Tag Archive for: oral minoxidil

What the Experts Know About Alopecia

Happy Head customer with thinning hair reviewing his progress with our custom topical treatment made my board-certified dermatologists.

Did you know that dermatologists treat more than just skin issues? During their twelve-plus years of training, dermatologists are also taught how to diagnose and treat patients’ hair and nail conditions. That’s why a licensed dermatologist should be your first stop if you’re experiencing hair loss that seems more than the norm. Yes, it’s possible that Covid-19 or the flu temporarily shocked your hair, and it will grow back on its own. However, some types of hair loss require attention. If that’s the case, you don’t want to risk losing valuable time and hair when you could be in treatment.  

So, if seeing hair everywhere but on your head is stressing you out, go ahead and schedule an appointment. Don’t have time to head to an office? Take our online questionnaire and we’ll match you with a dedicated dermatologist to help answer your questions. Don’t worry about your dermatologist thinking you’re crazy or an alarmist. They have seen it all. Meanwhile, here’s a sneak peek at what expert dermatologists know about alopecia and what may be in store for you.  

Alopecia is a Broad Term

Type “alopecia” into Google, and what comes up? Lots of results on alopecia areata. Alopecia areata is one very specific type of alopecia (we’ll talk more about it in a minute). However, there are many different types of alopecia, ranging from there’s nothing you can do but wait for your hair to grow back to it’s time to get on some medication. Alopecia is more of a finding than an actual condition. The word is used by professionals whenever there is some disorder causing hair loss. If you’re losing facial hair, that’s considered alopecia too. So, if your dermatologist uses the word alopecia, don’t worry. It’s a broad term that encompasses many types of hair loss.  

There Are Different Types of Alopecia

Hair loss is not one-size-fits-all. Symptoms and treatments vary based on what type of alopecia you are experiencing. Here’s a primer to help you understand what your dermatologist may look for during your consultation.  

Temporary Hair Loss

Finding hair everywhere but on your head can be upsetting. Before you plan for the worst, though, consider this. Not all hair loss is permanent. Certain medications, illnesses, surgery, and even ultraviolet rays from the sun disrupt your hair’s growth cycle and cause a condition called telogen effluvium. Telogen effluvium is self-limiting, which means that peace will be restored to your scalp once the trigger is removed.  

Insider Advice:  Although hair usually grows back on its own within six months to a year, the waiting game can feel long.  Supplements, thickening shampoos, conditioners, and regular trims can help support healthy hair growth while you wait.  

Genetic Alopecia

Have you ever heard of androgenetic alopecia?  Maybe not, but you’re probably familiar with Male and Female Pattern Baldness (MPB or FPB) which is the same thing.  But wait!  Isn’t that something that only happens to old people?  Well, not exactly.  Anyone who has gone through puberty can experience male or female pattern baldness, a form of genetic hair loss.  As a matter of fact, many people who experience MPB or FPB realize that they started losing their hair before the age of 40. (01)  Androgenetic alopecia is inherited through your family tree and occurs when testosterone converts to a substance called Dihydrotestosterone (DHT).  DHT attaches to your hair follicles and gradually shrinks them until they close up.  Hair falls out in easily distinguishable patterns that can be compared to a Norwood-Hamilton Scale to determine the extent of your hair loss.  

Insider Advice:  Don’t fall for any “grow hair fast” gimmicks.  The most effective way to strengthen and regrow your hair is by using vasodilators and prescription DHT blockers.  Topical or oral Minoxidil, Finasteride, Dutasteride, and Spironolactone are all good options.  Don’t expect miracles overnight, though.  You’ll need to be patient.  It takes six months to a year to see results.  

Autoimmune Hair Loss

Autoimmune diseases occur when your body mistakenly attacks healthy cells in your body. When your hair is involved, your hair follicles are attacked, leaving you scrambling to find ways to fight inflammation that blocks your hair follicles’ openings. Autoimmune hair loss falls into two different categories: Non-scarring and scarring. Alopecia areata is a non-scarring alopecia.  Hair falls out in sporadic round or oval patches on the scalp. In some alopecia areata cases, hair will spontaneously grow back on its own.  

Scarring alopecias behave differently and do what their name indicates. Scars grow over the hair follicles and close them off, leaving doctors and patients to play a game of beat the clock. The goal is to keep hair follicles open and to preserve existing hair before the hair follicles are shrunken to the point where they are closed off.  

Insider Advice: Autoimmune hair loss can be tricky to manage. What works for one person may not work for another. Treatment may also require multiple medications. Be patient through the trial process while your dermatologist determines which combination of medications works best for you.  

