Oral minoxidil works in the same way as the topical version. However, it will promote hair growth all over the body and not just the scalp. Research suggests that it could be more effective than topical minoxidil but comes with a greater chance of side effects. It should be taken only after consulting a doctor, in low dosage rising up with frequent cardiovascular checks.

When referring to hair loss treatments, topical minoxidil is considered one of the main treatments available at tackling the issue. It remains the only FDA approved product in treating hair loss and is usually the first form of treatment that men use when they notice their hair thinning.

Oral minoxidil, is not used as often as the topical version but it might be a more effective at combating hair loss. This post will break down both oral and topical minoxidil so that you are educated on the topic and can decide on which treatment is ideal for yourself.

What Is Minoxidil?

Minoxidil was developed in the 1960’s under the the trade name of Loniten. The medication was designed to treat hypertension; not male pattern baldness (MPB).

However, it was noticeable that patients who had taken the treatment had developed some side effects, one of those was growing hair. The hair growth was not exclusive to the scalp but also bodily hair growth.

This lead pharmaceutical companies to turn it into a topical solution that can be sold to treat hair loss. Initially it was as a topical liquid, but recently an alternative foam is now also available.

Rogaine (Regaine in the UK) was the trade name for this drug. To this day it remains as the only FDA approved treatment for hair loss in men. Available in most pharmacies over the counter or online without a prescription in most countries.

Yet, minoxidil did not always start of as a topical form of treatment. It was initially in the form of a tablet that was taken orally. It’s available in 2.5mg and 10mg to treat hypertension.

How Does Minoxidil Work?

Minoxidil works by promoting growth of keratinocytes. It functions through potassium channels, essentially working as a stimulator to the hair follicles. Minoxidil can increase the growth cycle of the hair, stimulate follicle movement to the growth phase and increase blood flow around the follicles. This achieves an increase in the size and thickness of the hair.

In clinical trials, minoxidil was used to analyze its effectiveness for hair loss. 90% of the patients either regrew hair or maintained their hair over a five-year period. Showcasing that minoxidil could be a highly effective treatment for hair loss.

However, minoxidil does not affect the underlying issue of hair loss. It does not inhibit DHT at all or interfere in the conversion of the testosterone hormone into DHT by the 5 alpha Reductase. It also does not address why miniaturization of the hair follicles occurs.

In male pattern baldness, the levels of DHT is what causes hair loss to occur in men. The hairs will shrink and become weaker with time eventually falling out, from being starved of oxygen and nutrients; this is known as the miniaturization stage.

Topical vs Oral Minoxidil?

Topical minoxidil is used on the scalp by spraying the liquid solution or foam onto the scalp and massaging it in. In men the recommended percentage is 5% minoxidil. It’s to be used twice a day preferable in the morning and evening everyday.

Oral minoxidil comes in a form of a tablet. A recommend dosage is around 1 – 2.5mg daily is sufficient to achieve the benefits of minoxidil. In most countries the tablet itself originally comes in a 10mg dosage. This is too strong and doctors suggest this should be cut into quarters of 2.5mg.

Which is more effective?

Unfortunately there isn’t much research that compares the efficacy of the two version against each other with male subjects. Nevertheless, there is a study that used 52 females with female pattern baldness, and analysed the use of minoxidil 1mg oral versus minoxidil 5% topical solution for the treatment of hair loss.

The results indicated that 1mg oral minoxidil was equally effective as 5% topical minoxidil applied daily. It was also determined that subjects using oral minoxidil had achieved greater hair density. Although, the difference was not statistically significant.

What is the key difference?

Oral minoxidil works in the same way as topical minoxidil. However, the main difference is that taken orally it will function all around the body. This will lead to hair growth everywhere, not just the scalp. Meaning the potential of thicker eyebrows, longer eyelashes, thicker facial hair and more body hair etc.

Which provides ease of use?

