Is Minoxidil (Rogaine) Safe for Women?

You may be familiar with Minoxidil that’s used to treat thinning hair and bald spots.  The medication was initially tested, marketed, and FDA-approved for men with male pattern baldness.  If you’re a woman experiencing hair loss, you may wonder if Minoxidil is safe and effective for you too.  After all, Minoxidil is available under the brand name Rogaine over the counter at most big box retailers and pharmacies.  It’s easy to buy and use.  

Dermatologists Often Recommend Minoxidil to Their Female Patients

Minoxidil is safe, and it’s the medication most often recommended to women by dermatologists to treat their hair loss conditions.  Before you run to the store, though, there are a few things you should know.  

Minoxidil Is FDA Approved for Women

If you’re considering using Minoxidil to treat your hair loss, you’ll be happy to know that the five percent topical foam and solution was FDA-approved for women in 2014.  The medication was used off-label for women before it was approved.  Why is FDA approval notable?  Because it means that the manufacturer proved that its product is safe and effective for its intended use.  FDA approval also means the product is manufactured to federal quality standards.  

Higher Doses of Minoxidil are Available by Prescription

Oral and topical Minoxidil doses above five percent are available to women but only off-label by prescription.  Don’t be concerned about using prescription medication off-label, though.  The FDA knows that medical providers do that.  Off-label means that dermatologists may prescribe a drug for use that isn’t approved when the provider determines that the medication is medically appropriate.  

Minoxidil Is Used to Treat Female Pattern Baldness and Other Hair Loss Conditions

Minoxidil is most often recommended and prescribed to treat androgenetic alopecia, commonly known as female pattern baldness.  Female pattern baldness occurs in women who are genetically predisposed to hair loss.  When women experience this condition, they typically see hair loss along their parts first.  Over time, the part widens as the hair in the area continues to thin and fall out.  While men who experience male pattern baldness can lose all of their hair over time, women typically don’t.  Women are more likely to see diffuse thinning on the crown of their heads.  

Minoxidil is often prescribed for other hair loss conditions as well.  Dermatologists often recommend Minoxidil to their female patients with alopecia areata, frontal fibrosing alopecia, lichen planopilaris, and other types of alopecia.

Minoxidil is Available to Women in Different Forms and Doses

Liquid & Foam Rogaine

If you go to the store, you’ll find foam and liquid Minoxidil in two and five-percent formulas.  Minoxidil is the same as Rogaine.  You may also find generic store brands of Minoxidil under names such as Equate and Kirkland Hair Regrowth Treatment, which contain the same active ingredients.  

Initially, only two percent formulas were marketed for women.  However, research indicates that higher doses are more effective for treating female pattern hair loss.  Although both two and five percent solutions increased hair growth, the five percent demonstrated statistical superiority over the two percent. (01)  When choosing between the liquid and foam, you may want to consider foam that does not contain propylene glycol which can be an irritant to some women. 

Oral Minoxidil

Oral Minoxidil is an alternative to topical and is available by prescription.  The medication is effective in regrowing hair in women with female pattern baldness. (02)  Oral Minoxidil was initially tested in higher doses to treat high blood pressure.  When used to treat genetic hair loss, much lower doses are prescribed.   

Minoxidil with DHT Blockers

The most effective treatments attack hair loss from different angles.  Women often use Minoxidil simultaneously with DHT blockers such as Finasteride or Spironolactone.  Minoxidil enlarges the hair follicles, while Finasteride or Spironolactone prevents testosterone from converting to DHT.  When DHT is blocked, it can’t bind to the receptors in your hair follicle so your hair won’t be at risk.  

Customized Topical Minoxidil Formulas

Treatments for female pattern baldness may differ from woman to woman.  What works for one may not work for another, which is why customized formulas are often best.  The most effective treatments attack hair loss from different angles.  A benefit of customized formulas is that Minoxidil can be prescribed up to 10 percent, which is significantly higher than what’s available over the counter.  Retinol can be added to increase absorption, and cortisone can be added if necessary to prevent irritation from higher concentrations of Minoxidil. Many women also like the convenience of having all of the hair loss medications they need to be compounded into one formula rather than having to take or use multiple medications.       

Minoxidil Side Effects are Usually Minimal

Minoxidil users usually don’t experience many side effects.  Topicals can cause some redness, flaking, and irritation.  However, eliminating propylene glycol usually resolves the issue.  Oral Minoxidil was originally tested and marketed to treat high blood pressure.  Because oral medications are systemic, side effects such as a fluctuating heart rate are possible.  Side effects are rare, though.  Doses of oral Minoxidil prescribed for hair loss are typically significantly lower than for high blood pressure.  

Minoxidil Can Cause Initial Shedding

If you’ve been researching Minoxidil for your hair loss, you may have heard about the “dread shed” that can occur when first using Minoxidil.  Yes, some women find that they lose more hair at first.  The reason why is because Minoxidil speeds up your hair’s growth cycle.  The resting phase occurs faster than it otherwise would.  Everyone doesn’t experience an increase in shedding.  However, If you do shed initially, don’t panic.  Your hair’s growth cycle will regulate within a few weeks.  

Trying Minoxidil is the Best Way to Determine Whether it will Work for You

It would be nice if there were a way to know whether Minoxidil will help regrow your hair.  A response test has been designed and marketed to do just that.  The test measures the amount of sulfotransferase enzyme activity in plucked hair follicles to predict whether or not Minoxidil will be effective. Research indicates that the sulfotransferase activity predicts treatment response with 93 percent sensitivity and 83 percent specificity. (03)  There’s a catch, though.  

The test will only help determine if women will respond to two or five percent topical Minoxidil.  The test does not indicate whether or not women will potentially respond to higher topical dosages or to oral Minoxidil.  It also does not indicate whether Minoxidil will be effective when used with a DHT blocker such as Finasteride or Spironolactone.  The best way to know if Minoxidil will work is by trial.  It typically takes six to twelve months to see results. 

If you have been diagnosed with female pattern baldness and are thinking about trying Minoxidil, here’s the takeaway.  Minoxidil is safe for women to use and has been proven to be an effective treatment for many.  Minoxidil often works best with Finasteride, Spironolactone, or another DHT blocker.  A topical with a percentage higher than five or oral Minoxidil will require a prescription.  If you have more questions about whether Minodixidl is right for you, Happy Head’s board-certified dermatologists can help.  Contact us and our hair growth experts will help select the best solution for you, without a visit to the doctor’s office. 

 

Resources:

(01) https://pubmed.ncbi.nlm.nih.gov/15034503/

(02) https://pubmed.ncbi.nlm.nih.gov/32851744/

(03) https://pubmed.ncbi.nlm.nih.gov/24773771/