Facial Hair Loss

If you’re losing facial hair, it’s nothing to be ashamed of. It’s a real thing called alopecia barbae, and it’s usually autoimmune related. Alopecia barbae can cause hair to fall out in small round patches in men’s beards or mustaches. Hair can spontaneously regrow, or patches may stick around for a while. It’s difficult to predict the condition’s path.

Insider Advice: Don’t feel like you have to live with facial hair loss. Many of the treatments used to treat scalp hair loss can be used on your face too. These treatments may include steroids, topicals such as Minoxidil, or, in extreme cases, a class of medications called JAK inhibitors that calm the immune system.  

Give Yourself Time to Grieve, Then Move On

It’s only natural to go through a grieving process, regardless of the type of alopecia you’re battling. For some people like Congresswoman Ayanna Pressley, hair can be part of your “brand,” something you’re known for. When that hair is gone, you can feel like you’re losing part of your identity. That’s completely normal. Although nobody wants to have any form of alopecia, keep in mind that the awful feeling you get during your diagnosis won’t last forever. Over time, you and the people surrounding you will get used to your new look.

Topical treatment by Happy Head, being piped out of the glass pipette. Each topical treatment is customized to your patient profile.

If you have difficulty accepting your new normal, try giving yourself a time frame. Say something like, “Self, it’s been a while since I’ve been happy. ’m giving you one more week to be down in the dumps, and then I’m making an appointment for a new haircut.  Then, I’m moving on.” If that doesn’t work for you, a support group or counseling may be what you need to get in the right frame of mind. 

So let’s recap what experts know about alopecia. You’d be surprised how many people suffer from hair loss before consulting a dermatologist. If you think your hair is thinning or balding, get an expert opinion. Your hair woes may be nothing to worry about, or there may be something that can be treated. You won’t know unless you talk with a professional.  

Tight on time? Happy Head can help. Our board-certified dermatologists are available to help answer your pressing questions and help you regrow your hair. Remember one-size-fits-all treatments are a thing of the past, so let’s create a custom treatment that’s formulated to your needs. Fill out our short questionnaire and add a few photos to get started.

Resources

(01) https://pubmed.ncbi.nlm.nih.gov/9865198/

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.  

Resources:

(01) https://www.aad.org/dw/dw-insights-and-inquiries/archive/2022/low-dose-oral-minoxidil-alopecia

(02) https://www.aad.org/dw/dw-insights-and-inquiries/archive/2022/low-dose-oral-minoxidil-alopecia

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691938/

(04) https://pubmed.ncbi.nlm.nih.gov/33639244/

(05) https://cosmoderma.org/combination-therapy-with-oral-minoxidil-and-dutasteride-in-the-treatment-of-male-patterned-baldness-a-case-report/

 

Your Guide to the Top Hair Loss Treatments for 2023 (Yes, They Really Work!)

2022 was a big year for advancements in the medical field.  Scientists learned how to track rapidly changing Covid variants, promising medications for prostate cancer were identified, and breakthroughs were made in diabetes management.  JAK inhibitors were found to be successful in helping patients with severe alopecia areata regrow their hair. (01)

We’ve been busy too.  In addition to seeing patients throughout the year, Dr. Ben Behnam and Dr. Sean Behnam, board-certified dermatologists and hair specialists, were behind the scenes developing, testing, and marketing stronger treatments for male and female pattern hair loss based on scientific data and their clinical experience.  

If bald spots, thinning hair, or hairballs in the shower are stressing you out, now is the time to stop the shedding and start regrowing your hair.  Here’s our guide to the Top Hair Loss Treatments for 2023.  We’ll also share the science behind the formulas so you can make smart decisions about the products you use.  

Top Oral Medications for Hair Loss

The most effective hair loss medications are prescription drugs discovered by accident.  During testing for high blood pressure and benign prostatic hyperplasia, researchers found that the medicines had a peculiar side effect.  Balding men suddenly started to regrow their hair.  Further research was conducted, and sure enough, the findings were confirmed.  Finasteride is now FDA approved to use by men with male pattern hair loss.  Although all the other medications listed below have been tested for efficacy, they are currently prescribed off-label at low doses.  Oral hair loss medications are easy to take and are relatively inexpensive.    

Oral Minoxidil

Oral Minoxidil was recently touted in the New York Times as a “cheap treatment” that “restores hair in many patients.” (02)  Minoxidil works by opening the blood vessels.  More oxygen flows to the scalp, expanding the blood vessels and enlarging the hair follicles.   Topical liquid or foam works for many people, but it does not work for some.  People who do not respond to the topical formula may have better luck with the pill.  A specific enzyme must be present in the skin and hair roots to convert topical Minoxidil to an active form.  Oral Minoxidil does not need to be converted. 

