Low-Dose Oral Minoxidil for Alopecia: A Comprehensive Review

January 2023 in “ Skin appendage disorders ”

Aditya K. Gupta, Mesbah Talukder, Avner Shemar, Bianca Maria Piraccini, Antonella Tosti

low-dose oral minoxidil LDOM androgenetic alopecia male androgenetic alopecia female-pattern hair loss FPHL hypertrichosis cardiovascular symptoms alopecia hair count headaches vertigo edema clinical hypotension minoxidil AGA hair loss hair growth side effects

Studysummary This review discusses the potential of low-dose oral minoxidil as a safe and effective treatment for certain hair disorders, including alopecia, but reports no new clinical results. Our plain-language summary of this paper — not a Tressless recommendation.

Low-dose oral minoxidil (LDOM) has shown potential in treating various hair disorders, including male androgenetic alopecia (AGA) and female-pattern hair loss (FPHL), despite not being FDA-approved for this use. The efficacy and side effects of LDOM appear to be dose-dependent, with common side effects being hypertrichosis and cardiovascular symptoms. Several studies were reviewed, with varying numbers of participants, showing that LDOM can be effective in treating different types of alopecia. For example, a study with 30 male patients taking 5 mg minoxidil daily showed a significant increase in total hair count after 12 and 24 weeks. However, a study with 25 male patients taking 0.25 mg/day of minoxidil for 24 weeks showed no substantial enhancement in total hair count, suggesting a higher dose might be necessary. Side effects were minor and included headaches, vertigo, and edema, but no clinical hypotension. Females were found to be more prone to develop hypertrichosis compared to males when taking less than 2.5 mg minoxidil orally per day. Despite its potential, LDOM is not recommended for use in pregnant women and breastfeeding mothers due to potential risks. Further studies are needed to establish its safety and efficacy in pediatric patients.

View this study on pmc.ncbi.nlm.nih.gov →

Discuss this study in the Community →

Research cited in this study

51 / 51 results

research Comprehensive Review of Oral Minoxidil in Alopecia

September 2022 in “Journal of Cosmetic Dermatology”

This review reports that oral minoxidil has shown promising results in treating various types of alopecia, including androgenetic alopecia and female pattern hair loss, at low doses with minimal side effects, offering an alternative to topical treatments.

research Systemic Minoxidil for Hair Disorders in Pediatric Patients: A Safety and Tolerability Review

August 2022 in “International Journal of Dermatology”

In this study, low-dose oral minoxidil and sublingual minoxidil were generally well-tolerated in children with alopecia, with mild hypertrichosis as the most common adverse event.

research Pericardial, Pleural Effusion and Anasarca: A Rare Complication of Low-Dose Oral Minoxidil for Hair Loss

3 citations , August 2022 in “JAAD case reports”

This review discusses the emerging evidence for low-dose oral minoxidil in treating various types of alopecia, without providing new clinical results.

research Comparison of Oral Minoxidil, Finasteride, and Dutasteride for Treating Androgenetic Alopecia

1 citations , August 2022 in “Journal of Dermatological Treatment”

In this study, the authors reported that oral dutasteride at 0.5 mg/day showed a probable greater efficacy in treating male androgenetic alopecia compared to finasteride and minoxidil, but it may cause sexual dysfunction and neuropsychiatric side effects.

research Safety and Tolerability of Low-Dose Oral Minoxidil in Adolescents: A Retrospective Review

2 citations , July 2022 in “Journal of the American Academy of Dermatology”

In this study, researchers aimed to evaluate the safety and tolerability of low-dose oral minoxidil in adolescents, as existing data on its use in this population are limited and there are no specific pediatric guidelines for prescribing it. Results are not reported.

