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Hair Health

Your Comprehensive Guide to Oral Minoxidil

If you are dealing with male or female pattern baldness, you’ve probably spent hours researching regrowth options for your hair. And, you probably learned about Minoxidil topical foams and liquid solutions. At Happy Head, we’ve created your comprehensive guide to Oral Minoxidil to answer all of your questions on your search.  Two and five percent Minoxidil is sold at pharmacies and other retailers under the name Rogaine and by prescription in higher doses. You may have even given it a try.

But, you may not be aware that Minoxidil is also available as a pill.  It’s only available by prescription, and it’s not advertised. A lot of people don’t know about it. But, they should. Some people who don’t respond to topical Minoxidil may have success with oral Minoxidil.  Here’s everything you need to know about oral Minoxidil and how it works.

Oral Minoxidil Was the First Hair Regrowth Treatment

Back in the ‘70s, Minoxidil was only available in a pill format.  Neither topical foam nor liquid existed.  Here’s the background.

Minoxidil tablets were initially designed to treat high blood pressure. The medicine is a vasodilator that opens up the blood vessels and relaxes artery walls.  During testing for hypertension, researchers discovered that one of the (not so) adverse effects was hypertrichosis, excessive hair growth. More testing ensued, word spread, and dermatologists began prescribing Minoxidil pills to treat their patients with male and female pattern hair loss.

In 1987, topical Minoxidil was developed and quickly became the go-to treatment for androgenetic alopecia and other types of hair loss. As topicals took off, the pills fell by the wayside. After all, topicals didn’t require a prescription. Everyone seemed to forget that pills were even an option to treat hair loss.

Oral Minoxidil Works, But Don’t Ask Anyone to Explain Why

Even today, doctors have yet to learn exactly why Minoxidil works.  One hypothesis is that the medication increases oxygen and blood flow to the hair follicles.  When that happens, the hair growth cycle’s anagen (growth) phase is prolonged and the telogen (resting) phase when your hair falls out is reduced. (01)

If you take the oral Minoxidil route, the odds of it working are favorable.  In a study of over 19,000 people taking low doses of Minoxidil from .25 to 5 milligrams once or twice per day, 61 to 100 percent of participants saw significant improvement after taking oral Minoxidil. (02)

What’s also interesting is that oral Minoxidil may work when topical Minoxidil doesn’t.  Here’s why.  Many people have an enzyme called sulfotransferase.  Sulfotransferase wakes up your hair follicles and activates Minoxidil.  When people don’t have that enzyme in their hair follicles, they don’t respond to topical Minoxidil.  However, those same people do have sulfotransferase in their livers, which means that people may respond to oral Minoxidil when they don’t respond to topical Minoxidil. (03)

Oral Minoxidil is Used to Treat Many Hair Loss Conditions

Dermatologists prescribe oral Minoxidil to treat various hair loss conditions, most commonly male and female pattern hair loss (androgenetic alopecia).  Oral Minoxidil is also used for other types of non-scarring alopecia, including alopecia areata, traction alopecia, anagen effluvium, and severe telogen effluvium.

Happy Head's Oral Minoxidil pill that you can take at the highest strength for the best hair growth results.

Here are the Reasons Why You May Want to Consider Oral Minoxidil

Why do people choose the oral route if topical Minoxidil is also an option?  There are a few reasons. Topical Rogaine can sometimes contain propylene glycol, which can be irritating. Removing the ingredient can help, but people still sometimes develop a rash or an allergy.  In this case, oral Minoxidil may be a better option. Pills are also an option if you’ve already tried topical Minoxidil for at least six months and the growth isn’t meeting expectations. Lastly, some people find that topical Minoxidil dries their hair changing the texture and causing breakage. Oral Minoxidil alleviates the issue.

1. Minimal Side Effects

Taking an oral medication designed for hypertension can seem scary. You don’t want to trade off one problem for another, especially when the issue you are trying to address is cosmetic.  Not to worry. Minoxidil doses prescribed for hair loss are so low side effects are rare.  Here’s what people have experienced:

Hypertrichosis – When oral Minoxidil makes your hair grow, it doesn’t distinguish between the hair on your head, body, or face.  It can make all of your hair grow.  Yes, it’s an annoying side effect, but it can easily be managed.  Men usually aren’t as bothered as women, but hair removal (ironic, right?) and dosage adjustments are quick fixes if necessary.