Oral Finasteride

Low-dose oral Finasteride is a first-line DHT blocker that can be used by both men and women who are not pregnant or planning to become pregnant.  DHT blockers prevent testosterone from converting to a hormone called dihydrotestosterone (DHT).  DHT binds to your hair follicles, makes them shrink during a process called miniaturization, and makes your hair fall out.  When DHT production is blocked, your hair follicles remain healthy.  Oral Finasteride has minimal side effects on women who qualify to take the medication.  Although  not  common, some men report sexual side effects from the pills.  Switching to topical Finasteride is a good solution for men who are concerned.       

Oral Dutasteride

Oral Dutasteride is similar to Finasteride. The main difference is the number of isoenzymes inhibited.  Finasteride inhibits Type 2 isoenzyme of 5a-reductase (5AR).  Dutasteride inhibits Type 1 and Type 2.  5AR is the enzyme that converts testosterone to dihydrotestosterone (DHT).  Research indicates that Dutasteride reduces more serum DHT than Finasteride. (03)  Should you skip the Finasteride and go straight to Dutasteride?  Not necessarily.  Finasteride is effective for many users and can be taken at a lower dose.  It’s typically recommended to step up to stronger medications as needed.  Of course, there are always exceptions, so your dermatologist should guide you.  

Oral Spironolactone

Oral Spironolactone, a medication used to treat high blood pressure and heart failure, is used off-label at low doses to treat hair loss.  Spironolactone falls into the category of mineralocorticoid receptors (MRAs).  The medication slows the production of androgen to block DHT production.  It’s usually only prescribed to women because it can cause side effects such as enlarged breasts in men.  

Combination Oral Medications

Over time, dermatologists have discovered that treating male or female pattern hair loss requires multiple approaches working simultaneously.  Many people need a cocktail of medications to stop their hair loss and to grow new hair.  However, taking numerous medications usually isn’t convenient.  That’s where SuperCapsules play a role.  These medications combine a Minoxidil (a vasodilator), Finasteride or Dutasteride (a DHT blocker), and vitamin D. 

Why Vitamin D?  Because the number of people with Vitamin D deficiencies is more significant than you would imagine. Vitamin D deficiency affects about 40 percent of the people who live in the U.S. (04)   Vitamin D is metabolized in the skin by cells that process keratin, the protein found in your hair, nails, and skin.  When your body has a Vitamin D deficiency, your body has trouble regulating hair growth and shedding.

Top Topical Medications for Hair Loss

Oral medications are effective, but they’re not ideal for everyone.  Although rare, oral hair loss medicines can sometimes cause side effects such as low blood pressure or decreased libido.  That doesn’t mean you have to forgo hair loss treatment, though.  Topical treatments can penetrate the scalp and have been found equally effective, without the same risk of side effects. (05) 

All of our oral medications are available in topicals.  For your convenience, topicals are also available in combinations.  After all, it’s much easier to apply one medication than two, three, or four.  Combined topicals also allow ingredients to be added, such as retinoic acid and cortisone.  Retinoic acid improves the absorption of the formula.  Sometimes, topicals that include higher percentages of Minoxidil can cause irritation.  Cortisone proactively alleviates the issue.  If you don’t see the exact formula you need, it’s not a problem.  We can customize a formula for you.  

Can you get topicals over the counter without a prescription?  Minoxidil, yes.  The only catch is that the foam and liquid available at the store is a lower dosage.  Percentages higher than five are only available by prescription.  Topical Finasteride, Dutasteride, and Spironolactone are only available by prescription.  

Here are the topical formulas available:

Thickening Shampoos & Conditioners

Shopping for the right shampoo and conditioner can be overwhelming.  Store shelves are packed with different options for every hair type.  There are shampoos and conditioners for dry hair, greasy hair, curly hair, straight hair, dandruff, and more.  What do you use if your hair is thinning or falling out?  Well, there’s a plethora of options for that too.  When developing their shampoo and conditioner, Dr. Ben Behnam and Dr. Sean Behnam were very particular about the ingredients they chose.  Here are some of the natural ingredients they selected and why:  

Argan oil 

Research indicates that aragan oil has antioxidant and anti-inflammatory properties.  Aragan oil can protect your hair against elements and make it look shinier.  

Biotin

Biotin, vitamin B7, is known for stimulating keratin production and increasing follicle growth rate.  It was added to help make your hair stronger.  

