Hair loss can be a distressing experience, affecting one's physical appearance and self-esteem. Minoxidil, a medication initially developed to treat high blood pressure, effectively promotes hair growth and combats hair loss.
But when it comes to minoxidil, there are two primary forms to choose from: oral and topical minoxidil.
While both medication forms have been proven effective in treating hair loss, they have their differences, benefits, and drawbacks.
In this blog post, we'll be taking a comprehensive look at the differences between oral and topical minoxidil, their mechanisms of action, their pros and cons, and which may be the best option for your needs.
Table of content
What is minoxidil and how does it work?
Minoxidil is a medication commonly used to treat hair loss, particularly male and female pattern baldness. It is available in various forms, such as topical solutions and foams, and is applied directly to the scalp.
Minoxidil works by prolonging the growth phase of hair follicles, known as the anagen phase, and increasing blood flow to the scalp.
Doing so stimulates hair growth, helps to maintain existing hair, and can potentially slow down or prevent further hair loss.
However, it is important to note that minoxidil's effectiveness varies among individuals, and its results may not be permanent. Regular use is typically required to maintain the benefits, and hair loss may resume if treatment is discontinued.
Topical minoxidil
Topical minoxidil is a liquid solution applied directly to the scalp to promote hair growth and prevent loss.
It is available in different strengths, typically 2% to 5%. One of the main advantages of topical minoxidil is that it is easy to apply and generally well-tolerated.
It is also non-invasive and does not require a prescription at the lower strength. Additionally, it can be used by both men and women to promote hair growth.
Studies have demonstrated that topical minoxidil, particularly in the first phases of hair loss, can successfully boost hair growth and stop further hair loss. It can also improve hair thickness and quality and may even lead to the regrowth of dormant hair follicles.
Topical minoxidil is a safe and effective option for promoting hair growth and preventing hair loss.
However, as with any medication, it is essential to consult a healthcare professional before starting treatment to determine the best dosage and ensure it is safe.
Side effects of topical minoxidil
Despite the fact that topical minoxidil is typically regarded as secure and well-tolerated, there are certain possible adverse effects that people should be aware of.
These side effects may include:
- It may cause itching, dryness, flaking, or redness on the scalp.
- Topical minoxidil can cause hair growth in areas other than the scalp, such as the face, neck, or hands.
- Rarely, topical minoxidil may cause an increase in heart rate or other cardiovascular symptoms.
- Some individuals may experience dizziness or lightheadedness after applying topical minoxidil.
- In rare cases, individuals may develop an allergic reaction to topical minoxidil. It may cause hives, rash, or difficulty breathing.
It is significant to remember that these adverse effects are typically minor and disappear independently.
However, it is imperative to speak with a healthcare provider if you suffer any severe or lingering adverse effects.
Oral minoxidil
Oral minoxidil is a medication taken orally, typically as a tablet. Initially developed to treat high blood pressure, it has also been effective in promoting hair growth and combating hair loss.
Oral minoxidil is available by prescription only and is typically prescribed at a lower dosage for hair loss treatment than for blood pressure management.
The dosage of oral minoxidil for hair loss treatment is typically much lower than that used to treat high blood pressure. It may start at 0.25 mg daily and gradually increase to 2.5 mg daily.
The dosage may be adjusted based on the individual's response and any potential side effects.
One of the main advantages of oral minoxidil is that it can promote hair growth on the scalp and in other areas of the body, such as the arms, legs, and chest.
It can benefit individuals who may have experienced hair loss in these areas due to conditions such as alopecia universalis.
Oral minoxidil may also be effective for individuals not responding well to topical minoxidil or other hair loss treatments.
Side effects of oral minoxidil
Oral minoxidil can cause several side effects, some of which can be serious. These side effects may include:
- Oral minoxidil can cause a drop in blood pressure, which may cause dizziness, lightheadedness, or fainting.
- Oral minoxidil can cause an increase in heart rate or other cardiovascular symptoms, such as chest pain or shortness of breath.
- It can cause swelling of the hands, feet, or face.
- It can cause hair growth in areas other than the scalp, such as the face, neck, or hands.
- Fluid retention and swelling in various parts of the body can be caused.
- Rarely, oral minoxidil can cause an allergic reaction, which may result in skin rash or hives.
Additionally, it is essential to use oral minoxidil only with the strict guidance of a qualified healthcare professional, as incorrect use may increase the risk of side effects.