Prospective Cardiovascular Evaluation with 24-Hour Holter and Ambulatory Blood Pressure Monitoring in Men Using 5-mg Oral Minoxidil for Androgenetic Alopecia

research Prospective Cardiovascular Evaluation with 24-Hour Holter and Ambulatory Blood Pressure Monitoring in Men Using 5-mg Oral Minoxidil for Androgenetic Alopecia

3 citations , May 2022 in “Journal of The American Academy of Dermatology”

This source notes that while low-dose oral minoxidil is effective for treating androgenetic alopecia, it has been associated with electrocardiogram changes and palpitations even at low doses.

research Low-Dose Oral Minoxidil for Treatment of Androgenetic Alopecia and Telogen Effluvium in a Pediatric Population: A Descriptive Study

6 citations , April 2022 in “Journal of The American Academy of Dermatology”

In this study, low-dose oral minoxidil was found to improve hair density in 80% of pediatric patients with androgenetic alopecia or telogen effluvium, with mild side effects primarily reported.

research Relative Efficacy of Minoxidil and the 5-Alpha Reductase Inhibitors in Androgenetic Alopecia Treatment of Male Patients

13 citations , February 2022 in “JAMA Dermatology”

This meta-analysis reported that 0.5 mg/d of dutasteride significantly increased total hair count at 24 weeks compared to finasteride and minoxidil in men with androgenetic alopecia.

research Randomized Clinical Trial of Low-Dose Oral Minoxidil for the Treatment of Female Pattern Hair Loss: 0.25 mg Versus 1 mg

3 citations , January 2022 in “Journal of The American Academy of Dermatology”

This study found that 1 mg/day low-dose oral minoxidil significantly increased hair count compared to 0.25 mg/day over 24 weeks in women with female pattern hair loss, though no differences were observed in hair-shedding and quality-of-life scores between the two doses.

research Role Of Oral Minoxidil In Patterned Hair Loss

January 2022 in “Indian Dermatology Online Journal”

This study suggests that low-dose oral minoxidil could be a safe and effective option for male and female-patterned hair loss, potentially benefiting those unable to tolerate topical treatments.

research There Is a Positive Dose-Dependent Association Between Low-Dose Oral Minoxidil and Its Efficacy for Androgenetic Alopecia: Findings From a Systematic Review With Meta-Regression Analyses

2 citations , January 2022 in “Skin appendage disorders”

This study found that for people with androgenetic alopecia, increasing the dosage of low-dose oral minoxidil is associated with improvements in hair diameter and density, but also raises the risk of hypertrichosis and cardiovascular adverse events.

research Systemic Minoxidil as Maintenance Treatment in Alopecia Areata: A Retrospective Case Series of 24 Patients

December 2021 in “Clinical and Experimental Dermatology”

This article is a letter to the editor regarding the use of systemic minoxidil as maintenance treatment in alopecia areata and includes no study results.

research Bicalutamide Improves Minoxidil-Induced Hypertrichosis in Female Pattern Hair Loss: A Retrospective Review of 35 Patients

4 citations , November 2021 in “Journal of The American Academy of Dermatology”

This article notes that low-dose systemic minoxidil combined with antiandrogen therapy is effective for treating female pattern hair loss, though hypertrichosis can occur in a significant percentage of patients.

research Low-Dose Oral Minoxidil Increases Hair Density and Thickness in Androgenetic Alopecia: A Retrospective Analysis of 60 Patients

4 citations , October 2021 in “Journal of The European Academy of Dermatology and Venereology”

Low-dose oral minoxidil increases hair density and thickness in people with hair loss.

research A Randomized Clinical Trial on Therapeutic Effects of 0.25 mg Oral Minoxidil Tablets on Treatment of Female Pattern Hair Loss

5 citations , September 2021 in “Dermatologic Therapy”

In this triple-blind randomized clinical trial, researchers found that oral minoxidil 0.25 mg tablets were as effective as 2% topical minoxidil for increasing hair diameter and density in women with female pattern hair loss, with similarly minor side effects.

research Minoxidil: A Comprehensive Review

16 citations , June 2021 in “Journal of Dermatological Treatment”

This study reported that while topical minoxidil exhibits hair regrowth in androgenetic alopecia, oral minoxidil 5 mg/day was more effective than topical forms after six months, with low doses also potentially effective for women and other hair loss types.

research Atypical Case of Minoxidil-Induced Generalized Anasarca and Pleuropericardial Effusion

7 citations , June 2021 in “Cureus”

This case report discusses minoxidil-induced anasarca as a potential side effect in patients using minoxidil for hypertension, emphasizing the importance of recognizing it for early diagnosis and management.

research Safety of Low-Dose Oral Minoxidil for Hair Loss: A Multicenter Study of 1404 Patients

39 citations , February 2021 in “Journal of The American Academy of Dermatology”

In this study, low-dose oral minoxidil for hair loss was associated with infrequent systemic adverse effects, and only 1.7% of patients discontinued treatment due to these effects.

research Low-Dose Oral Minoxidil Improves Global Hair Density and Length in Children with Loose Anagen Hair Syndrome

9 citations , December 2020 in “British Journal of Dermatology”

This research letter reports that low-dose oral minoxidil improved hair density and length in children with loose anagen hair syndrome.

