How Does Minoxidil Work?
Minoxidil is, along with Finasteride, one of the best-known and proven treatments for MPB on the market today. But, unlike Finasteride, you don’t need a prescription — and you don’t need to pop any pills either.
MPB occurs due to the shrinkage of the hair follicles on your scalp. This process of miniaturisation, as it’s known, is a natural result of age and is due to your body’s production of the hormone, dihydrotestosterone (DHT), to which your scalp follicles can be sensitive.
Minoxidil works to reverse this process. As a vasodilator, the treatment dilates the blood vessels in your scalp, encouraging blood flow to the area. From the greater amount of blood, your hair follicles take more nutrients and oxygen, which helps to maintain both their health and that of your hair.
However, this process takes time; shrunken follicles can’t just go from off to on. Rather, Minoxidil intervenes in what is known as the hair growth cycle. Your follicles work cyclically, by producing hair, detaching themselves from the hair, and resting, at which point your hair ultimately falls out.
Minoxidil causes the growth phase, or “anagen” phase, to start sooner, resulting in a longer period of healthy hair growth. However, the follicles have to pass through the other parts of the cycle first. This is why it takes time, and it can also mean that you’ll see some hair fall out before it starts growing again.
How Effective is Minoxidil?
Minoxidil results are seen in the vast majority of men. In fact, a study of over 11,000 men[iii] found that, after a year of Minoxidil use, 92% reported the resulting hair growth to be excellent, good, or fair.
However, that study used the 2% Minoxidil solution, while evidence suggests that the 5% topical solution is more effective. According to research comparing the two strengths, those who used the 5% solution had 45% greater hair coverage after 48 weeks than those who used the 2%.
Indeed, the study cited above seems to confirm the efficacy of the Minoxidil 5% solution: after 48 weeks, it is effective in 60% of men.
As you’ll have noticed, these things do take time. But don’t let that “48 weeks” put you off. While it might seem like a lifetime, this isn’t necessarily how long you’ll need to wait.
When Will I See Minoxidil Results?
Minoxidil starts working immediately. However, you should expect to wait between three and six months before you see its visible results.
That’s because that’s the time it takes for your hair follicles to return to the anagen phase of hair growth. While studies have shown that healthy hair growth can be between four and five inches a year, for miniaturised hair follicles this rate is slower.
One study cited by the US FDA found that, after four months, 26% of men had moderate to dense regrowth[vi], with a further 33% showing some regrowth too. Another study into Minoxidil didn’t find any change at three months, but did see significant effects after six months of continuous use.
Unfortunately, there is no quick fix to MPB. But the longer you use Minoxidil, the more likely you are to see results.
Are there Ways to Make Minoxidil More Effective?
Treatments for MPB require patience and perseverance. You can’t realistically expect a new head of hair overnight. However, with commitment — and the knowledge that the majority of men see regrowth with a regular application — you’ll see Minoxidil results.
Meanwhile, here are a couple of tips to ensure that you get the most out of your treatment:
Combine Minoxidil with Finasteride
Alongside Minoxidil, Finasteride is another effective, safe, and clinically approved treatment for MPB. Luckily, these two drugs can be used together to further improve the chances of hair regrowth.
Where Minoxidil encourages follicular health by encouraging the transport of oxygen and nutrients to the scalp, Finasteride inhibits the body’s production of DHT, the hormone that causes follicular miniaturisation. This cuts off the cause of MPB at its root.
One study found that Finasteride increased hair growth in 87% of men. Minoxidil and Finasteride independently do halt and even reverse hair loss, but give best results when both are used together in one treatment plan.
Start Treatment Early
There’s something else we need to mention: the sooner you start treatment, the better the results will be.
If the process of miniaturisation progresses too far, the hair follicles in your scalp become permanently damaged, and there will be no way to revive them. This means that, if there are areas on your head with no hair at all, you may not see any hair regrowth as a result of Minoxidil treatment.
When it comes to treating MPB, the earlier you get started the better.
Key Takeaways
Minoxidil is effective in treating MPB. However, no treatment for hair loss will give instant results. That’s largely because hair follicles need time to return to their anagen phase, the moment in their growth cycle in which they produce hair.
This usually takes between three to six months of daily use. However, combining Minoxidil with Finasteride will give you better results in the long run.
¹emc – Regaine for Men Extra Strength Scalp Solution 5% w/v Cutaneous Solution: https://www.medicines.org.uk/emc/product/5765/smpc#INDICATIONS
²Laura Alonso, Elaine Fuchs (2006). The hair cycle: https://jcs.biologists.org/content/119/3/391
³Jerry Shapiro (2003). Safety of Topical Minoxidil Solution: A One-Year, Prospective, Observational Study: https://link.springer.com/article/10.1007%252Fs10227-002-0121-6
⁴Journal of the American Academy of Dermatology – A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men: https://www.researchgate.net/publication/11191067_A_randomized_clinical_trial_of_5_topical_minoxidil_versus_2_topical_minoxidil_and_placebo_in_the_treatment_of_androgenetic_alopecia_in_men
⁵Geneviève Loussouarn PharmD Charles El Rawadi PhD Gilles Genain PhD (2005). Diversity of hair growth profiles: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-4632.2005.02800.x
⁶Example Drug Facts Label for Minoxidil Topical Solution 2% for Men and Women: https://www.fda.gov/media/72189/download
⁷Yunes Panahi, Mohsen Taghizadeh, Eisa Tahmasbpour Marzony, Amirhossein Sahebkar (2015). Rosemary oil vs minoxidil 2% for the treatment of androgenetic alopecia: a randomized comparative trial: https://www.ncbi.nlm.nih.gov/pubmed/25842469
⁸Akio Sato, Akira Takeda (2012). Evaluation of efficacy and safety of finasteride 1 mg in 3177 Japanese men with androgenetic alopecia: https://www.ncbi.nlm.nih.gov/pubmed/21980923
While we've ensured that everything you read on the Health Centre is medically reviewed and approved, information presented here is not intended to be a substitute for professional medical advice, diagnosis, or treatment. It should never be relied upon for specific medical advice. If you have any questions or concerns, please talk to your doctor.
