Oral Minoxidil

Oral minoxidil is a one-a-day capsule containing 1.25mg or 2.5mg of minoxidil aimed at preventing hair loss and regrowing hair. It has been introduced as an alternative to the clinically proven hair loss treatment, topical minoxidil. Due to the fact that topical minoxidil is a liquid or cream that needs to be applied to the scalp daily, some will find a one-a-day capsule more convenient and effective to use.

What Is Minoxidil

Minoxidil is a vasodilator. In its oral form and in strengths 5mg-100mg, minoxidil is a licensed medication for treating high blood pressure; in its topical form in 2% and 5% strengths, minoxidil is a licensed medication for male pattern hair loss and female pattern hair loss. The Belgravia Centre’s pharmacy prepares special prescription formulations of topical minoxidil at different strengths and formulations, and with various additives to maximise effectiveness.

Low dose oral minoxidil 1.25mg or 2.5mg, has gained popularity as a hair loss treatment due to its stimulating effects on the hair follicles. It has shown positive effects on the hair growth in multiple types of hair loss, although more research is needed to understand its exact mechanism of action. Minoxidil increases blood circulation which helps to increase the oxygen and nutrients reaching the hair follicles. It prolongs the growing phase of the hair cycle (anagen), stimulating stronger and thicker hair growth in conditions such as androgenic alopecia and chronic telogen effluvium. Minoxidil may even have T-cell immunomodulatory effects and is used in autoimmune conditions such as alopecia areata.

When minoxidil is applied topically, it is converted to its active form minoxidil sulfate in the presence of sulfotransferase enzyme which is normally expressed in the scalp. Some people produce less sulfotransferase enzyme on their scalp, reducing the benefit of topical minoxidil. In such cases oral minoxidil may be more helpful as the same enzyme is produced by the liver. The Belgravia Centre’s pharmacy has introduced low dose oral minoxidil preparations – this is a prescription only medication, subject to a thorough consultation with one of our hair loss specialists.

How Effective Is Oral Minoxidil?

Oral_Minoxidil_Bottle_w800px.jpgOral minoxidil can be highly effective as a treatment for multiple hair loss conditions including male and female pattern hair loss. Systemically absorbed medications can in some cases be more potent than their topically applied counterparts and studies have found that low dose oral minoxidil can be just as safe and effective, or in some cases more effective, in promoting hair growth.

Jimenez-Cauhe et al (2019) found that men with male pattern hair loss using low dose oral minoxidil achieved stabilisation or improvement of hair growth within 6 months. Perera and Sinclair (2017) used low dose oral minoxidil on women with chronic telogen effluvium and found that stabilisation and improvement in hair shedding was achieved within 12 months. Ramos et al (2020) found that low dose oral minoxidil can be considered an option for patients with female pattern hair loss who have poor compliance with the topical minoxidil preparations or who cannot tolerate topical minoxidil on their scalp due to irritations, itching, and scaling.

Can Oral Minoxidil Cause Side Effects?

As with most medications, oral minoxidil has possible side effects, although not everyone will experience them. They are not permanent and should resolve once oral minoxidil is stopped. When oral minoxidil is prescribed for hair loss, this is always in low dose which tends to be tolerated well by most people. The likelihood of experiencing side effects on low dose oral minoxidil is considerably lower compared to the high strengths used to treat high blood pressure. Possible side effects may include increased unwanted hair growth, lower blood pressure, headaches, dizziness, faster heartbeat and water retention. Side effects are not permanent and should resolve once oral minoxidil is stopped.  

When starting minoxidil, it is possible to experience a temporary period of increased hair shedding. This is completely normal with both oral and topical preparations as they stimulate new hair to grow quicker in the hair follicle. As a result, old and weak hair comes out allowing the follicle to grow the new stronger hair in its place.

Overall, low dose oral minoxidil is a safe treatment for multiple hair loss conditions and it tends to be well tolerated. In the rare occasion of someone experiencing severe side effects, treatment should be stopped and side effects will wear off.

It is important that you read the patient information leaflet (PIL) provided with each supply of oral minoxidil, before using it.

What's right for you?

For those looking for a hair loss treatment, topical minoxidil should always be considered as a first line treatment choice. However, oral minoxidil can be an alternative for those who struggle with compliance, have skin conditions on the scalp, or haven’t achieved satisfactory results using topical preparations.

Results of both oral and topical minoxidil have been well documented. Overall, available research shows excellent efficacy from both therapies so it is up to the individual to decide on which treatment they feel suits them best, following a thorough consultation with a hair loss specialist.

If you are worried about hair loss you can arrange a free consultation in our Central London clinic with a hair loss expert or complete our Online Consultation Form from anywhere in the world, following which a Zoom consultation can be booked.