Efficacy and Safety of Oral Minoxidil 5 mg Once Daily in the Treatment of Male Patients with Androgenetic Alopecia: An Open-Label and Global Photographic Assessment

research Efficacy and Safety of Oral Minoxidil 5 mg Once Daily in the Treatment of Male Patients with Androgenetic Alopecia: An Open-Label and Global Photographic Assessment

24 citations , September 2020 in “Dermatology and therapy”

This study found that low-dose oral minoxidil 5 mg daily significantly increased hair growth in men with androgenetic alopecia over 24 weeks, with increased hair count and vertex area improvement, though most experienced hypertrichosis and some had pedal edema.

research Efficacy and Safety of Oral Minoxidil in Female Androgenetic Alopecia

14 citations , September 2020 in “Dermatologic Therapy”

This study reported that oral minoxidil improved hair density and had an acceptable safety profile in women with androgenetic alopecia.

research Targeting Wnt/β-Catenin Pathway for Developing Therapies for Hair Loss

86 citations , July 2020 in “International Journal of Molecular Sciences”

This review discusses the role of Wnt/β-catenin signaling in hair follicle regeneration and highlights recent progress in developing hair loss treatments targeting this pathway, but reports no new clinical results.

research Topical and Oral Minoxidil for Hair Disorders in Pediatric Patients: What Do We Know So Far?

12 citations , July 2020 in “Dermatologic Therapy”

This review discusses the use of topical and oral minoxidil for pediatric hair disorders, pointing out the lack of guidelines and the potential risks associated with systemic absorption, but reports no clinical results.

Migration Inhibitory Factor in Conditioned Medium from Human Umbilical Cord Blood-Derived Mesenchymal Stromal Cells Stimulates Hair Growth

research Migration Inhibitory Factor in Conditioned Medium from Human Umbilical Cord Blood-Derived Mesenchymal Stromal Cells Stimulates Hair Growth

19 citations , May 2020 in “Cells”

This study found that 5% primed conditioned medium from human umbilical cord blood-derived mesenchymal stromal cells significantly improved hair density, thickness, and growth rate in patients with androgenetic alopecia.

research Oral Minoxidil Improves Background Hair Thickness in Lichen Planopilaris

15 citations , April 2020 in “Journal of The American Academy of Dermatology”

This article discusses the challenges of treating lichen planopilaris, reviews various therapeutic options including minoxidil, and reports no new clinical findings.

research Dihydrotestosterone Regulates Hair Growth Through the Wnt/β-Catenin Pathway in C57BL/6 Mice and In Vitro Organ Culture

23 citations , January 2020 in “Frontiers in Pharmacology”

In this study, DHT was observed to have varying effects on hair follicle growth and related protein expression depending on concentration, with the Wnt/β-catenin pathway potentially playing a significant role.

research Female Androgenetic Alopecia: An Update on Diagnosis and Management

43 citations , November 2019 in “American Journal of Clinical Dermatology”

This review discusses female androgenetic alopecia, highlighting its diagnostic challenges and management strategies, but it reports no new results.

research Very-Low-Dose Oral Minoxidil in Male Androgenetic Alopecia: A Study with Quantitative Trichoscopic Documentation

24 citations , September 2019 in “Journal of The American Academy of Dermatology”

This study found that using very-low-dose oral minoxidil (0.25 mg/d) led to improvement or stabilization of hair parameters in 40% to 60% of men with androgenetic alopecia, although results were not statistically significant for the overall group.

research Combination Tofacitinib and Oral Minoxidil Treatment for Severe Alopecia Areata

23 citations , September 2019 in “Journal of The American Academy of Dermatology”

In this retrospective analysis, combination therapy with tofacitinib and oral minoxidil led to significant scalp hair regrowth in patients with severe alopecia areata, with 67% achieving at least 75% regrowth, although the small sample size limits the findings.

