Does Minoxidil Cause Skin Aging?

Article Summary

Online discussions have raised alarms about a possible link between minoxidil and premature skin aging, especially among users reporting under-eye puffiness, dryness, and fine lines. Could a hair loss treatment really be affecting facial skin quality? This article takes a balanced look at the science and speculation. It explores the proposed biological mechanisms, like prostaglandin changes and collagen disruption, and considers alternative explanations such as allergic reactions or water retention. You can also find tips on how to prevent or mitigate potential skin-related side effects when using topical or oral minoxidil.

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What is Minoxidil?

Minoxidil was originally developed in the 1970s as an oral medication for the treatment of hypertension (high blood pressure). This was due to its key function as a vasodilator, widening the blood vessels and, in turn, increasing blood flow and reducing blood pressure. However, an unintended side effect quickly became apparent in nearly all use cases: excessive hair growth. 

Seeking to take advantage of this, minoxidil was re-formulated as a topical solution for the treatment of hair loss. After showing great efficacy in clinical trials of patients with androgenetic alopecia (AGA), topical minoxidil [5%] received FDA approval for the treatment of male pattern hair loss in 1988, with a lower dose of topical minoxidil [2%] later being approved for the treatment of female pattern hair loss. And, while it is not technically an FDA-approved treatment, oral minoxidil is also used off-label to treat hair loss.^[1]Suchonwanit, P., Thammarucha, S., & Leerunyakul, K. (2019). Minoxidil and its use in hair disorders: a review. Drug design, development and therapy. 2777-2786. Available at: … Continue reading

Given that this application of minoxidil was first identified as an unintended side effect, it is unsurprising that the use of both topical and oral minoxidil can lead to other unwanted effects. In a previous article, we discussed the most common and widely recognized side effects of minoxidil use. Here, however, we will explore a potential side effect that has been reported by some minoxidil users: accelerated skin aging.

Is it possible that minoxidil can accelerate skin aging? In this article, we’ll review the current landscape of research and dive into the anecdotes, the biological mechanisms, alternative explanations, and where we currently stand on this topic.

What is Skin Aging?

Skin aging is a multifactorial biological process that is mediated by intrinsic (genetically determined) and extrinsic (environmental) factors. Natural, intrinsic aging occurs over a long time, with a gradual decrease in skin structure and function leading to the formation of fine lines, wrinkles, thinning, dryness, and reduced elasticity. This is compounded by the extrinsic factors, such as ultraviolet radiation and pollution, which can cause wrinkles that are more coarse, more severe loss of elasticity, and pigmentation disorders.^[2]Shin, S. H., Lee, Y. H., Rho, N. K., & Park, K. Y. (2023). Skin aging from mechanisms to interventions: focusing on dermal aging. Frontiers in physiology. 14. 1195272. Available at: … Continue reading

There are several key mechanisms that underlie these factors, including:

• Oxidative stress: the accumulation of reactive oxygen species leads to oxidative stress, which subsequently causes damage to the DNA, proteins, and lipids that are found in the skin.^[3]Rinnerthaler, M., Bischof, J., Streubel, M. K., Trost, A., & Richter, K. (2015). Oxidative stress in aging human skin. Biomolecules. 5(2). 545-589. Available at: … Continue reading
• Cellular senescence: aged cells of the skin enter a permanent state of arrest whereby they no longer divide, impairing the ability of the skin to repair and regenerate. Moreover, senescent cells release harmful factors (senescence-associated secretory phenotype) that can disrupt the homeostasis of the skin and promote inflammation.^[4]Chin, T., Lee, X. E., Ng, P. Y., Lee, Y., & Dreesen, O. (2023). The role of cellular senescence in skin aging and age-related skin pathologies. Frontiers in physiology. 14. 1297637. Available at: … Continue reading
• Altered collagen homeostasis: with age, collagen production (primarily type I collagen) decreases in the skin. This compromises the structural integrity of the skin, reducing its elasticity and firmness and leading to the appearance of wrinkles.^[5]He, X., Gao, X., & Xie, W. (2023). Research progress in skin aging, metabolism, and related products. International journal of molecular sciences. 24(21). 15930. Available at: … Continue reading

As stated, intrinsic factors and genetics means that these mechanisms will naturally cause skin health to deteriorate as we get older. However, we also know that certain environmental factors can accelerate the aging process by promoting the activity of the described mechanisms. It is therefore possible that a therapy that acts upon these mechanisms could influence the aging process.

Is There a Link Between Minoxidil and Skin Aging?

On reddit, some people using topical minoxidil have reported what sounds like accelerated aging: that their under-eye bags worsened and that their facial skin seemed drier and less smooth than before. Others have documented these changes with before-and-after photos taken just 1-2 months after starting the topical medication. Similar anecdotes have been reported by some users of oral minoxidil. This has led to claims that minoxidil use may accelerate skin aging.

But do these anecdotes make sense biologically? And are these reports truly suggestive of faster skin aging, or is something else going on?

Let’s take a look at what the scientific evidence says.

Could Minoxidil Accelerate Skin Aging?