Collagen

Collagen is used to increase your hair’s ability to build protein.  It can help make your hair longer and thicker.  If you have gray hair, collagen may help improve your hair’s appearance by supporting the hair follicle where your hair’s pigment is produced.  

Keratin

Want smoother, shinier hair?  Keratin will help.  The  hair cuticle absorbs keratin, a structural and protective protein which helps keep your hair under control.  

Saw Palmetto

Saw palmetto is a member of the palm family.  The powder is made from the shrub’s berries.  Saw palmetto not only has anti-inflammatory properties, but it also acts as a DHT blocker.  

Remember that no shampoo or conditioner alone will prevent hair loss or regrow your hair.  The right ones will, however, help keep your hair and scalp healthy and healthy looking. 

Hair Supplements

Nutritional deficiencies, hormonal issues, and stress all contribute to hair loss.  Daily hair supplements with Vitamin A, Vitamin D, Ashwagandha, probiotics, and other natural ingredients included in our hair supplements help offset the effects to give you stronger, healthier hair.  

Researched and Tested Prescription Hair Loss Treatments 

Most people are upset when they realize that they’re losing their hair.  If that’s you, it’s time to usher in the new year with a fresh approach to managing your hair loss.  Thanks to telemedicine, you can quickly, easily, discreetly access the prescription hair loss treatment you need.  Our caring, licensed dermatologists are available to help you along the way.  There’s even a special edition holiday pack to help you get started.  

Remember, it can take six to twelve months to see the full results, so make sure to celebrate your milestones along the way.  You may not think that you’re making much progress.  After all, you see yourself every day.  However, taking photos monthly will make it easier to see new growth.  Cheers to new beginnings!

Resources:

(01) https://pubmed.ncbi.nlm.nih.gov/31930807/

(02) https://www.nytimes.com/2022/08/18/health/minoxidil-hair-loss-pills.html

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472914/

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6075634/

(05) https://pubmed.ncbi.nlm.nih.gov/34634163/

 

Oral Minoxidil: Truth Behind Its Hair Growth Success

There has been some press and a lot of talk about the benefits of low-dose oral Minoxidil recently. Our phone lines have been flooded with questions in response. Is oral Minoxidil the cure for balding and thinning hair? Will it work for me? What’s the truth behind its growth success? That’s what everyone wants to know.  

In response, we thought it would be helpful to share answers to some of the frequently asked questions we’ve been getting.  If you’re thinking about asking for a prescription, make sure you read this first. We’ll explain what oral Minoxidil is, how it works, and some things you should consider if you decide to give it a try.

Oral Minoxidil by Happy Head, formulated by board certified dermatologists. What's the secret behind its success?

What’s the Big Deal About Oral Minoxidil?

In previous blog posts, we talked a little bit about the abundance of over-the-counter (OTC) products on the market that promise to help people who are experiencing hair loss regrow their hair.  Shampoos, conditioners, vitamins, and supplements are easy to buy and tempting to try.  If you’ve already tried one (or five), you know what we mean.  We’ve also discussed how with the exception of two and five percent Minoxidil liquid and foam, which are marketed under the brand name Rogaine, the products that are truly effective in treating hair loss are only available by prescription.  

Recent press has reiterated this point and has touted the benefits of low-dose oral Minoxidil.  Minoxidil is an inexpensive medication and has been proven to be effective in treating male and female pattern hair loss (androgenetic alopecia) and other types of alopecia.  

What is Minoxidil?

Minoxidil was originally developed and marketed to treat high blood pressure. The medication is a vasodilator.  It relaxes the blood vessels, allowing blood to pass through more easily.  When Minoxidil was initially tested for high blood pressure, doctors and researchers noticed that one of the side effects was hair growth.  Minoxidil brings more oxygen to the scalp’s surface, enlarging the hair follicles and offsetting the effects of miniaturization that results in hair thinning and balding.  Through the enlarged follicles, new hair can grow, and existing hair remains strong and healthy.  

Why is Oral Minoxidil Prescribed Off Label?

Liquid and foam Minoxidil are FDA approved for treating hair loss.  Oral Minoxidil is prescribed off-label for hair loss because it has been approved to treat high blood pressure but not for hair loss.  Prescribing medications off-label is common practice in dermatology. Many dermatological conditions ranging from skin pigment disorders to inflammatory conditions, do not have standard FDA-approved treatments, so dermatologists use research findings to prescribe off-label to treat their patients’ conditions.  

How is Oral Minoxidil Usually Prescribed to Treat Hair Loss?