Pregnant women or individuals with certain medical conditions, such as kidney or heart disease, should not use it without consulting a healthcare professional.
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Oral minoxidil vs. topical minoxidil: efficacy and safety
When comparing the efficacy and safety of oral and topical minoxidil, it is essential to note that they have different mechanisms of action and are used for various purposes.
Oral minoxidil is primarily used to treat high blood pressure, while topical minoxidil is used for hair growth and to prevent hair loss.
However, they may have different levels of effectiveness and side effects. Let's look at clinical studies, the side effects of both these solutions, and how to combat them.
Efficacy
Several clinical studies have compared the effectiveness of oral and topical minoxidil in treating hair loss. Here are some of the key findings:
While topical minoxidil is a viable alternative for treating hair loss, many patients do not adhere to the regimen due to the medication's requirement to be applied twice daily, unfavorable hair texture, and irritated scalp.
Oral minoxidil at a modest dose has been suggested as a secure substitute in recent years. This study evaluated the efficacy and safety of oral minoxidil as a substitute by reviewing studies that utilized it to treat hair loss.
Seventeen studies involving 634 participants discussed oral minoxidil as the leading hair loss therapy option. The ailment that had been investigated the most was androgenetic alopecia.
The findings demonstrated that minoxidil is a practical and well-tolerated treatment option for healthy patients who have trouble using topical preparations.
Low-dose oral minoxidil improved scalp hair growth while reducing hair shedding in a 3-year retrospective case study. Moving on, a case-control investigation including 80 women and 25 men who received once-daily treatments of 0.625 to 2.5 mg of minoxidil for 52 weeks found that 52.4% of patients had improved clinical outcomes and 42.9% had clinical stabilization.
Lastly, it was found that 1 mg of oral minoxidil was significantly more efficient than 1 ml of 5% topical minoxidil given daily in research on 52 patients with female pattern hair loss and thinning hair. Most of the participants taking oral minoxidil experienced an upsurge in hair density.
A randomized clinical trial published in the Journal of the American Academy of Dermatology compared the efficacy and safety of oral and topical minoxidil in male and female patients with androgenetic alopecia (AGA). The study found that oral and topical minoxidil effectively promoted hair growth. Still, the topical formulation was better tolerated and had fewer side effects than the oral formulation.
These studies suggest that oral and topical minoxidil can effectively promote thicker hair and prevent hair loss.
However, the topical formulation may be better tolerated and have fewer side effects than the oral formulation.
Additionally, the oral formulation may significantly affect hair density and thickness more than the topical formulation.
Ultimately, the choice between oral and topical minoxidil will depend on individual factors such as the severity of hair loss, scalp condition, personal preference, and the advice of a healthcare professional.
Safety
Both oral and topical minoxidil can cause some common side effects. These may include scalp irritation, unwanted hair growth in areas other than the scalp, dizziness or lightheadedness, edema, and skin irritation.
Moving on, while rare, both oral and topical minoxidil can cause some severe side effects. Oral minoxidil treatment may cause low blood pressure, heart palpitations, or fluid retention, which may be challenging in some individuals.
Topical minoxidil may cause an allergic reaction, resulting in skin rash or hives. These severe side effects are relatively uncommon, but if they occur, it is essential to contact a healthcare professional immediately.
Individuals should be aware of several precautions and contraindications when using either oral or topical minoxidil. These may include:
- Individuals with known hypersensitivity or allergy to minoxidil should not use this medication.
- The safety of minoxidil during pregnancy or breastfeeding has not been established, and it should not be used without consulting a healthcare professional.
- Oral minoxidil can cause an increase in heart rate and fluid retention, which may worsen symptoms in individuals with cardiovascular disease.
- The kidneys excrete oral minoxidil, which may harm individuals with kidney disease.
- Topical minoxidil should not be applied to open wounds or irritated scalp, as it may cause further irritation or damage.
- Minoxidil may interact with other medications, such as blood pressure or drugs used to treat erectile dysfunction. Keeping in touch with a healthcare professional if you are taking other medications is mandatory.
How to choose the proper treatment?
To select the appropriate treatment between oral and topical minoxidil, consider the following factors:
- Severity and pattern of hair loss
- Hair growth rates
- Age and gender
- Personal preference
- Medical history
- Advice of a healthcare professional
Key considerations for different groups:
- Topical minoxidil: Both men and women can use the FDA-approved 2% strength. Men can use the 5% strength, while women should consult a healthcare professional before using the 5% strength.
