Oral Minoxidil: Before and After Photos [2025]

Article Summary

Oral minoxidil is emerging as a popular off-label treatment for hair loss, offering an option for those who can’t use or don’t respond to topical formulas. While some achieve dramatic regrowth, most see more modest improvements. Discover why results vary, how to interpret before-and-after photos realistically, and what evidence-based strategies can help maximize outcomes.

Full Article

Oral minoxidil has become a widely used off-label option for androgenic alopecia (AGA) in men and women, despite initially being approved only as an antihypertensive medication decades ago.

Oral minoxidil is increasingly offered to address specific unmet needs in AGA treatment: 

• Topical non-responders: Some people don’t see satisfactory results with topical minoxidil, possibly due to inadequate absorption, variations in scalp skin properties, or genetic factors affecting drug metabolism.
• Scalp sensitivity/irritation: Topical minoxidil can cause local side effects such as itching, flaking, or dermatitis due to the vehicle (especially propylene glycol) or the active ingredient itself. Switching to oral minoxidil bypasses these local reactions.
• Simpler routines/adherence: Oral dosing eliminates the need for daily topical application, which can be messy, time-consuming, or interfere with hair styling. For some, this leads to better long-term adherence and quality of life.

Regrowth with oral minoxidil can be variable, however. This variability mainly stems from biological differences between patients. Because minoxidil is a prodrug that requires conversion by the enzyme sulfotransferase (SULT1A1) into its active form, individual variation in enzyme activity strongly influences response.^[1]Ramos, P.M., Goren, A., Sinclair, R., Miot, H.A. (2020). Oral minoxidil bio-activation by hair follicle outer root sheath cell sulfotransferase enzymes predicts clinical efficacy in female pattern … Continue reading  

Interested in Oral Minoxidil?

Low-dose oral minoxidil available, if prescribed*

Take the next step in your hair regrowth journey. Get started today with a provider who can prescribe a topical solution tailored for you.

Click Here For 15% Off

*Only available in the U.S. Prescriptions not guaranteed. Restrictions apply. Off-label products are not endorsed by the FDA.

Unfortunately, what most people see online are extremely successful oral minoxidil before and after photos (which you’ll see below), which can lead people to believe that they will experience more regrowth than they actually might.

In this article, we will explore what the likely (not just possible) results are and what the clinical trials show.

But first, let’s have a quick refresher on what oral minoxidil is.

What is Oral Minoxidil?

Oral minoxidil is a tablet medication originally developed as a vasodilator for severe hypertension, but now increasingly used off-label at low doses to treat AGA and other hair loss conditions. It enhances scalp flow and prolongs the growth phase (anagen) of hair follicles, primarily by increasing prostaglandin E2 and vascular endothelial growth factor (VEGF). 

Oral minoxidil acts by opening ATP-sensitive potassium channels in vascular smooth muscle, which increases perifollicular blood flow. It also prolongs the anagen phase of the hair cycle. Unlike topical minoxidil, which requires local sulfotransferase enzyme activity in the scalp for conversion to its active form, oral minoxidil is metabolized systemically via hepatic sulfotransferase, potentially bypassing poor scalp enzyme activity in some individuals.^[2]Kaiser, M., Abdin, R., Gaumond, S.I., Issa, N.T., Jiminez, J.J. (2023). Treatment of Androgenetic Alopecia: Current Guidance and Unmet Needs. Clinical, Cosmetic and Investigational Dermatology. 16. … Continue reading 

For hair loss, oral minoxidil is prescribed at significantly reduced dosages compared to antihypertensive therapy – typically:

• 0.25 mg – 1.25 mg for women
• 2.5 mg – 5 mg for men
• Adverse effects are much less frequent at these low doses but may include hypertrichosis (excess unwanted body hair), fluid retention, and, rarely, cardiovascular effects.^[3]Bloch, L.D., Carlos, R.M.D. (2024). Side Effects’ Frequency Assessment of Low Dose Oral Minoxidil in Male Androgenetic Alopecia Patients. Skin Appendage Disorders. 11(1). 14-18. Available at: … Continue reading 

While oral minoxidil is not FDA-approved for hair loss, a number of studies show its efficacy. 

The Evidence

You can see a complete table of oral minoxidil studies here, but we have picked a few to show.

Study One – AGA (Female)

Vahabi-Amlashi et al (2021) conducted a triple-blind, randomized clinical trial in 72 women with female pattern hair loss, comparing oral minoxidil 0.25 mg daily to 2% topical minoxidil twice daily over 36 weeks.^[4]Vahabi-Amlashi, S., Layegh, P., Kiafar, B., Hoseininezhad, M., Abbaspour, M., Khaniki, S.H., Forouzanfar, M., Sabeti, V. (2021). A randomized clinical trial on the therapeutic effects of 0.25 mg oral … Continue reading 

• Measured outcomes included hair shedding, Sinclair scores by three independent evaluators, trichoscopy assessments of hair density and diameter, and safety labs (liver, kidney, electrolytes).
• Both groups showed significant improvement in hair diameter and density:
  • Group 1 (oral): 13% improvement in hair density.
  • Group 2 (topical): 6% improvement in hair density.
• Sinclair and shedding scores decreased significantly in both groups by the end of the study.
• There was no significant difference between groups in any measured endpoint. 
• Oral minoxidil showed slightly better improvement in hair density; topical minoxidil showed slightly better improvement in hair diameter.
• Adverse events:
  • Group 1 (oral): hirsutism (7.7%), gastrointestinal intolerance (7.7%), weight gain (3.8%), hypotension (3.8%), leading to withdrawal.
  • Group 2 (topical): hirsutism (8%).

