Hair loss is never an easy truth to face, but there is quite the chance that you just might have to; but thankfully, with the advances in medicine, there are ways to combat almost everything, including hair loss. Two of the most commonly used terms in medicines associated with treating hair loss are minoxidil and finasteride and because the first is an over-the-counter drug, Minoxidil topical solution is quite popular.

Table of Contents

• What is Minoxidil?
• Types of Minoxidil
• • • Topical Solutions
    • Topical Foam
    • Oral

• • Medical Interactions

• • Precautions while using

• • Common Side Effects

• • Serious side effects

• • Side Effects of Oral Minoxidil

• • Minoxidil Side Effects Sexually

• • FAQ

What is Minoxidil (Rogaine)?

The introduction of Minoxidil as an oral medication was in the 1970s, when it was used as a medication for hypertension treatment; but generalized hypertrichosis (excessive hair growth) was noticed in balding persons, which is when another prospective usage of minoxidil was discovered. It was in the 1980s that the first version of 2% minoxidil solution was introduced in the market, targeted at allowing hair regrowth and in the 1990s, the 5% solution appeared on the shelves. Till date, topical minoxidil is the first step treatment for androgenetic alopecia and several other forms of hair loss.

Types of Minoxidil

Minoxidil comes in several forms, primarily differing in concentration and method of application. Here’s a breakdown of the common types:

1. Topical Solutions

• 2% Solution: Often recommended for women, this lower concentration is effective for those with mild to moderate hair loss and is less likely to cause scalp irritation.
• 5% Solution: Commonly used by men, the 5% solution is more potent and can lead to faster and more noticeable hair growth, but it may also increase the risk of side effects like irritation or dryness.

2. Topical Foam (5% Foam): This version is alcohol-free, which can reduce the likelihood of irritation and is often preferred by people with sensitive scalps. The foam is easier to apply without dripping and can be more comfortable for some users.
3. Oral Minoxidil (Oral Tablets): Originally developed as a blood pressure medication, oral minoxidil is now sometimes prescribed off-label for hair loss. It is usually considered for patients who do not respond well to topical treatments, but it requires careful medical supervision due to the risk of systemic side effects.

Does Minoxidil really work on hair loss?

There are those who are constantly questioning the efficacy of this medication – they wonder if it really works. The combination of chemicals in minoxidil are meant to instigate the hair follicles and that leads to hair growth – ideally, you can start using this medication if you are just starting to see hair loss or have been observing a receding hair line. When the stimulation happens properly, there is a strong chance that the new hair that grows in is thicker, offering you more dense hair.

However, it might not be possible to regrow hair on a completely bald head – this is one of the facts that you need to understand, rather than blindly using Minoxidil or Rogaine (one of the more popular brand names for minoxidil) and then having to undergo Rogaine side effects.

Minoxidil Possible Medical Interactions

The good news is that overall, there are no serious medical interactions of minoxidil and the chances of negative drug interaction are minimal too. However, that does not mean that you need not be careful before starting on a course, because oral Minoxidil needs to be taken with medical supervision. This is why it is imperative that you tell your doctor about all the medications you are in, even if it is vitamins or herbal products. Clarifying all these details with your doctor is essential because minoxidil is known to known interact with guanethidine and it could possibly lead to “profound orthostatic hypotensive effects.”

On the other hand, topical minoxidil has a synergistic relation with other topical medications such as tretinoin – this means that when they are used together, they could possibly increase the benefits that either would offer. Yet, it would be wise to take proper medical advice in advance, especially since the medication has impact on hypertension.

Precautions While using Minoxidil

Even though Minoxidil topical solution is considered an over-the-counter medication and can be purchased quite easily, it is at the end of the day, a medication and there are some precautions that you need to take.

Your very first step should be to do a patch test, so that you can adjudge whether you have any allergies – in case you have any allergic reaction, you need to consult a doctor. If you are using the topical version, you need to make sure that your hair and scalp are absolutely dry and you apply on the prescribed amount and only on the areas being treated. As soon as you are done, you need to make sure that you wash your hands immediately with a good quality soap. It is important that you allow the medication to dry completely and the medication not be transferred to any other parts of the body. If the solution goes into your eyes, nose or mouth, you need to wash it thoroughly with clean water.

Common Side Effects of Minoxidil?