- Oral minoxidil: Women are generally more sensitive to its effects and may require lower doses. Older individuals may be more susceptible to side effects.
Medical history and current medications:
- Oral minoxidil: Individuals with cardiovascular or kidney disease history may be at increased risk of side effects and require monitoring or a lower dosage. Those taking certain medications, such as blood pressure medications or medications for erectile dysfunction, may be at increased risk of interactions.
- Topical minoxidil: Individuals with a history of scalp irritation or dermatitis may require a lower strength or a different delivery method. Those using other topical medications on the scalp may need to space out minoxidil applications to avoid irritation.
Consult a medical expert before starting treatment with either oral or topical minoxidil to evaluate your medical history and current medications and recommend the most appropriate dosage and delivery method.
Can you use both oral and topical minoxidil together?
Combining oral and topical minoxidil is generally not recommended, as it may increase the risk of side effects such as low blood pressure, heart palpitations, and fluid retention. It is essential to consult with a healthcare professional before using different forms of minoxidil simultaneously to ensure the safety and suitability of this approach for your specific situation.
Oral minoxidil vs. topical minoxidil: which one is better?
Oral and topical minoxidil are both FDA-approved treatments for hair loss, each offering its own benefits and drawbacks. Topical minoxidil is more widely known and has been used longer, and is typically applied directly to the scalp as a solution or foam. It is well-tolerated, with a lower risk of side effects. On the other hand, oral minoxidil is administered as a pill and can potentially provide more systemic benefits for hair growth. However, it carries a higher risk of side effects, such as fluid retention and increased heart rate.
Here is a comparison table for Oral minoxidil vs topical minoxidil:
| Aspect | Topical Minoxidil | Oral Minoxidil |
|---|---|---|
| Form | Liquid solution or foam | Tablet |
| Application | Applied directly to the scalp | Taken orally |
| Prescription required | Not required for lower strengths (2%) | Yes |
| Usage | Both men and women | Both men and women, with dosage adjustments |
| Availability | Over-the-counter (OTC) for lower strengths (2%) | Prescription-only |
| Strengths | 2% and 5% | Typically 0.25 mg to 2.5 mg daily |
| Onset of action | Varies, may take 3-6 months | Varies, may take 3-6 months |
| Effectiveness | Varies among individuals | Varies among individuals |
| Primary Benefits | Easy to apply, non-invasive, localized treatment | Can promote hair growth in other body areas, systemic treatment |
| Side Effects | Scalp irritation, unwanted hair growth, itching, dryness, redness | Low blood pressure, heart palpitations, fluid retention, unwanted hair growth, dizziness |
| Contraindications | Open wounds, irritated scalp, allergy to minoxidil | Pregnancy, kidney or heart disease, allergy to minoxidil |
| Interactions | Possible with other topical medications | Possible with blood pressure medications and erectile dysfunction medications |
| Discontinuation Effects | Hair loss may resume | Hair loss may resume |
| Maintenance | Regular use required to maintain benefits | Regular use required to maintain benefits |
| Long-term effectiveness | May not be permanent | May not be permanent |
| Cost | Varies, generally affordable | May be more expensive, prescription-only |
| Suitability | Better for localized hair loss and scalp application | Better for widespread hair loss or those not responding to topical minoxidil |
Ultimately, the choice between oral and topical minoxidil will depend on individual factors, such as personal preference, tolerance, and the severity of hair loss.
It is essential to consult with a healthcare professional before beginning any hair loss treatment to determine the most appropriate option for your specific situation.
Conclusion
Both oral and topical minoxidil have proven effective in promoting hair growth and combating hair loss.
Each form has its unique benefits and drawbacks, with topical minoxidil being well-tolerated and more widely known, while oral minoxidil potentially provides more systemic benefits.
The choice between the two depends on individual factors such as the severity of hair loss, personal preference, and medical history.
It is crucial to consult with a healthcare professional before starting any hair loss treatment to determine the most suitable option for your specific needs.
By carefully considering your circumstances and working closely with a medical expert, you can make an informed decision and successfully address your hair loss concerns.
References:
- https://rarediseases.info.nih.gov/diseases/614/alopecia-universalis
- https://www.jaad.org/article/S0190-9622(03)03692-2/fulltext
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691938/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649170/
- https://www.aad.org/dw/dw-insights-and-inquiries/archive/2022/low-dose-oral-minoxidil-alopecia
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