw in those patients who they were treating, incredible hair growth in their arms, and neck, and also on their scalp.
And, so they decided to make it into a topical medication, and that’s how we got Rogaine.
And, so we’ve always known that Minoxidil had these hair growth properties, but we didn’t want it to have systemic effects.
So, more recently, there has been a lot of research, in the world of hair loss and hair restoration on low-dose oral Minoxidil for hair regrowth.
And, that’s what we’re going to talk about today.
So, what is the mechanism of Minoxidil and how does it work?
Well, today, we still don’t really know. It is an antihypertensive, it could make your blood pressure lower, but we also know it is an anagen-stimulating agent, and an anagen-promoting agent.
Anagen is the growth phase of the hair follicle. So, if you prolong anagen in a weakened or miniaturized hair, you’re gonna get a longer, thicker, stronger hair.
And, so that’s why Minoxidil topically works directly on the scalp. If we use an appropriate dose of Minoxidil orally, we can get that same kind of effect, hopefully without systemic side effects.
The other thing we know about Minoxidil is that it is a blood vessel dilating agent. That means it’s going to increase blood flow in the microcirculation.
Obviously, that’s important and helpful, we think, for hair regrowth.
So, what are the most common questions and concerns about using oral Minoxidil? What are the potential side effects?
Well, since oral Minoxidil was a blood pressure agent, lowering blood pressure was its primary objective. If you use too much oral Minoxidil, you could impact your blood pressure.
And, how would this manifest? You would experience headaches, you could experience dizziness.
You could also see water retention, and swelling in the ankles or the hands. And, so we want to minimize those systemic side effects, systemic side effects that occur from taking oral Minoxidil, and maximize the hair growth effects.
So how will we do that?
We want to start with a low dose and work and work our way up slowly, if you’re gonna increase.
For this reason, you need to be medically screened by a physician and perhaps even have your blood pressure taken and monitored if you’re on the medication. And, of course, check yourself for side effects.
But, starting at a very, very low dose minimizes the chance of side effects because the medication is very, very safe.
Can we use oral Minoxidil and topical Minoxidil together?
Yes. In fact, many patients have a very, very profound hair regrowth effect when using both treatments together.
Sometimes it's because they’re synergistic, you’re getting enough Minoxidil to stimulate the follicles from the topical version and also the oral version at the same time.
Sometimes it’s because maybe someone’s not a hundred percent compliant with their dosing strategy with the topicals, which should typically be twice a day every day, and if you’re skipping doses, you’re really missing out on some Minoxidil benefits. So, adding a Minoxidil oral or pill version can certainly help with that.
The other thing is that sometimes folks have an irritation from topical Minoxidil that prevents them from using a topical Minoxidil at a consistent rate.
So again, using the oral version, kind of on a daily basis can sometimes help. If you’re having irritation from topical Minoxidil products.
And, for sure, topical and oral Minoxidil can certainly be combined with anti-androgen treatments like Finasteride and Dutasteride, which will help inhibit the DHT production, the main trigger for male pattern and female pattern hair loss.
So, there are a number of reasons why maybe topical Minoxidil doesn’t work for everybody.
It can sometimes disrupt your hairstyle, it can sometimes cause your scalp to be irritated. Sometimes people simply don’t have the sulfotransferase enzyme, which is the enzyme in the scalp that converts Minoxidil into its active ingredient Minoxidil Sulfate, and that’s a genetic predisposition.
So, if any of these things apply to you, then oral Minoxidil might be your savior, might be a great benefit.
One of the questions I get almost every day is, is oral Minoxidil better than topical Minoxidil?
And, unfortunately, we can’t make that call right now. There are many, many more studies on topical Minoxidil, it’s been out so much longer.
But, I will tell you that everybody’s situation is a little bit different. As we mentioned earlier, there are many reasons why people don’t necessarily do well on topical Minoxidil.
And, it’s not because it’s not effective, it’s just because there are things that interrupt the compliance and adherence to the regimen.
So, oral Minoxidil has been shown in a number of clinical trials for many years to be extremely effective in male pattern hair loss and female pattern hair loss, and in many other alopecia conditions including chemotherapy-induced alopecia, as well as alopecia areata.
So, I’ll add some links to these studies below in the notes, and you can click through and take a look at those if you wish.
Oral Minoxidil Studies:
Oral minoxidil treatment for hair loss: A review of efficacy and safety
Review of oral minoxidil as treatment of hair disorders: in search of the perfect dose
Safety of low-dose oral minoxidil for hair loss: A multicenter study of 1404 patients
Can both women and men use oral Minoxidil?
And the answer is yes, of course.
However, women sometimes are more sensitive to the side effects, which would be increased hair growth in unwanted places than men. Men typically do not have that concern.
But, it can be effective in both men and women.
And, in fact, women tend to have a lot more weaker, miniaturized hair than men do. And, sometimes it is an amazing miracle for women who are on oral Minoxidil.
So, who should not use Minoxidil orally for hair regrowth?
Well, there are some folks who have to be either extra careful when they’re using Minoxidil or shouldn’t be using it at all.
And, actually, the package insert for Minoxidil for high blood pressure comes with a black box warning, which is a warning for potentially serious heart adverse effects including cardiac effusion, cardiac tamponade, and chest pain or angina. In animal models, myocardial lesions and other cardiac events were noted.
While these effects are noted on the higher dose of Minoxidil, it’s unclear how safe the lower doses are over time.
So, it’s important to pay attention to your blood pressure situation and discuss with your doctor if oral Minoxidil is right for you for hair loss.
As I previously mentioned, oral Minoxidil can also cause salt and water retention, swelling in the limbs, kidney issues. And, so, if you have any kidney problems, again, speak to your doctor before starting on oral Minoxidil.
Minoxidil is also contraindicated in people who have pheochromocytoma.
When Minoxidil is used for hair loss orally, we’re going to be using a much, much tinier dose than what would typically be used for blood pressure.
Blood pressure might be tens of milligrams, 10 to 50 milligrams. We're typically going to be using somewhere between less than a milligram or even up to 5 milligrams or 10 milligrams when we’re treating orally for hair loss.
So these are much, much smaller dosages, which are considered safer.
Your doctor will review all of your medical information and discuss with you whether oral Minoxidil is right for you.
So, to summarize, oral Minoxidil may be a great adjunct to your hair restoration regimen, but it does come with some concerns.
So speak to your doctor about whether oral Minoxidil is right for you and check out my other videos below for more information on hair loss and hair restoration, and happy growing!
Watch more Dr. Bauman videos:
Dr. Bauman Explains: 3 Reasons To Stay On Your Hair Growth Treatments (Video)
Dr. Alan Bauman: Does Melatonin Have an Impact on Hair Growth? (Video)
Dr. Alan Bauman: Review of Strut Hair Booster with Latanoprost (Video)
At Strut Health, we offer oral and topical Minoxidil online for men and women who are looking to treat their hair loss.
To get started, simply select the Minoxidil product you are considering, and then complete a free online questionnaire-based consultation in under 15 minutes. Our U.S. doctors will review your information and make sure the treatment is appropriate for you.
Then, a U.S. pharmacy will put your medication together and ship it to your front door with our free shipping.
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