Minoxidil

Also known as: Rogaine (topical brand), topical minoxidil, low-dose oral minoxidil (LDOM)

Hair Restore

In plain English

Minoxidil helps hair grow by keeping follicles in their growth phase longer and improving blood flow to them. The topical 2% and 5% forms are available over the counter and are FDA-approved; low-dose minoxidil pills are used off-label and can be convenient for people who dislike the topical. Regrowth takes about 3-6 months to show and, like other hair treatments, reverses within months of stopping. A temporary increase in shedding when starting is common and expected.

The science

Minoxidil is a potassium-channel opener; its active sulfated metabolite shortens telogen, prolongs anagen, and increases follicular vascularization, enlarging miniaturized follicles. A 48-week randomized trial of 393 men found 5% topical solution produced about 45% more regrowth than 2% and was superior to placebo. A systematic review of low-dose oral minoxidil across 634 patients found it effective and generally well tolerated as an alternative when topical use is impractical.

References

• Olsen EA et al., J Am Acad Dermatol 2002 (5% vs 2% topical, men)
• Randolph M & Tosti A, J Am Acad Dermatol 2021 (oral minoxidil review)