Oral minoxidil is much easier to take as it’s just a pill that is swallowed. Topical minoxidil can be time consuming and many have complained about its application. Leaving scalps itchy and greasy. Many men have struggled to style the hair whether with the foam or topical liquid.

Which is safer?

Topical minoxidil is FDA approved and has been used throughout the years to treat hair loss. It is available widely and is considered safe for long term use.

Both versions contain side effects, yet they are more common in those using oral minoxidil. There is also no long term research on the potential effects of taking minoxidil orally.

Which is cheaper?

Oral minoxidil is an off label treatment, it is not as easily accessible. The oral version is also considered more expensive.

What are the similarities?

Minoxidil acts as independent hair growth treatment. Taking or stopping other forms hair loss treatment will not have an effect on minoxidil. This is the case for both the oral and topical versions.

Both treatments will lead to a temporary shedding phase 3 or 4 weeks after initially starting the treatment. This is a good indicator as it suggests that the new hair growth cycle is beginning.

Minoxidil is a lifetime commitment. Coming off the medication will result in all gains achieved being lost. This is true for both the oral and topical form of minoxidil.

Side Effects of Oral Minoxidil

Side effects are not common but there is a chance that some might be experienced:

Hypertrichosis: Oral minoxidil will cause hair growth to occur all over the body, not just the scalp.

Hyperpigmentation: might cause darker patches on the scalp and cause hair colour to be permanently darker.

Variations in blood pressure: Due to minoxidil being initially designed to treat high blood pressure. It may cause variations and complications in blood pressure. Young, healthy patients with no cardiovascular issues should have not experience these issues.

Leukopenia: Taking minoxidil could cause a reduction in white blood cells. These are critical for fighting off diseases.

Thrombocytopenia: Minoxidil could lower platelet count. The blood platelets are responsible for minimising blood loss.

Cardiovascular issues: Could cause issues with breathing and heart palpitations.

Abnormal electrocardiogram (ECG): Could affect the heart’s rhythm and electrical activity.

Swelling in your legs, ankles, or feet;

Nausea

Dizziness / Headaches

Fatigue

Where Can I Buy Oral Minoxidil?

Oral minoxidil is an off label drug that is not FDA approved to treat hair loss. It is still possible to find a doctor to prescribe the drug for you but it will be done under their own discretion.

It is still available via some online pharmacies. These pharmacies are able to sell you prescription approved medications but will rarely ever ask for proof of this prescription. This can be extremely dangerous, and is essential that it is discussed with a doctor first.

Who Should Use Oral Minoxidil?

Looking at the side effects, it is recommended to avoid oral minoxidil. In the rare occasion that someone is intolerable towards the topical version, or has achieved no results with the topical version as well as other treatments for hair loss, then potentially using oral minoxidil could be an option after consulting their doctor.

How to Take Oral Minoxidil

First and foremost, if you are thinking about taking oral minoxidil then discuss this with your doctor.

Starting off on a low dosage then slowly raising it would be ideal for minimising the side effects. Starting off at 0.625mg once a day, then raising it to twice daily. Overall, this will equal 1.25mg a day and that should be sufficient enough to reap the benefits of minoxidil, especially if taken with a treatment that blocks DHT.

For those men who insist on taking a high dose such as 5mg. Additional precautions should be taken:

Cutting down on alcohol and caffeine

Use with a beta blocker

Lower dosage or cutting down use of non-essential medication

Lower salt consumption

Check on your cardiovascular status frequently

Conclusion

It’s so important to understand everything before using a drug. At times so many men become desperate seeking anything to save their hair. However, never should we experiment with drugs on our own, as it could lead to catastrophic results.

Although, oral minoxidil could prove to be a more effective version of treatment, one should consult this with their doctor before attempting to take it. It’s side effects could prove to be too dangerous, and as such the benefit might not outway the risks in this case.

Have you tried oral minoxidil? Tell us about your experience with the drug below.