There is a lack of understanding regarding the specific underlying mechanism by which minoxidil promotes hair growth. Indeed, several different mechanisms have been suggested, and it is believed that more than one may be responsible for mediating the effects of minoxidil. In the context of aging skin, one of these mechanisms is particularly interesting: the minoxidil-induced increase in prostaglandin E2 (PGE2) production.

Back in 1997, researchers discovered that minoxidil significantly increased the production of PGE2 in murine fibroblast cells in vitro. Moreover, they showed that minoxidil also increased the production of PGE2 in human dermal papilla fibroblasts, cells that sit within the base of the hair follicle and play an important role in maintaining hair health.^[6]Michelet, J. F., Commo, S., Billoni, N., Mahé, Y. F., & Bernard, B. A. (1997). Activation of cytoprotective prostaglandin synthase-1 by minoxidil as a possible explanation for its hair … Continue reading Later, in mice, it was also demonstrated that the topical application of PGE2 exhibited some, albeit limited, ability to promote hair growth. ^[7]Sasaki, S., Hozumi, Y., & Kondo, S. (2005). Influence of prostaglandin F2α and its analogues on hair regrowth and follicular melanogenesis in a murine model. Experimental dermatology. 14(5). … Continue reading

So PGE2 may be part of a mechanism that minoxidil uses to promote hair growth, but what does that have to do with skin aging?

One study found that PGE2 levels in the skin increase with age, with fibroblasts being the main source of increased production. When the same researchers cultured fibroblasts with PGE2 in vitro, they also demonstrated that PGE2 treatment causes a reduction in the expression of type I procollagen.^[9]Li, Y., Lei, D., Swindell, W.R., Xia, W., Weng, S., Fu, J., Worthen, C.A., Okubo, T., Johnston, A., Gudjonsson, J.E. and Voorhees, J.J. 2015. Age-associated increase in skin fibroblast–derived … Continue reading 

Additional studies have provided further evidence that PGE2 impairs collagen homeostasis within the skin. In cultured human dermal fibroblasts, it was shown that treatment with PGE2 significantly decreased collagen type I levels, which may have been driven by the significant increase in matrix metallopeptidase 1 (MMP1) levels.^[11]Shim, J. H. (2019). Prostaglandin E2 induces skin aging via E-prostanoid 1 in normal human dermal fibroblasts. International Journal of Molecular Sciences, 20(22), 5555. Available at: … Continue reading Thus, there exists a wealth of evidence which suggests that PGE2 plays a role in the aging of skin by impairing collagen homeostasis.

Does Minoxidil Really Accelerate Skin Aging?

Given that minoxidil has been shown to increase PGE2, and that PGE2 is associated with aging skin, does this mean that minoxidil use leads to accelerated aging of the skin?

Not necessarily.

Firstly, and most crucially, there are currently no studies that have shown a direct link between the use of minoxidil and accelerated skin aging. Until such research is conducted, it is not possible to draw an accurate conclusion.

Now, in general, with safety concerns — it’s usually important to emphasize that the absence of evidence does not mean evidence against a concept. For instance, just because we don’t have a randomized, controlled clinical study determining the likelihood of death from jumping out of an airplane without a parachute, the risk here is inherently obvious: we don’t need a study to prove death is likely. We can just look at surrogate data on max velocity, the heights of falls, and the human capacity to endure such a violent impact. And then we can presume death is the most likely outcome.

So, can we use surrogate data on minoxidil — such as these in vitro studies — and then can we associate these to skin thinning, pair those with the anecdotal reports from Reddit, and presume that topical minoxidil is accelerating skin aging in some people, regardless of what the clinical studies say?

You could. But given that this side effect wasn’t picked up in any of the large, randomized, controlled clinical trials on minoxidil prior to these internet posts, our opinion is that we should exercise extreme caution in coming to this conclusion. Why? Because beyond the absence of clinical data on minoxidil doing this in well-designed studies, there are also two side effects of minoxidil application that might be fully-to-blame for why some think minoxidil use accelerates skin aging. And encouragingly, these side effects aren’t permanent:

• Water retention
• Allergic dermatitis (skin dryness)

We’ll take these one-by-one.

Minoxidil & water retention

Minoxidil is able to function as a vasodilator by opening potassium channels, thus relaxing the vascular smooth muscle and lowering blood pressure. However, this modification of potassium channels also increases sodium reabsorption by the kidneys which, in turn, leads to greater retention of water by the body.^[12]Sica, D. A. (2004). Minoxidil: an underused vasodilator for resistant or severe hypertension. The Journal of Clinical Hypertension. 6(5). 283-287. Available at: … Continue reading 

Water retention can lead to edema (swelling) and, although this is typically seen in peripheral regions such as the feet, use of oral minoxidil (even at low doses) has been found to cause facial edema in up to 1% of use cases.^[13]Sanabria, B., de Nardo Vanzela, T., Miot, H. A., & Ramos, P. M. (2021). Adverse effects of low-dose oral minoxidil for androgenetic alopecia in 435 patients. Journal of the American Academy of … Continue reading Indeed, a recent study demonstrated a dose-dependent relationship between oral minoxidil and the incidence of edema.^[14]Salas, J., Esse, I., Kincaid, C. M., Birda, A., Choe, S., & Mesinkovska, N. A. (2025). Characterizing low-dose oral minoxidil-induced peripheral edema in alopecia patients. Journal of the … Continue reading Some users of topical minoxidil have also reported swelling around the face after use, particularly in the region surrounding their eyes.