Although minoxidil is considered to be safe overall, it is a medication after all, and Minoxidil side effects are not completely unheard of. What is good is that most of the side effects are mild and don’t last for more than a few hours or at the most, a few days. And in most cases, the side effects are known to resolve on their own, without the need of any other interventions. Here are some of the most common side effects of Minoxidil:

• Contact dermatitis – leading to itching and skin scaling (studies have shown that the chances of the same are lesser with 2% concentration, as opposed to 5%)
• There could be itching in the eyes or redness and irritation
• In case there is an allergic reaction, there could be swelling in the mouth, face, lips and even tongue
• Some people could feel slightly dizzy or nauseous
• There have been cases of temporary hair loss as well as emergent dandruff

Serious side effects of minoxidil?

Now that we have looked at the more common side effects of topical Minoxidil, we need to move onto the more severe side effects and it has been observed that these tend to present more often in oral minoxidil. These are the more serious side effects:

• Minoxidil can increase your heart rate and that could lead to chest pains or shortness of breath
• There could be a sudden weight gain or swelling in hands and feet
• In very rare cases, the person using Minoxidil could feel severe anxiety or depression (Klonopin)
• There could be decreased libido and erectile dysfunction

Side Effects of Oral Minoxidil

Oral minoxidil, initially developed to manage high blood pressure, is now also used for hair loss treatment, but it can cause more systemic side effects than its topical counterpart. Here are some of the common and serious side effects associated with oral minoxidil:

Common Side Effects:

• Fluid Retention: Can cause swelling in the hands, feet, and face due to fluid retention.
• Increased Heart Rate: Tachycardia or a faster heart rate is a possible side effect.
• Dizziness: May occur, especially when standing up quickly, due to changes in blood pressure.
• Weight Gain: Often related to fluid retention.

Serious Side Effects:

• Chest Pain: Due to increased cardiac workload.
• Shortness of Breath: Especially if there is significant fluid retention affecting the lungs.
• Hypotension: Lowered blood pressure might lead to fainting or dizziness.
• Hypertrichosis: Excessive hair growth in unintended areas, such as the face and body.

Is there any way to avoid the side effects of oral minoxidil?

If you are looking to try an oral version of Minoxidil, then you need to make sure that you are prescribed a beta blocker as well as a diuretic along with it. Swelling that is often associated as a common side effect of oral Minoxidil is mainly caused due to the retention of fluids in the body and that can be handled by a diuretic. This could also tackle the sudden weight gain that could be caused by water retention – more importantly, if not treated on time, these excess fluids could lead to congestive heart failure.

Similarly, a beta blocker will help keep the blood pressure on the lower side, because minoxidil was originally a medication given to control heart conditions. When the epinephrine is blocked by the said beta blocker, the chances of blood pressure elevating are significantly decreased.

Is there any way to avoid the side effects of topical minoxidil?

In case you are using topical minoxidil or Rogaine, the easiest way to avoid side effects is to use it as directed – there will be a specific set of instructions and it is imperative that the same be followed. Do not rush the process, because hair growth is not an instant miracle; it will take time. Make sure that you apply the doses on the right time – if you miss a dose, apply it as soon as possible and if the time for the next dose is near, wait for the time. Double doses will not fasten the hair growth process; rather it could lead to any of the Minoxidil 5 side effects such as itching, swelling, rashes, nausea and dizziness.

Minoxidil Side Effects in Men and Women

Minoxidil is a common treatment for hair loss in both men and women, but it can cause various side effects depending on the individual.

Common Side Effects:

• Scalp Irritation: Redness, itching, and flaking of the scalp are common in both men and women, especially with the 5% solution. Women often use the 2% solution to minimize irritation.
• Initial Hair Shedding: Users may experience increased hair loss initially, which usually resolves as new hair growth begins.

Long-term Side Effects:

• Hypertrichosis: Increased hair growth in unintended areas, such as the face and body, is a possible side effect for both genders. This is more frequently reported by women.
• Skin Rash and Discoloration: Prolonged use may lead to skin rashes or changes in scalp color.

Special Considerations for Women:

• Facial Hair Growth: Women may experience unwanted hair growth on the face or body, which can be distressing.
• Pregnancy and Breastfeeding: Women who are pregnant or breastfeeding should consult a healthcare provider before using minoxidil, as its effects on an unborn or nursing child are not fully understood.

