Minoxidil FAQ

What is minoxidil?
Minoxidil for Hair LossMinoxidil (Rogaine) was the first drug approved by the FDA for the treatment of male pattern baldness. It is a potassium channel agonist and contains the chemical structure of nitric oxide which is a potent blood vessel dilator. Originally, minoxidil tablets were developed to treat high blood pressure but it was later found to be an effective treatment for hair loss. The tablet was reformulated into a topical solution and foam that could be applied directly to balding areas of the scalp.

How does it work?
The exact mechanism by which minoxidil promotes hair growth is still uncertain. It was initially thought to be due to the vasodilatory effect of minoxidil on the blood vessels. This dilation presumably allows for improved oxygen flow as well as blood and nutrient flow to the hair follicles. We know there are several other mechanisms in play concerning minoxidil effect on hair growth but it is not certain which one is the main factor.

Can both men and women use the product?
Both men and women may use minoxidil for the treatment of androgenetic alopecia. The male and female over-the-counter versions of minoxidil only differ in the concentration.

Is there a difference between the results for men and women?
Minoxidil is formulated for use by both men and women with androgenetic alopecia. Not everyone responds the same to minoxidil. Those considered to have a good response should see an improvement in the density of their hair after several months of using the product twice a day.

How do I use Rogaine?
Depending on the area that you are treating, dispense an adequate amount of minoxidil onto your fingers. Part your hair in the thinning areas and place the foam directly on the scalp. Spread the foam on the scalp of the thinning area and gently massage to make sure it covers the entire area. Wash hands after the application is finished and then let your scalp dry. Apply once in the morning then repeat the same process at night before going to bed.

What happens if I forget to take it one day?
If you forget to use minoxidil one day, there is no need to double the dosage. Doubling the daily dose will not increase the results seen from the extra dose.   You will however, experience more side effects such as itching, burning, and irritation.

Can I buy it over the counter?
In 1996, the FDA approved the over the counter sale of topical minoxidil (Rogaine) for the treatment of male patterned baldness in men and women.

Who is not a good candidate for Rogaine use?
Minoxidil typically works for patients who have experienced hair loss for less than 5 years and still have a good number of hairs remaining on the balding areas. If your hair loss is completed, and there are only a few miniaturized hairs visible, minoxidil cannot bring your hair back. The medication label says that it can only help the vertex of the scalp based on the initial studies that lead to its market introduction for hair loss. After examining your hair loss, a hair specialist may recommend minoxidil to help decrease hair loss in other areas of the scalp.

What are the side effects of minoxidil?
Minoxidil used as a topical medication to treat androgenetic alopecia is generally well tolerated. Common side effects reported by users include itching, burning, irritation and redness. People who have an allergic reaction or irritation with the use of minoxidil should stop using it or switch to alternative products such as lotion or foam. The skin reaction could be due to another ingredient in the product and patients may not necessarily be allergic to the medication itself.

Can minoxidil cause temporary hair loss?
Patients have reported temporary hair loss in the form of shedding for the first few weeks to months. This might have to do with the increased turnover of follicular cells and is usually temporary.

Can minoxidil affect my blood pressure?
A drop in blood pressure in a standing position may be seen in some patients especially when the medication is applied on a wide area of scalp. If you have episodes of a drop in blood pressure with minoxidil, you need to stop using the medication and discuss it with your primary doctor.

When can I stop using minoxidil?
When you make the commitment to start using minoxidil, the treatment is a lifelong process. Minoxidil works for most people who try it. Some people may experience an improvement while others may just notice a slower hair loss. You would have to wait until a full 6 months of daily use has passed before you notice a difference. Minoxidil will only work during the period in which you use it. Should you stop, you likely will experience catch-up hair loss.

What is catch-up hair loss after minoxidil?
Some people who stop using minoxidil after a while may have “catch-up hair loss” in which they lose hair at an accelerated rate until they catch-up with whatever level of hair loss they were supposed to be at having never used minoxidil.

Is minoxidil safe for long term use?
Topical minoxidil is considered safe for long term usage to treat androgenetic alopecia. If patients experience any side effects such as itching, irritation, burning or redness, they note these in the first few months and should discontinue the medication if it is bothersome. Most patients use topical minoxidil indefinitely or until they start finasteride or have a hair transplant. Alternatively, minoxidil may be continued in conjunction with finasteride or with a hair transplant if native hair is still at risk.

Are there any medications I shouldn’t take with minoxidil?
Topical minoxidil may be taken with most oral medications. If you take oral blood pressure medications, consult with your general physician and let him or her know you are on topical minoxidil.

Are there any health conditions that prevent me from using minoxidil?
Oral minoxidil was initially marketed as a very potent antihypertensive medication. Topical minoxidil does have systemic absorption so if you have hypotension (low blood pressure), you should avoid using minoxidil unless cleared by your physician.

How do the results of minoxidil compare to finasteride?
Research has shown finasteride to be more effective for the treatment of male patterned baldness in men when compared to minoxidil. The combination of the two may augment the effect of finasteride but it is not always recommended due to its minimal added effect.

Do I need to stop using Rogaine after my hair transplant?
Patients may continue to use Rogaine up until the day before their hair transplant. After the hair transplant, patients must wait one week before resuming its use.

Can I use hair care products like conditioner with Rogaine?
As long as you apply Rogaine solution/foam to the scalp twice a day and allow it to dry, you may use other hair care products.

Can women use 5% minoxidil?
Rogaine extra strength (5%) has been approved for use by men in the foam formulation at a dose of twice daily. The label of this medication may say “Only for men” which is based on the initial studies that were done on its effectiveness and safety on men. This does not mean that it does not work on women as your doctor may decide you can use a higher percentage of minoxidil safely. Rogaine is not to be used by women during pregnancy.

Which product to use: Foam or solution?
Whether to use minoxidil foam or solution is your choice as they both have the same amount of the active ingredient and are equally effective. Some of the comments we have heard from patients is that the foam is a little sticky and that the solution runs down in unintended places.

Can it cause hair to grow on other parts of the body?
If topical minoxidil repeatedly comes in contact with other areas of the skin, you may experience hair growth. After applying minoxidil to the scalp with your fingertips, you should wash your hands.

Is there an optimum age range for patients to use minoxidil?
There is no specific age range with regard to using minoxidil foam or solution. It is best that the patients get evaluated by a hair doctor before starting minoxidil. Microscopic evaluation of the scalp, or mapping of miniaturization, helps the doctor get a good understanding of your hair loss before starting the medication. It can also help to assess the effectiveness of your treatment over time.

Can minoxidil work on making my eyebrows grow thicker?
Minoxidil is not initially intended for eyebrow hair growth but it has been shown to improve the appearance of eyebrows as long as the follicles are still present. Therefore, it likely will not work for those with over plucked eyebrows given that the brows are often devoid of follicles. It is not currently FDA approved for the use of eyebrow enhancement.

Can I use Rogaine during pregnancy or nursing?
Topical minoxidil has been given a category C during pregnancy by the FDA. Category C indicates that animal studies have shown risk to the developing fetus but there are no controlled studies in women. Topical minoxidil should not be given to pregnant or nursing women.

Can my husband use minoxidil during my pregnancy?
Current studies do not preclude minoxidil from being used by men while their partner is pregnant. The amount of minoxidil that would be excreted in the male semen is likely negligible. However, minoxidil should not be handled by a pregnant female due to possible risk to the fetus.