Minoxidil is a medicine used to treat hair loss, including male pattern baldness. You can take it as tablets, or as a liquid you apply to your scalp. The best option for you will depend on your personal preferences, medical history, and how you respond to treatment.
Key Takeaways
- Topical minoxidil is available over the counter at standard strengths, while higher strengths require a prescription and are used off-label
- Oral minoxidil requires a prescription and is used off-label for hair loss
- Both oral and topical minoxidil offer similar hair growth results for most people
- Topical minoxidil mainly causes scalp irritation, while oral can cause systemic effects like swelling or dizziness. Both may cause temporary initial shedding
- Most people start to see results in around three months, with fuller results by six to twelve months.
What’s the difference between oral vs. topical minoxidil?
Minoxidil is available in two forms:
- Oral minoxidil, which is taken as tablets
- Topical minoxidil, , which is applied to your scalp
Most people try topical minoxidil first and then switch to oral minoxidil if it doesn’t work for them. Both types of minoxidil stimulate hair growth and reduce signs of thinning hair.
Oral minoxidil vs topical minoxidil: At a glance
What is more effective, oral or topical minoxidil?
Research suggests that oral and topical minoxidil offer broadly similar hair growth results for most people, with no clear “winner” overall. Many patients report being equally happy with the results from both options.
One study looking at patient experience found that oral minoxidil felt easier to stick to than topical, with people reporting simpler routines, fewer missed doses, and less impact on how they style their hair. This translated into higher satisfaction with hair volume and overall results for some patients.
Whichever form you use, most people start seeing results within three months, with fuller results building over six to twelve months. There is some evidence that oral minoxidil may work a little faster for some people, but the difference is not dramatic.
With both options, taking minoxidil exactly as instructed, every day, is what matters most. It can be tempting to skip doses once you start seeing improvement, but consistency is key to keeping results.
What are the side effects of topical vs oral minoxidil?
Like all medicines, minoxidil can cause side effects.
Initial hair shedding
One of the most important things to know is that minoxidil can cause your hair to shed more in the first few weeks. This can be really worrying if you're already anxious about hair loss, but in most cases it's actually a sign the medicine is working. It's pushing old hairs out so new ones can grow.
Unwanted hair growth (hypertrichosis)
Both types of minoxidil can cause you to grow more hair on other parts of your body. With topical minoxidil, this is less common and can often be prevented by applying it carefully and washing away any excess. With oral minoxidil, hypertrichosis is more common, and the risk tends to increase at higher oral doses.
Topical-specific side effects
Applying minoxidil solution to your scalp can make it feel sore, itchy, dry, or irritated, and you might get some dandruff. This is often due to the alcohol in the solution. If this happens, drying your hair on a low-temperature setting after application can help evaporate the alcohol more quickly and reduce irritation.
Some people also experience headaches. However, because you apply it directly onto your skin, it's unlikely to cause symptoms anywhere else in your body.
Oral-specific side effects
Taking minoxidil pills can also cause headaches but won’t irritate your scalp. Because it circulates through your system, oral minoxidil can cause side effects in other parts of your body, such as low blood pressure, palpitations, dizziness, and swollen legs or ankles.
It's important to remember that not everyone will experience these side effects. If you do have side effects that are causing problems, speak to your healthcare provider. They can help by switching you to a different formulation, adjusting your dose or changing the timing of when you take it.
Accessing minoxidil in the UK
In the UK, you can buy regular topical minoxidil over the counter without a prescription, although you’ll still need a prescription for stronger formulas.
Oral minoxidil is only available on prescription. That’s because using oral minoxidil for hair loss is considered an ‘off-label’ use. This means it isn’t licensed for hair loss, but it can be used for this reason if a doctor or pharmacist determines it's appropriate for you.
Should I choose oral or topical minoxidil?
It depends on your individual circumstances. Most people try topical minoxidil first, as it's the licensed option for hair loss and has been used longer. However, oral minoxidil might be a better choice if:
- Topical minoxidil hasn't worked for you after 6-12 months
- You've experienced side effects from topical minoxidil, such as scalp dryness, irritation, or itching
- You find it difficult to apply the spray or foam consistently
- You have existing scalp conditions such as psoriasis, sunburn, or scalp damage from burns or scarring
- You prefer the convenience of taking a daily tablet
Some research suggests that oral minoxidil might be particularly effective if your hair loss is concentrated on the crown (top of your head) rather than the hairline, though more studies are needed to confirm this.
Important considerations for oral minoxidil
You shouldn't take oral minoxidil if you have certain health conditions, including severe kidney disease, uncontrolled high or low blood pressure, phaeochromocytoma (a rare adrenal gland tumor), or certain heart conditions. It may also interact with some medications.
Your healthcare provider will assess whether oral minoxidil is safe and appropriate for you based on your medical history and current medications.
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