A consequence of facial edema is a more plump appearance of the face and potentially sagging of the skin, which can also accentuate under-eye bags and make it appear as though someone is less rested than they actually are. These symptoms mimic those of aging skin and they can make it seem like minoxidil is accelerating the aging process. However, the same studies that observed the cases of facial edema also noted that the swelling typically resolved within two weeks of stopping treatment, so it is unlikely that these effects are truly reflective of accelerated skin aging.

Minoxidil & skin dryness (allergic dermatitis)

Another side effect of minoxidil use, particularly when it is applied topically, is allergic dermatitis. At the site of application, symptoms of allergic dermatitis such as itching, redness, and scaling, were observed in 5.7% of topical minoxidil [5%] users.^[15]Friedman, E. S., Friedman, P. M., Cohen, D. E., & Washenik, K. (2002). Allergic contact dermatitis to topical minoxidil solution: etiology and treatment. Journal of the American Academy of … Continue reading 

It was initially believed that the majority of allergic dermatitis incidences were caused by the carrier, not by the minoxidil. A 2002 study used patch testing to demonstrate that 81.8% of patients reacted to propylene glycol, which is a solvent that is used to improve the delivery of minoxidil. This was compared to just 36.4% of patients being allergic to minoxidil itself, and an even lower 9.1% showing a reaction to the alternative carrier butylene glycol.^[17]Friedman, E. S., Friedman, P. M., Cohen, D. E., & Washenik, K. (2002). Allergic contact dermatitis to topical minoxidil solution: etiology and treatment. Journal of the American Academy of … Continue reading However, more recent studies have started to challenge this theory. By reviewing 21 studies that investigated allergic dermatitis from minoxidil use, a 2025 study found that minoxidil is the predominant allergen, followed by propylene glycol.^[18]Junge, A., Radonjic-Hoesli, S., Bossart, S., Simon, D., De Viragh, P., Hunger, R.E., Heidemeyer, K. and Jafari, S.M.S., 2025. Contact Dermatitis Caused by Topical Minoxidil: Allergy or Just … Continue reading

Whether the allergen is minoxidil, propylene glycol, or another ingredient, it is clear that topical minoxidil has the potential to cause allergic dermatitis. Of course, the relevance of this is that the symptoms associated with allergic dermatitis may mimic signs of aging skin, once again leading users to believe that minoxidil is causing accelerated skin aging. However, as observed with water retention, it has been shown that the symptoms of contact dermatitis stop after ceasing minoxidil use.^[19]Pasricha, J. S., Nanda, A., & Bajaj, N. (1991). Contact dermatitis due to minoxidil. Indian Journal of Dermatology, Venereology and Leprology. 57. 235. Available at: … Continue reading 

Together, these effects are probably more likely to explain the skin quality-topical minoxidil connection than true accelerated skin aging. Otherwise, the results would sustain even after quitting the medication, but there is no scientific or anecdotal evidence of this.

What Can Be Done To Prevent These Effects?

How can one avoid potential skin-related minoxidil side effects? There are several options at your disposal:

1. If you are getting allergic dermatitis, it may be useful to determine which ingredient(s) in the minoxidil are driving that reaction. There are many alternative carrier ingredients available for topical minoxidil, and switching to a different brand of minoxidil (which uses different ingredients) may prevent these symptoms from emerging.
2. Switching to oral minoxidil may be another option for anyone struggling with allergic dermatitis from topical minoxidil. To date, there is no scientific evidence that the systemic effects of oral minoxidil can cause allergic dermatitis. However, if you do make the switch, be aware that oral minoxidil is linked to increased water retention in a small number of people.
3. Allow topical minoxidil to dry fully before going to bed. Some people apply topical minoxidil and then immediately go to bed – thereby pressing their heads against their pillow before letting the topical minoxidil fully dry. If this is you, you might be creating a situation whereby any undried topical minoxidil can spread to the pillow and, therefore, the face (when you move around throughout the night). This increased spread may lead to increased risk of allergic dermatitis and water retention in areas of the face where topical minoxidil is not applied, nor is supposed to reach. So, let the topical minoxidil fully dry and wait at least 20-30 minutes after an application before putting your head down at night.

Final Thoughts

There is some anecdotal evidence which suggests that the use of minoxidil causes accelerated aging of the skin. Although minoxidil does drive increased production of PGE2, which is associated with reduced collagen production in the skin, there is no direct scientific evidence that has proven a link between the use of minoxidil and skin aging. Furthermore, two side effects of minoxidil use – increased water retention and allergic dermatitis – produce symptoms that mimic those of aging skin. Therefore, it is possible that temporary side effects of minoxidil use, the effects of which reverse after stopping treatment, are simply being mistaken for accelerated skin aging. Based on this, it is unlikely (though not impossible) that there is a link between minoxidil and skin aging.