Dosage may differ based on your body weight and other factors; however, the typical prescription of oral Minoxidil to treat alopecia is 2.5 milligrams.  Dr. Ben Behnam, dermatologist, hair specialist, and founder of Happy Head hair loss solutions, recommends building up slowly over a month to avoid side effects. “Use a pill cutter,” says Dr. Behnam. “Take one-quarter of a tablet for the first two weeks, one half of a tablet during the second two weeks, and a full tablet after that.”  As with any prescription medication, patients should only take oral Minoxidil under the supervision of a licensed physician.

What are the Side Effects of Oral Minoxidil?

According to Dr. Benham, oral Minoxidil is a relatively safe medication, and side effects are rare.  Oral Minoxidil does not cause weight gain or sexual side effects.  Although most people do not have any side effects, people who do may experience changes in blood pressure, heart palpitations, headaches, and ankle swelling.  If you have concerns about fluctuating blood pressure, Dr. Benham suggests buying an inexpensive blood pressure cuff and checking your blood pressure weekly.

If you’re of middle-eastern descent and are using oral Minoxidil at higher doses, there’s a risk that you could grow hair on your face or other parts of your body.  That usually doesn’t happen at the lower doses though.  There’s also a higher chance of hirsutism in women than men.  

Most side effects resolve on their own after a week of continuously taking the medication.  However, if your symptoms don’t resolve, Dr. Ben recommends contacting your dermatologist and discontinuing the medication.  

Can You Use Oral Minoxidil and Topical Hair Loss Treatments at the Same Time?

Using oral Minoxidil at the same time as topical hair loss treatments is often recommended for the best results.  The reason is that oral Minoxidil may work as a stand-alone treatment for some, but many people will also require an anti-antigen such as Finasteride.  Minoxidil will open the hair follicles, but it won’t block testosterone from converting to DHT.   Therefore, most people need a DHT blocker to complement the Minoxidil.  

What other Medications Exist to Treat Male or Female Pattern Baldness?

Both oral and topical medications are available to treat androgenetic alopecia.  Oral medications include:

Finasteride (Propecia)

A DHT blocker that’s typically prescribed as a first-line medication due to its high efficacy.  Although not common, some men taking oral Finasteride experience some sexual side effects.  Topical Finasteride, has been proven to work equally as well as oral Finasteride without the same risk of side effects.

Dutasteride (Avodart)

Dutasteride is also a DHT blocker.  The difference between Finasteride and Dutasteride is that Dutasteride inhibits two isoenzymes while Finasteride inhibits one.  That said, FDA-approved Finasteride is effective for most people with male or female pattern baldness.  When Finasteride isn’t quite strong enough, Dutasteride is prescribed off-label.  Knowing whether Finasteride or Dutasteride will work best in each case is usually unknown until a patient tries one of the medications.  Based on Dr. Behnam’s experience, Finasteride works better for some people than Dutasteride, even though Dutasteride is a stronger medication.  That’s why Finasteride is used as the first-line treatment. 

Spironolactone

Sprironolactone is a second-line DHT blocker prescribed to women when Finasteride isn’t effective.  Men typically aren’t candidates for the medication because it can cause feminizing side effects.  

Topical Medications

In addition to Minoxidil, topical Finasteride and combination medications are available.  Formulas that combine prescription medications such as Minoxidil and Finasteride are beneficial because they contain both a vasodilator and a DHT blocker into one.  Patients often prefer the convenience of using one medication rather than multiple medications.  Topicals are also often preferred because they work as effectively as oral medications without the same risk of side effects.  

Is it Okay to Take Oral Minoxidil if You’re Already on Other Blood Pressure Medications?

If you are currently on a blood pressure medication, check with your cardiologist before adding oral Minoxidil.  Knowing whether you can take oral Minoxidil with other blood pressure medications depends on what you’re taking and your current blood pressure.  Again, your cardiologist is the best one to advise you.  

How Do I Get a Prescription for Oral Minoxidil?

The best way to get a prescription for oral Minoxidil is by scheduling a meeting with your dermatologist or hair specialist.  If you aren’t currently under the care of a practitioner, Happy Head has licensed dermatologists who can review your case and determine whether you are a candidate for the medication.  Contact us if you would like more information.  

We covered a lot of ground, so let’s review.  Dermatologists do often recommend oral Minoxidil to their patients.  It’s a reliable medication with relatively low side effects.  However, oral Minoxidil often needs to be combined with a DHT blocker to get the results that most people want.  The right combination of medications varies and can take some trial and error.  Hair loss treatment isn’t one-size-fits-all and can be affected by factors such as weight and genetic make-up.  If you have further questions, Happy Head is here for you.  Reach out and we’re happy to help.