Special Considerations for Men:

• Concentration Usage: Men typically use the 5% solution for male pattern baldness, which may increase the risk of scalp irritation.

Both men and women should discuss with their doctor the appropriate concentration of minoxidil to use and monitor any side effects that arise during treatment.

Minoxidil Side Effects Sexually

While minoxidil is primarily used for hair growth, there have been concerns about its impact on sexual health, though such side effects are rare and often anecdotal.

• Decreased Libido: Some users report a reduction in sexual desire, but this is not a widely documented side effect.
• Erectile Dysfunction: Rarely, minoxidil is mentioned in connection with erectile dysfunction, though this is not directly proven and may be related to psychological factors.

Minoxidil Side Effects After Stopping

When minoxidil use is discontinued, there are several potential outcomes related to hair health:

• Reversal of Hair Growth: Hair gained during treatment may be lost, returning to the original pattern of hair thinning or loss.
• Increased Shedding: Users often experience a shedding phase, where hair falls out more rapidly after stopping.
• Return to Pre-Treatment Condition: Over time, hair loss usually returns to the same level as before starting minoxidil treatment, as the medication’s effects are not permanent.

How to Choose the Right Type of Minoxidil

Consider Your Hair Loss Pattern

• Men: Typically use the 5% topical solution or foam for male pattern baldness.
• Women: Usually start with the 2% solution to avoid irritation, though some may use the 5% foam under medical advice.

Skin Sensitivity

• If you experience scalp irritation, the foam may be a better option due to its gentler formulation.

Consult with your Dermatologist

• Before starting any minoxidil treatment, it’s important to consult with a dermatologist or healthcare provider to choose the appropriate type and concentration based on your specific needs and medical history.

Tips to Apply Minoxidil for best Results

• Consistency is Key: Apply minoxidil as directed, typically twice a day for solutions and once a day for foam.
• Dry Scalp: Ensure your scalp is dry before application for maximum absorption.
• Wash Hands: Always wash your hands after applying minoxidil to prevent the solution from spreading to other areas.

Frequently asked questions about Minoxidil & its Side Effects:

What are the consequences of stopping Minoxidil?

Whether your hair loss will start again or you will retain your hair after stopping minoxidil will depend on what kind of hair loss you have had. If it is genetic, chances are that you might retain a few hair that you gained and lose the rest; but let’s say you lost your hair due to a medical treatment and once the treatment protocol has been completed, there is a chance that your hair will grow back, irrespective of you stopping the medication. Remember that this is not a treatment that you can start and stop when you want – if you want your existing hair to grow thicker and longer, then you will have to continue with the treatment, because the moment you stop, the hair loss will possibly return.

Is it okay to drink alcohol while taking minoxidil?

If you are taking oral minoxidil, then you will be asked not to take alcohol, because there could be an adverse drug reaction, that could lead to a drop in blood pressure. However, this should not be a problem with the topical version – but alcohol is known to dry the skin out, which could lead to scalp irritation as well.

Should I take finasteride when using minoxidil?

While taking finasteride in tandem with minoxidil is not unsafe, there can be some side effects, especially for pregnant or lactating women. It is important to keep in mind that Minoxidil side effects after stopping can appear should you stop either or both, the main being hair loss starting again.

What happens if I stop taking Minoxidil and start taking Propecia (Finasteride)?

There is actually no telling what will happen – for some people, minoxidil works better and for some, finasteride. There is no guarantee that you will not see elevated hair loss after stopping minoxidil or you will immediately see better hair growth with finasteride.

References:
https://www.webmd.com/drugs/2/drug-3503/minoxidil-topical/details
https://en.wikipedia.com/wiki/Minoxidil
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691938/
https://www.mayoclinic.com/drugs-supplements/minoxidil-topical-route/side-effects/drg-20068750?p=1
https://www.forhims.com/blog/minoxidil-interactions
https://www.mayoclinic.com/drugs-supplements/minoxidil-topical-route/precautions/drg-20068750?p=1#:~:text=Minoxidil%20topical%20foam%20or%20solution,to%20breathe%20in%20the%20spray%20.

NOTE: This content of this post is written by the experienced dermotologist based on formal medical studies. It is reliable and scientifically verified, reviewed and edited by concerned doctors or health professionals to provide objective information on the diagnosis and treatment of diseases. If you are a doctor or health scientist and find inaccuracies, errors or omissions, please contact us at info@akclinics.com