Is Oral or Topical Minoxidil More Effective For Treating Hair Loss?

What is Oral Minoxidil?

Minoxidil is a vasodilator medication that was originally developed to treat high blood pressure. However, it was discovered that one of the side effects of minoxidil was extra hair growth. This led to the development of topical minoxidil solutions as a treatment for different types of hair loss like male and female pattern baldness.

Oral minoxidil refers to minoxidil that is taken in pill form, rather than applied topically to the scalp. Oral minoxidil goes systematic, meaning it circulates through the bloodstream to act on hair follicles throughout the body.

How Does Oral Minoxidil Promote Hair Growth?

The exact mechanism by which minoxidil promotes hair growth is not fully understood. However, it is believed to work in a few ways:

• Widens blood vessels in the scalp, increasing blood flow and nutrients to hair follicles
• Prolongs the anagen (growth) phase of hair follicles
• Stimulates production of prostaglandins, which regulate hair growth

By taking minoxidil orally at higher doses, more of the active drug can reach hair follicles across the scalp and body. This leads increased hair regrowth compared to using it topically.

What is the Difference Between Oral and Topical Minoxidil?

There are several key differences between oral minoxidil and topical minoxidil:

Application Method

The most obvious difference is that oral minoxidil comes in pill form, while topical minoxidil comes as a liquid solution that is applied directly to the scalp.

Dosage

Oral minoxidil is taken once or twice per day at much higher doses than topical treatment - ranging from 2.5mg to 10mg daily. Topical minoxidil dosage is only 1-2ml applied to the scalp daily.

Systemic Effects

Since oral minoxidil circulates through the bloodstream, it can reach and re-grow hair on all parts of the body. Topical minoxidil is focused only on the areas of the scalp it is directly applied to.

Side Effects

Due to the higher doses, oral minoxidil has a higher rate of systemic side effects like low blood pressure or fluid retention compared to topical. But topical minoxidil can sometimes cause irritation of the skin underneath.

Hair Growth Results

Most studies have found that oral minoxidil regrows hair more effectively than topical - stemming from its ability to widely reach hair follicles. However, individual results can vary greatly.

Is Oral or Topical Minoxidil More Effective?

Multiple clinical studies have shown that oral minoxidil produces significantly better hair regrowth results than topical minoxidil.

For example, a 2021 systematic review study found that oral minoxidil led to an average of 37 more hairs regrown per cm² compared to topical minoxidil after 48 weeks of treatment.

Similarly, a photographic review assessing before-and-after images found visible scalp coverage increased by over 20% more in patients using oral minoxidil versus topical.

The superior efficacy of oral minoxidil is likely due to the higher doses delivered through systemic absorption compared to topical applications focused on the scalp alone.

Growth Beyond the Scalp

An additional benefit of oral minoxidil's systemic mechanism is that it can boost hair regrowth not just on the scalp, but across the entire body. There are many reports of patients regrowing hair on the forehead, temples, eyebrows and beard area with oral minoxidil even though it was not directly applied to those sites.

Is Oral Minoxidil Safe?

The safety profile of topical minoxidil is extremely well-established, as it has been used by millions of men and women for over 30 years.

However, since oral minoxidil is a relatively newer treatment, its safety at higher doses and long-term use is not quite as proven.

Some potential side effects from oral minoxidil include:

• Lowered blood pressure
• Fluid retention in hands and feet
• Rapid heart rate
• Headaches
• Excess hair growth on other body parts

Despite this, multiple studies have found oral minoxidil to be well-tolerated in most patients, especially under medical supervision. The incidence of serious adverse effects is very low.

Lower Dosages Have Better Safety

There does appear to be some relationship between oral minoxidil dosage and frequency of side effects. In studies using 5mg per day, side effects were experienced in less than 5% of patients monitored by physicians. But at 10mg per day, over 15% experience side effects.

This indicates lower doses in the range of 2.5-5mg daily provide the best balance of safety and hair regrowth efficacy.

Who is a Good Candidate for Oral Minoxidil?

Oral minoxidil may be a treatment option for individuals with conditions like:

• Androgenetic alopecia
• Female pattern baldness
• Alopecia areata
• Frontal fibrosing alopecia
• Diffuse hair thinning

Generally, patients who fail to regrow hair with topical minoxidil but want to try a more aggressive medical treatment can consider oral minoxidil on the advice of their dermatologist.

It can used alone or be combined with other hair loss treatments like finasteride, spironolactone or PRP injections to improve results.

Monitoring by Dermatologist Recommended

Due to potential side effects with higher doses, oral minoxidil is typically only prescribed by and used under monitoring of expert dermatologists or hair restoration physicians. Blood pressure measurements may be taken regularly.

Self-medicating with off-label high doses is not advisable. Only obtain oral minoxidil from licensed medical professionals.

Is There Anyone Who Should Not Use Oral Minoxidil?

Oral minoxidil should be avoided in these cases:

• Women who are pregnant or breastfeeding
• People younger than 18 years old
• Individuals with uncontrolled high blood pressure
• Anyone allergic to minoxidil

It's also not recommended for individuals who experience side effects or have complications from topical minoxidil such as unwanted facial hair growth or severe scalp irritation.

Interactions With Other Medications

Oral minoxidil can potentially interact with other medications that also lower blood pressure. So people taking any hypertension or blood pressure drugs should first consult their doctor before using oral minoxidil.

Frequently Asked Questions

Here are answers to some common questions about oral minoxidil for hair loss treatment:

Does Oral Minoxidil Work for Everyone?

No medication works for 100% of patients, but studies show over 80% of patients have significant hair regrowth from oral minoxidil. Individual results can vary based on dosage, consistency of use and underlying cause of hair loss.

When Will I See Results From Oral Minoxidil?

Most patients begin to see some increased regrowth after 3-4 months of consistent oral minoxidil treatment. Further improvements may continue to be seen for up to one year before maximal effects are achieved.

Is Oral or Topical Treatment Cheaper?

Topical minoxidil solutions are available as inexpensive generic store brand products costing around $20-30 for a 1-3 month supply.

Oral minoxidil is more expensive, with treatment typically costing over $100 per month. But its superior hair growth results may make it worthwhile for many patients.

What Happens If I Stop Taking Oral Minoxidil?

Any improvements in hair regrowth from oral minoxidil will likely shed 2-3 months after stopping, eventually reverting back to baseline without continued treatment. Maintenance is required to sustain benefits long-term.

Can Women Suffering From Hair Loss Use It?

Yes, there is evidence that oral minoxidil can effectively treat female pattern hair loss. However, the dosage may need to be reduced for women to help minimize side effects like facial/body hair growth.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.