How To Properly Use Topical Minoxidil

February 5, 2023 Dr. Steven Shapiro

One of the main causes of hair loss is androgenic alopecia, or a genetic predisposition to hair loss, also known as male or female pattern hair loss. Hair loss is quite common, especially among men, but some reports even suggest that hair loss rates are rising, by as much as 5% each year.

Currently, the only FDA-approved medications for the treatment of androgenic alopecia are minoxidil and finasteride. Topical minoxidil formulations are available for over-the-counter use without a prescription, while finasteride is a once-daily oral pill for use in men only. Both are effective, but because minoxidil does not require a prescription, it’s often where men and women start when dealing with patchiness or thinning.

It’s also effective for most men and women who try consistent, regular use of minoxidil.

Knowing how to use minoxidil properly is important to safely and effectively achieving your desired hair regrowth.

What You Should Consider Before You Use Minoxidil

Androgenic alopecia is how most men and women experience hair loss: a general thinning that often begins at the crown or hair line for men, and a broader thinning or widening of the part line for women.

While androgenic alopecia is a common cause of hair loss, especially in men, there are other reasons for hair loss or thinning that minoxidil may not be able to address, or where it may be unsafe to use.

Do not use topical minoxidil in the following situations:

Your hair loss is associated with childbirth.
You are under 18 years of age.
You experience sudden and/or non-pattern hair loss.
You currently have an inflamed, infected, or irritated scalp.
You are using another topical scalp medication.
Your reason for hair loss is unknown or sudden.
You are pregnant and/or are breastfeeding.

Understanding the cause of your hair loss before selecting topical minoxidil can be helpful, otherwise this medication may not be ideal for your situation. Sudden hair loss can suggest other underlying medical conditions, including auto-immune issues, and if your scalp is already irritated, minoxidil may make sensitivities worse.

Because oral minoxidil was originally prescribed to lower blood pressure, take caution if you are diagnosed with some types of heart disease. While topical minoxidil does not have a significant effect on blood pressure, you may want to consult with your cardiologist before using this medication in case it interacts with your current drug regimen.

When Topical Minoxidil Should Be Used

Topical minoxidil can be an effective treatment choice for many manifestations of hair loss, thinning, and patchiness in both men and women.

It has been shown to have effectiveness in hair loss beyond androgenic alopecia as well, and off-label use of topical minoxidil is common in the treatment of hair loss, including:

Alopecia areata
Chemotherapy-induced alopecia
Scarring alopecia

Keep in mind that the use of topical minoxidil for these conditions has not been approved by the FDA. In other words, not enough adequate clinical trials have been performed to definitively show the safety and efficacy of minoxidil in treating these specific conditions.

Still, minoxidil is a go-to for many manifestations of hair loss.

What Topical Formulations of Minoxidil Are Available

Minoxidil is most commonly known as Rogaine®, which was the name under which it was originally branded. Today, minoxidil is a generic drug, meaning that many manufacturers make it and at lower prices than ever.

Both 2% and 5% strengths exist in liquid solutions and aerosol foam formulations. Minoxidil is approved for use in men at a 2% concentration and a 5% concentration. It is approved for use in women at only 2%.

Because many hair regrowth products are available today, look for minoxidil listed under the "active ingredients" section on a medication’s label to be sure you have the right product.

The directions for minoxidil use can differ depending on the topical formulation you select.

Directions for Minoxidil Liquid Solution

For a basic liquid solution, apply 1 ml using the dropper provided, twice each day. Only apply it to areas of hair loss on the scalp. Do not apply the solution to other body parts. Wash your hands thoroughly after applying.

Directions for Minoxidil Aerosol Foam

When using a minoxidil foam, apply one-half a capful to the area of hair loss on the scalp twice each day. Only apply minoxidil foam to the scalp area. Massage the foam directly into the scalp with your fingers and wash your hands thoroughly after each application.

Do not apply to other areas of your body. Consider using gloves during application to avoid unnecessary exposure to your skin. Because the contents are under pressure, do not puncture or heat the aerosol container. Properly store at room temperature and keep the container away from flames.

Important Considerations for Minoxidil

Whichever formulation you choose, keep in mind these pointers for safe and effective minoxidil use:

Avoid direct exposure to eyes. In the event of contact with your eyes, rinse your eyes with large amounts of cool water. If irritation occurs despite proper cleansing, seek medical attention.

Continued use is necessary to maintain hair regrowth. Discontinuation of use can result in hair loss occurring again.

Hair regrowth takes time. Results may not show up for two months and it can be upwards of four months for some users.

Using extra amounts of medication more frequently is not likely to speed up results or cause increased hair regrowth. Only use the amount of minoxidil intendted on your medication box.

Topical minoxidil may not work for all men and women, and the amount of hair regrowth is variable.

Change in hair texture and/or color may occur in some people.

If either formulation is ingested, especially with children, seek medical attention or contact your local Poison Control Center immediately.

How Fast Does Minoxidil Work?

Minoxidil can work in as little as 60 days, and the benefits of this ingredient can continue to grow for 12-24 months. Most people should try consistently using minoxidil for 90 to 120 days at a minimum.

If you stop using minoxidil, your hair loss may resume.

When You Should Stop Using Minoxidil

Knowing when to discontinue the use of topical minoxidil is just as important as understanding when to initiate this medication. Although this medication has shown for the past 30 years to produce significant hair regrowth in many people, there are times when it may not be the right fit. Stop using this medication and talk to your doctor if any of these symptoms occur:

You develop chest pain, faintness, dizziness, or increased heart rate.
You suddenly lose weight for no apparent reason.
Your scalp becomes irritated or red after use.
You begin to grow new facial hair.
Your hands or feet begin to swell.
Your scalp shows no signs of hair regrowth in four months.

How To Determine If Topical Minoxidil Is for You

While the mechanism for minoxidil's role in hair loss is not fully understood, the medication has been shown to contribute to increased hair regrowth, increased hair follicle thickness, and decreasing the rate of hair loss in people with androgenic alopecia. Minoxidil's place in the treatment of this issue is clearly supported by research

Depending on your personal situation, it may be best to support topical minoxidil with other supplements or oral medications to achieve the maximum amount of hair regrowth. For men, finasteride and minoxidil can be a powerful combination for more dense, thicker hair, if prescribed. Getting enough protein and eating a healthy diet can support hair growth, and looking out for vitamin or mineral deficiencies is key to giving your body the nutrition it needs. Natural ingredients may help too, like the DHT fighting ingredients in Shapiro MD’s all-natural shampoo and conditioner, for healthier and shinier hair.

At Shapiro MD, we understand all kinds of hair loss and want to help you in your hair regrowth journey. Get started by taking our free hair quiz. Our experienced team of healthcare professionals can guide you to a treatment plan for your situation.