What it is
Topical minoxidil is an over-the-counter treatment applied directly to the scalp, available in 2% and 5% concentrations. Originally developed as an oral blood-pressure medication, its hair-growth properties were discovered as a side effect. It is FDA-approved for androgenetic alopecia and is one of the most widely used hair loss treatments worldwide.
Who it's commonly used by
Topical minoxidil is used by both men and women experiencing pattern hair loss. Men commonly use 5% topical minoxidil (often twice daily). For women, labeling includes 5% foam used once daily or 2% solution used twice daily. It is most effective for diffuse thinning, particularly at the vertex (crown). Those with recent-onset thinning tend to respond better than those with long-standing hair loss.
Typical timeline
Initial shedding (sometimes called 'dread shed') may occur in the first 2 to 8 weeks as resting hairs are pushed out by new growth. Visible improvement typically begins between 3 and 6 months of consistent use (once or twice daily depending on the product and label). Maximum benefit is usually reached at 12 months. Like finasteride, benefits depend on continued use.
Common side effects
Topical minoxidil is generally well tolerated. The most frequently reported effects are local in nature.
- Scalp irritation or dryness
- Flaking at the application site
- Increased facial hair (more common in women)
- Temporary increase in shedding during first weeks
- Headache (uncommon)
- Lightheadedness (rare)
Questions to ask a clinician
Even though topical minoxidil is available over the counter, a clinician can help you use it more effectively.
- Should I use the 2% or 5% concentration?
- Is once-daily application sufficient, or should I apply twice daily?
- Can I combine topical minoxidil with other treatments?
- How long should I continue if I don't see results?
- Are there signs that would indicate I should stop using it?
- Does the foam or solution formulation matter?