Low dose minoxidil for hair loss in men and women 

Table of Content:
What is minoxidil? | What is the recommended dose for hair loss? | What is the starting dose for hair loss? | What is the highest dose for hair loss? | What happens if I miss a dose? | What happens if I take a double dose? | How does it work for hair loss? | Advantages | Side-effects | How to get a prescription

The low dose of oral minoxidil for hair loss has become more popular in recent years.  Although this medication is not FDA-approved for the treatment of hair loss in men and women, clinical studies show promising results in the treatment of different types of hair loss including male and female pattern loss (androgenetic alopecia), alopecia areata, telogen effluvium, traction alopecia and chemotherapy-induced hair loss.

In this article we cover the basics on the doses typically prescribed for hair loss in men and women what happens if you skip a dose, as well as the benefits and side effects of taking this medication.

This information will help you and your online dermatologist make an informed decision whether minoxidil is adequate for you. 

What is minoxidil?

Minoxidil was originally developed as an oral medication to treat hypertension, but its unintended side effect of hypertrichosis (excessive hair growth) led to the off-label treatment of hair loss at a low dose. Here you can learn more about the differences of oral and topical minoxidil and a comparison between two popular hair loss drugs minoxidil and finasteride. 

What is the recommended dose of minoxidil for hair loss?

Studies show promising results as hair loss treatment with the use of minoxidil at a low dose which can vary from 0.25 mg – 5 mg day with minimal side-effects^{1 2 3} .

What is the starting dose of oral minoxidil for hair loss?

A common starting dose of oral minoxidil for hair loss for women is typically 0.625 mg per day. The starting dose for men is usually higher, around 2.5 mg per day⁴. However, according to Dr. Patrick Mahar, expert dermatologist,  there are no hard rules about which to start, and patients may be reasonably prescribed anywhere from 0.25 mg – 2.5 mg orally per day depending on patient factors.

Since minoxidil is available in tablets of 2.5 mg, 5 mg and 10mg, you should get a pill cutter to obtain the desired dose or consider a compounding pharmacy, such as Skin Medicinals, to make up capsules of the intended dose.

What is the highest dose of minoxidil for hair loss?

The highest dose of minoxidil usually prescribed for hair loss in men is 5 mg per day and 1.25 mg per day for women⁵.

What is the lowest dose of minoxidil for hair loss?

The lowest reported doses of oral minoxidil prescribed for hair loss in women is 0.25 mg per day and for men it is 2.5 mg⁶.  In clinical practice, however, Dr. Mahar says that there isn’t a ‘lowest dose’ for men and women since the dose may be influenced by patient factors such as age, blood pressure, other medications or the severity of a patient’s condition.

What happens if I miss a dose of minoxidil for hair loss?

If you miss a dose of oral minoxidil, you should take it as soon as possible. However, if it is very close to your next dose, skip the missed dose and follow your regular dosing schedule. You should not take double doses.

What happens if I take a double dose of minoxidil?

Dr. Mahar says that if you take a double dose of minoxidil by accident once, you will probably be fine, but make sure this does not happen on a regular basis and pay attention to any side effects that may arise as a consequence of the double dose. If you notice serious side effects, notify your doctor. 

How does minoxidil work for hair loss?

Minoxidil extends the anagen phase of the hair growth cycle, which results in decreased hair loss and enhanced hair length. It also amplifies the thickness of the hair strands, bolstering their strength and reducing the chances of breakage. Moreover, it counters the hair miniaturization process (which is seen in both female and male pattern hair loss) thereby augmenting the number of hairs in areas of the scalp experiencing thinning or baldness⁷.

What type of hair loss can be treated with oral minoxidil?

Oral minoxidil is primarily used in the treatment of androgenic alopecia, also known as male or female pattern baldness⁸. However, sometimes it is also used in the treatment of:

Alopecia Areata: Studies show that some people with alopecia areata (an autoimmune disorder that causes hair loss) have successfully used minoxidil to regrow hair⁹.

Telogen effluvium: Studies show that patients with telogen effluvium (hair loss related to stress, illness, or dietary deficiencies) have experienced hair growth and reduced hair shedding¹⁰.

Traction alopecia: Oral minoxidil can also be used to treat traction alopecia, a type of hair loss that occurs due to hairstyles that pull on the hair roots¹¹, although stopping the practices that lead to the traction is the primary treatment.

Hair loss due to chemotherapy: In some cases, minoxidil might be effective to help regrow hair after chemotherapy¹².

Although minoxidil works by helping extend the growth phase of the hair follicles, which can in turn promote hair growth, it usually takes several months of consistent use to see results, and it may not work for everyone¹³.

Advantages of using minoxidil for hair loss

There are some advantages of using oral minoxidil for hair growth and the precise optimal dose is the subject of ongoing research, and may vary according to patient factors such as severity of hair loss, other medical conditions and medications you may be taking. However potential advantages may include:

Affordable: Minoxidil tablets are only priced between $25 to $40 per 30 tablets, which is less expensive than topical formulations, especially when considering the long-term use. 

Effective: Studies suggest that oral minoxidil is at least as effective than topical minoxidil in promoting hair growth¹⁴.

Uniform hair growth: Oral administration ensures better absorption and since it is systemically absorbed, it promotes a much more even hair growth.

Convenient: Taking a tablet is often easier and less messy than applying a topical solution evenly throughout the entire head.

Combination therapy: oral minoxidil may be used in combination with other treatments, potentially enhancing the effectiveness of a hair loss treatment regimen.

Side-effects of using minoxidil at a low dose for hair growth

The most frequent adverse effect of taking a low dose of oral minoxidil for hair loss are: 

• Excessive hair growth in unwanted areas of the scalp and body
• Lightheadedness
• Fluid retention
• Increased heart rate 
• Headache
• Reduced blood pressure
• Swelling around the eyes
• Insomnia¹⁵

Additionally, keep in mind that you shouldn’t take minoxidil if it has expired or has been open for an extended period of time. Read all about minoxidil and its expiration date in our in-depth article reviewed by Dr. Anna Chacon → Does minoxidil expire and does it work after its expiration date?

So, how to get a prescription for minoxidil?

To get oral minoxidil for hair loss we can put you in touch with an independent online dermatologist. If oral minoxidil is suitable and safe for you, your assigned online dermatologist can write you a prescription after a short photo-based virtual consultation.

Article References:
https://www.sciencedirect.com/science/article/abs/pii/S0190962221004187
https://www.aad.org/dw/dw-insights-and-inquiries/archive/2022/low-dose-oral-minoxidil-alopecia
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649170
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9650732/
https://www.ncbi.nlm.nih.gov/books/NBK482378/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9650732/
https://pubmed.ncbi.nlm.nih.gov/3674909/
https://pubmed.ncbi.nlm.nih.gov/35244759/
https://www.medscape.com/viewarticle/986017
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691938/