Hair loss is a common concern that affects people around the world. For years, topical minoxidil has been a go-to treatment option for many individuals dealing with hair loss. In this video below, Dr. Paulo Müller Ramos, a Brazilian dermatologist specializing in hair disorders, discusses the use of oral minoxidil as an alternative hair loss treatment for those that have adverse effects with topical minoxidil such as itching, scaling, altered hair texture, or difficulties in hairstyling.
What is Oral Minoxidil?
Oral minoxidil is a medication that belongs to the class of vasodilators. Originally developed to treat high blood pressure, minoxidil was found to have a side effect of promoting hair growth. As a result, it has been repurposed and is sometimes prescribed as a treatment for certain types of hair loss, particularly androgenetic alopecia (pattern baldness). It still hasn’t been approved by FDA in the USA but internationally, lower doses of oral minoxidil are considered safe to take for treating hair loss by many physicians.
Oral Minoxidil vs Topical Minoxidil
Unlike topical minoxidil, which is applied directly to the scalp, oral minoxidil is taken in pill form. It is believed to work by increasing blood flow to the hair follicles and potentially prolonging the hair cycle’s anagen (growth) phase. It isn’t a DHT blocker like finasteride and dutasteride.
Advantages of Oral Minoxidil
Oral minoxidil is an alternative for individuals who do not want to use topical minoxidil as it might be too inconvenient to regularly apply the liquid minoxidil solution to their scalp for a long time. Taking a simple tablet of Oral Minoxidil is more convenient in this case.
Oral minoxidil is also more convenient for individuals using hair pieces or keratin fibers to conceal hair loss. Additionally, oral minoxidil can be used in combination with other hair loss treatments, such as finasteride, dutasteride, or hair transplant procedures, providing a versatile approach to combating hair loss.
In a study, researchers also found that Oral Minoxidil can work with a lower activity of follicular sulfotransferase enzyme which is one of the major reasons for the inefficacy of Topical minoxidil. So oral minoxidil is a better alternative for individuals with lower follicular sulfotransferase enzyme activity levels.
Effectiveness of Oral Minoxidil
In the same study, the efficacy of 5mg oral minoxidil for men with androgenetic alopecia was tested. Researchers concluded that 43% of the patients had excellent results in hair growth.
In another study by Dr. Paulo Müller Ramos, the efficacy of 1mg of Oral Minoxidil in the treatment of female pattern hair loss was compared to 5% topical minoxidil solution, and the results were similar. Both oral minoxidil and topical minoxidil were equally effective in treating hair loss.
Oral Minoxidil Doses
Determining the optimal dosage of oral minoxidil can vary from person to person. Studies are ongoing to establish the most effective doses, but it’s generally recommended that women start with lower doses (around 1 milligram), while men may use higher doses (up to 5 milligrams) in some cases. However, the ideal dosage should be determined in consultation with a healthcare provider.
Side Effects of Oral Minoxidil
Like any medication, oral minoxidil may have potential side effects. The most common one is generalized hypertrichosis, which involves the growth of fine hairs on the face and other parts of the body. Oral minoxidil can also cause beard hair growth. While these side effects are typically mild and well-tolerated, some patients may experience headaches, insomnia, or edema (swelling), often related to the dosage. To minimize these effects, it’s crucial to consult with a healthcare professional, start with lower doses, and gradually increase them under medical supervision.
Precautions before using Minoxidil
You should always consult a doctor before taking oral minoxidil but generally, there are some medical conditions in which oral minoxidil could have negative effects.
- Pheochromocytoma
- Severe hepatic impairment
- Before or during pregnancy (Conception issues)
- Heart Disease (Angina, Heart Attack, etc)
- Pulmonary hypertension with mitral stenosis
- Porphyria
Combining Treatments with Oral Minoxidil
In many cases, dermatologists combine oral minoxidil with other treatments, such as finasteride and dutasteride. These drugs work on hair follicles in different ways, potentially leading to better results when used together. However, the choice between monotherapy or combination therapy depends on individual factors and should be discussed with a healthcare professional.
Personalized Treatment Plans
There is no one-size-fits-all solution for hair loss. Each patient’s case is unique and requires a personalized treatment plan tailored to their specific needs and goals. Consulting with a dermatologist is the first step in creating a comprehensive plan that addresses short-term and long-term hair restoration.
In conclusion, while topical minoxidil has long been a popular choice for hair loss, oral minoxidil offers a promising alternative, particularly for individuals who face challenges with topical application. Its convenience, ability to combine with other treatments, and potential efficacy make it a valuable option in the fight against hair loss. However, always seek professional guidance to determine the right approach for your specific situation and achieve the best possible results in your journey towards hair restoration.
For a consultation with a hair restoration surgeon, access our Find A Doctor tool where you can search for an ISHRS member by location.
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