Don’t Hate on Topical Minoxidil
Topical minoxidil, more commonly known as Rogaine, is often recommended as a part of a hair loss regimen. The funny thing is when I talk with patients about using topical minoxidil, many of them look disappointed and start to doubt me. However, I want to tell you that topical minoxidil can be beneficial for hair loss and yes, as dermatologists, we recommend it!
Think of minoxidil like fertilizer for your scalp. It helps promote healthy hair growth by increasing blood flow around the hair follicle and wakes up those hair follicles that are a little sleepy. Typically, minoxidil is recommended for male or female pattern baldness, what we call androgenetic alopecia, but it is also used to treat a variety of hair loss conditions. By itself minoxidil may not be the golden ticket, but it’s often an important part of a complete treatment approach to hair loss.
Think you know everything about topical minoxidil? Well, think again. Below, I review some of the common misconceptions about topical minoxidil so you can stop being a hater.
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Minoxidil will cure my baldness. False! Topical minoxidil use will help increase hair growth and density, but it does not get hair follicles that are essentially dead to rise up again and start growing hair. Minoxidil targets what we call dormant hair follicles or hair follicles that need a pep talk or motivational speaker to get working again. The dilemma is that these hair follicles learn to love minoxidil and need it to keep growing. That’s why we don’t recommend stopping minoxidil once you start. People will say, if you stop then your hair falls out. What really happens is that your hair goes back to the growth pattern it used to have and you can experience a shed before that happens.
Minoxidil causes hair loss. True! But it’s temporary. When you first start using minoxidil, it might cause some hair shedding. Scary, I know, but it is temporary and typically happens in the first 4-6 weeks. This is expected since minoxidil pushes dormant hairs out so that new hairs can start growing in. Minoxidil works by extending the growth phase of your hair so if you stop it, you will also see hair shedding as your hair returns to its previous pattern.
Minoxidil 2% is just as good as 5%. False. Studies have shown that 5% minoxidil is more effective than 2%. Many dermatologists, including myself, recommend the 5% for both men and women.
Minoxidil foam is better than the liquid or vice versa. False! Whether you use foam or liquid (solution), they are both effective. The choice of foam or liquid is a personal one. If you have an allergy to propylene glycol, then it’s best to avoid the solution. Minoxidil solution contains propylene glycol as a preservative while the foam does not.
Minoxidil didn’t work after a few months. Probably True! You usually wouldn’t see much improvement applying topical minoxidil in just a few months. Minoxidil takes time to work, which is utterly frustrating when you feel like you lost your hair quickly, yet regrowth is slow. Typically, we recommend waiting about 4-8 months to see the benefits of using topical minoxidil.
Minoxidil didn’t work for me so I don’t want to use it. Probably False! Think back and really consider if you used it correctly. Did you use the 5% concentration and were you consistent with applying twice daily? Yes, technically it’s twice a day but most often for practical purposes, it’s recommended daily. Did you leave it on for at least 4 hours before washing your hair? Did you give it enough time to work? Were you using it after your hair loss was appropriately diagnosed? Hair loss is complex, and treatment needs to be tailored to the cause and expectations need to be set as to the results you might see. And minoxidil might just be one piece of the treatment puzzle.
If topical minoxidil didn’t work for me, then maybe I should consider oral minoxidil. Well, maybe. Keeping up with topicals is hard, even for the most dedicated person. It’s messy and time consuming, so maybe taking a pill would be a better option. Studies have shown both oral and topical minoxidil can be equally effective. The real challenge is using topical minoxidil consistently. Honestly, I’m not sure that I could! Oral minoxidil is convenient and might be a good option for those who get irritation from the topical version or just can’t keep up with applying it regularly. Just remember that if you take oral minoxidil there is a risk for potential systemic side effects like dizziness, headache and fatigue to name a few.
Trotter’s Take: Don’t be a hater on topical minoxidil and talk with your dermatologist about integrating it into your hair loss regimen and setting expectations.
Ready to get your minoxidil on? Then sit down and listen to Dr. Ronda Farah on my podcast as she talks more about treatment for hair loss.
