Hair loss (also known as alopecia) often affects the scalp, but can occur anywhere on the body. This is very common and usually nothing to worry about. Around half of Australian men show obvious signs of baldness by the age of 50, and more than a quarter of Australian women report thinning hair by the same age. It is often genetic.
However, if you notice hair loss and are concerned, please see your GP or dermatologist before trying any treatments. Products that claim to reverse hair loss are everywhere, but very few have been scientifically tested to see how effective they are.
However, one family of products that has actually been scientifically tested is known as topical minoxidil products. These include products such as Regaine®.
So do they work? Here’s what the research evidence shows, what you can realistically expect, and what you need to know if you’re considering this treatment.
Hair loss is very common and often has a genetic cause. TunedIn by Westend61/Shutterstock
Read more: Hair removal techniques: A brief history of hairless men
What is minoxidil and does it work?
Topical minoxidil usually comes as a type of foam or serum that you apply to your scalp.
It is approved by Australia’s Therapeutic Goods Regulatory Authority, the Therapeutic Goods Administration, for the treatment of hereditary hair loss in men and women. Minoxidil is also available in pill form, but this is not currently approved for hair loss (more on that later).
So, is topical minoxidil effective? In short, yes, but results vary greatly from person to person, and you will need to use it consistently for several months to see results.
Scientists don’t know exactly how minoxidil works. It can affect different stages of the hair life cycle, thereby promoting growth. It also opens blood vessels near the hair follicle.
This increases blood flow, delivering more oxygen and nutrients to your hair.
Minoxidil is unlikely to restore thicker, fuller hair all over your head, but it can help slow hair loss and encourage hair regrowth.
This is the over-the-counter option with the most evidence. Two strengths are available: 5% and 2%.
An analysis of randomized controlled trials found that applying minoxidil to the scalp twice a day increased the number of hairs per square centimeter by 8 to 15, with higher-intensity treatments having a slightly greater effect. Ta.
Can it be used for non-hereditary hair loss?
There are many causes of hair loss. In both men and women, the main cause is a genetic disorder called androgenetic alopecia.
Topical minoxidil is only approved for use in Australia for androgenic alopecia, but there is some evidence that it may also be effective for other conditions that cause hair loss.
For example, it may speed up hair growth in patients who have lost hair due to chemotherapy.
Unfortunately, minoxidil is not effective if the hair follicles have disappeared, such as after a burn.
A small study has found promising results using minoxidil to promote facial hair growth (augmentation of beards and eyebrows), but topical minoxidil products are not currently approved for this use. Further research is needed.
The main cause of hair loss is a genetic disease called androgenic alopecia. tativophotos/shutterstock
What else do I need to know?
Minoxidil does not work for everyone. In the early stages of treatment, you may notice a temporary increase in hair loss as the hair cycle changes to make way for new growth. Minoxidil requires a 3-6 month trial to determine if it is effective.
Also, it does not cure hair loss, so you will need to continue using it every day to maintain the effect. If you stop, you will start losing new hair within 3-4 months.
Minoxidil products are not suitable for everyone. If you have a medical condition or are taking any medications, consult your doctor or pharmacist before using minoxidil products.
It has not been tested for safety in people under 18, over 65, or pregnant.
For more information about using over-the-counter minoxidil products, please see our Consumer Drug Information Sheet.
Many people do not like to use minoxidil solutions or foams for long periods of time, as they require daily application, which is inconvenient. Alternatively, you may notice side effects such as scalp irritation or changes in hair texture.
Some people may tolerate foam products better than solutions because solutions contain more of a compound called propylene glycol (which can irritate the skin).
Hair loss also affects women. zentradyi3ell/Shutterstock
What about minoxidil oral tablets?
Minoxidil is also available by prescription as oral tablets. Traditionally used to treat high blood pressure, it has also been used to treat hair loss.
A 2020 systematic review identified 17 studies involving 634 patients who used oral minoxidil for various hair loss conditions.
The authors found that oral minoxidil is effective and generally well tolerated by healthy people who have problems using topical products.
The review notes that oral minoxidil can increase hair growth all over the body and may cause heart-related side effects in some patients. Further research is needed.
In Australia, oral minoxidil is available under the trade name Loniten®. However, it is currently only approved for use in hypertension.
When people seek prescription treatment for an unapproved purpose, this is called “off-label” prescribing. Off-label prescribing of oral minoxidil, which may be used for alopecia, may have contributed to the shortage of Loniten® tablets in recent years. This could reduce the availability of this drug to people who need it to treat high blood pressure.
Read more: Big hair? Bald? How much of a difference does it really make whether your hair keeps you cool or warm?