Shedding – Yes, it’s true that just like topical Minoxidil, oral Minoxidil can also cause temporary shedding when first using the medicine.  The reason why is that Minoxidil adjusts your hair’s growth cycle.  If shedding occurs, it’s best to continue taking your oral Minoxidil as prescribed.  Shedding usually happens within the first six weeks and resolves after four weeks.

Low Blood Pressure – Minoxidil is prescribed at much higher doses (10-40 milligrams) to control high blood pressure.  Even though much lower doses are used to treat male and female pattern baldness,  it is possible, yet not typical, for people to experience dizziness due to low blood pressure.  If that happens, contact your dermatologist, who can adjust your dosage.

Other side effects may include swollen ankles, fluid retention, headaches, and a fast heart rate.  Keep in mind that less than two percent of people using oral Minoxidil experience side effects, so the likelihood that you will have these or other symptoms are low. (04)

2. Keep Track of Your Blood Pressure and Heart Rate

Although it’s not likely that you will experience side effects from taking oral Minoxidil, some people do experience fluctuations in blood pressure, even at low doses. As a precaution, purchasing and using a home blood pressure monitor is a good idea.  Take readings before you begin the medication and check again once each week. It’s a good idea to track the readings, keep a chart, and bring the results to appointments.

3. It’s Inexpensive

If you have health insurance with a prescription plan, oral Minoxidil is usually covered. If not, the retail cost is low. Depending upon where you fill your prescriptions, a 30-day supply of oral Minoxidil can cost less than seventy-five cents per pill.

4. It’s Easy to Take

Topical Minoxidil works well for many people without any issues. However, some people find that topical Minoxidil can cause irritation or be difficult to apply. Minoxidil works on the scalp, but the foam sometimes gets stuck in the hair.  Liquids can be runny.  Oral Minoxidil only requires one or two daily low-dose pills without any hassle or mess.

5. Low Doses are Available

As mentioned, the amount of Minoxidil necessary to treat male or female pattern baldness is significantly less than what’s required to treat high blood pressure. Whereas 20 to 40 milligrams are prescribed to treat hypertension, a range of .25 to 1.25 milligrams is often prescribed for androgenetic alopecia.   If necessary, a 2.5-milligram tablet can easily be cut into quarters or halves with a pill cutter.  Men sometimes take higher doses than women.

6. Can Be Combined with Other Hair Loss Medications

Always check with your doctor before combining medications, especially if you use other medicines that affect your blood pressure. That said, it’s generally safe to take oral Minoxidil with DHT blockers such Finasteride or Dutasteride like in our SuperCapsule™. Oral and topical medications can be combined as well. Research indicates that using Minoxidil and DHT blockers simultaneously leads to effective results. (05)

7. Take it Under a Doctor’s Care

You may not be aware of situations when it’s not safe to take oral Minoxidil. That’s why it’s important to have a doctor supervising your treatment protocol.  You want to avoid aggravating drug allergies, liver conditions, adrenaline dysfunction, heart conditions, and other health issues.

8. It Isn’t a Quick Fix or a Hair Loss Cure

Like topical Minoxidil, oral Minoxidil is a long-term commitment. Once you stop taking Minoxidil pills, you can lose new hair growth.  That’s why it’s important to use the medication under the supervision of a licensed dermatologist and be consistent.

9. Be Sure to Keep Your Follow-up Appointments

If you begin an oral Minoxidil protocol, it’s important that you follow up with your provider as he or she recommends.  Initially, you may need to schedule appointments every three months.  Once your dose is established and stable, you may only need to see your doctor every six months to a year.

Now that you know the benefits of oral Minoxidil, you may wonder if it’s right for you.  That’s where we come in.  Thanks to telemedicine, you can consult with one of our board-certified dermatologists without ever visiting an office or pharmacy. We’ll review your medical history and get a better understanding of the type of hair loss you’re experiencing. If oral Minoxidil is the way to go, we’ll ship your prescription in discreet packaging directly to your door.

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