research Minoxidil 1 mg Oral Versus Minoxidil 5% Topical Solution for the Treatment of Female-Pattern Hair Loss: A Randomized Clinical Trial

53 citations , August 2019 in “Journal of The American Academy of Dermatology”

This study observed that low-dose oral minoxidil and topical minoxidil 5% solution both improved hair density in women with female-pattern hair loss, but oral minoxidil may offer advantages in reducing hair shedding.

research Loose Anagen Hair Syndrome: Treatment with Systemic Minoxidil Characterized by Marked Hair Color Change

12 citations , March 2018 in “Australasian Journal of Dermatology”

This letter to the editor discusses the use of systemic minoxidil for loose anagen hair syndrome, noting a significant change in hair color, but reports no new study results.

research Minoxidil Downregulates Interleukin-1 Alpha Gene Expression in HaCaT Cells

16 citations , January 2018 in “International Journal of Trichology”

In this study, minoxidil significantly downregulated interleukin-1 alpha expression in human keratinocyte cells, suggesting an anti-inflammatory effect that may be a mechanism of action in treating alopecia.

research Female Pattern Hair Loss: A Pilot Study Investigating Combination Therapy with Low-Dose Oral Minoxidil and Spironolactone

80 citations , December 2017 in “International Journal of Dermatology”

This study reported that once-daily treatment with oral minoxidil and spironolactone for 12 months reduced hair loss severity and hair shedding in women with pattern hair loss, with generally mild side effects, though results came from an uncontrolled, observational pilot study.

research Treatment of Chronic Telogen Effluvium with Oral Minoxidil: A Retrospective Study

40 citations , September 2017 in “F1000Research”

In this study, women with chronic telogen effluvium experienced reduced hair shedding after being treated with once daily oral minoxidil for 12 months, but facial hypertrichosis was a reported side effect, suggesting the need for further placebo-controlled research.

research Treatment of Monilethrix with Oral Minoxidil

37 citations , May 2016 in “JAAD case reports”

This abstract describes monilethrix, an autosomal dominant genodermatosis with symptoms like hair fragility and keratosis pilaris, and does not report new experimental results.

research Treatment of Permanent Chemotherapy-Induced Alopecia with Low Dose Oral Minoxidil

36 citations , May 2015 in “Australasian Journal of Dermatology”

This case report described cosmetically significant hair regrowth in a 39-year-old woman with permanent chemotherapy-induced alopecia after continuous oral minoxidil use.

research Minoxidil Activates β-Catenin Pathway in Human Dermal Papilla Cells: A Possible Explanation for Its Anagen Prolongation Effect

88 citations , February 2011 in “Journal of Dermatological Science”

This study found that topical minoxidil modestly extended the anagen phase in mice by activating β-catenin activity in dermal papilla cells.

research Hair Growth and Rejuvenation: An Overview

81 citations , June 2010 in “Journal of Dermatological Treatment”

This review discusses recent advancements in hair rejuvenation strategies and assesses the potential of herbal drugs as safer alternatives, but reports no new clinical results.

research Medical Treatments for Male and Female Pattern Hair Loss

212 citations , September 2008 in “Journal of The American Academy of Dermatology”

This review discusses the various treatment options for male and female pattern hair loss and provides no new clinical results; the authors outline the most effective strategies based on existing evidence.

research Human Hair Follicles Contain Two Forms of ATP-Sensitive Potassium Channels, Only One Sensitive to Minoxidil

102 citations , February 2008 in “The FASEB Journal”

This study found that human hair follicles express ATP-sensitive potassium channels, suggesting that minoxidil acts on these channels and that drugs targeting them may treat hair disorders.

Minoxidil Increases 17β-Hydroxysteroid Dehydrogenase and 5α-Reductase Activity in Cultured Human Dermal Papilla Cells from Balding Scalp

research Minoxidil Increases 17β-Hydroxysteroid Dehydrogenase and 5α-Reductase Activity in Cultured Human Dermal Papilla Cells from Balding Scalp

34 citations , February 1999 in “Journal of Dermatological Science”

This study found that minoxidil increased 17ß-hydroxysteroid dehydrogenase activity by nearly 40% in dermal papilla cells from balding scalps but not in nonbalding scalp cells or dermal fibroblasts.