Study Two – AGA (Male)

Panchaprateep and Lueangarun (2020) conducted an open-label, prospective single-arm study in 30 men with AGA, treated with 5 mg oral minoxidil once daily for 24 weeks.^[5]Panchaprateep, R., Lueangarun, S. (2020). Efficacy and Safety of Oral Minoxidil 5 mg Once Daily in the Treatment of Male Patients with Androgenetic Alopecia: An Open-Label and Global Photographic … Continue reading

• Statistically significant increase in total hair count at 24 weeks (+35.1±18.9 hairs/cm2; p=0.003).
• Hair diameter improved by 15.2% from baseline (p<0.001).
• Global photographic assessment: 43% of patients achieved an “excellent improvement” score by study end.
• High rate of hypertrichosis (93.3% at 24 weeks); pedal edema was reported in 3 patients, resolving after 2-3 months in all cases.
• No serious cardiovascular side effects were observed.

Study Three – AGA and TE (Male and Female)

Feaster et al. (2023) performed a multicenter retrospective study in 210 patients (50 men, 160 women) with AGA and/or telogen effluvium (TE), comparing low-dose oral minoxidil (0.625 – 2.5 mg daily) to a control (no minoxidil or other non-minoxidil treatments) over 52 weeks.^[6]Feaster, B., Onamusi, T., Cooley, J.E., McMichael, A.J. (2023). Oral minoxidil use in androgenetic alopecia and telogen effluvium. Archives of Dermatological Research. 315(2). 201-205. Available at: … Continue reading 

• Group 1 (oral minoxidil): 52.4% of patients showed clinical improvement in hair growth; 41.9% had hair loss stabilization; 5.7% experienced worsening.
• These results were significantly better than the control group (p=0.001). 
• The mean duration of oral minoxidil use was 25.1 months (range 12-54); the most common dose was 1.25 mg daily.
• Adverse effects were uncommon (9.5% of patients), generally mild, and included:
  • Hypertrichosis (4.8%)
  • Edema (1.9%)
  • Hair shedding (1%)
  • Lower extremity cramping (1%)
  • Palpitations (1%)
  • Scalp dysesthesia (1%)
• There were no serious side effects or study withdrawals due to adverse events in the analyzed population.

Overall, these studies demonstrate that oral minoxidil is an effective and generally well-tolerated treatment option for both AGA and TE in men and women. Across the studies, clinical improvements were observed, with similar efficacy to topical minoxidil.

However, the results that people show online are usually more dramatic than what is seen in clinical studies. 

What’s Possible ≠ What’s Probable

When reviewing outcomes, such as oral minoxidil before and after photos, it’s essential to distinguish what can happen from what is likely to happen. Take a look at the example we have created below. The scattered data points represent the full spectrum of possible individual results, while the central trendline shows the average, reflecting the most common or expected response.

These anecdotes (arrows on the graphs) often highlight “hyper-responders”. These are individuals who experience notably dramatic hair regrowth. They may have higher SULT1A1 activity, leading to higher levels of minoxidil activation.

These accounts, although genuine, illustrate results that surpass what most people can achieve. Problems can then arise when people fixate on these exceptional outcomes and assume that their experience will be similar. If their own hair growth is slower or less impressive, they might discontinue treatment early, or wrongly conclude that it isn’t working.

Impressive results are more frequently shared than modest improvements as a result of survivorship bias. This bias happens when only the most impressive successes receive attention, while the many cases with typical or less remarkable outcomes are overlooked or not reported.

Survivorship bias can distort our understanding of how hair loss treatments perform. Online narratives often draw attention to the most extreme cases, either astonishing successes or clear failures, while the more typical moderate outcomes that most people experience are rarely seen or discussed.

Now that we have covered the clinical evidence, strategies, and reasonable expectations for oral minoxidil, let’s now look into 10 firsthand accounts of oral minoxidil before and after photos shared by real users on Reddit.

Oral Minoxidil Success Stories

Keep in mind that the experiences below are purely anecdotal in nature and are not subject to any independent verification. They strictly reflect the individual journeys of each poster and should not be construed as reliable clinical evidence or medical advice.

Case 1: Male (29), Oral minoxidil monotherapy (11 months, 5 mg nightly)

This Redditor began oral minoxidil monotherapy at a dose of 2.5 mg before increasing to 5 mg once nightly. He had switched from topical minoxidil after a year of subpar results. He experienced shedding in the early months of therapy, with visible regrowth by month 3, and a major improvement in hair density by 11 months. Overall, the patient was satisfied with thicker scalp coverage, a fuller beard and brows, and did not report any significant side effects.

Case 2: Male (26), finasteride and oral minoxidil (2 years total; 1 mg finasteride and 2.5 mg oral minoxidil daily)

This 26-year-old used a combination of 1 mg finasteride and 2.5 mg oral minoxidil once daily, having switched from topical to oral minoxidil one year into treatment. He reported notable improvement one year into therapy, with visible regrowth by the 4-month mark. He did not report any shedding or other side effects after switching from topical to oral formulations. After two years of treatment, the patient reported marked hair thickening and cosmetic improvement.

Case 3: Female, oral minoxidil monotherapy (2 years; 2.5 mg daily, titrated up from 1.25 mg)

This user reported one her progress with oral minoxidil monotherapy over 2 years. She started at a daily dose of 1.25 mg, before increasing to 2.5 mg. She had tried vitamins, spironolactone, oils, and Nioxin/Nizoral without benefit for one year prior. Shedding started shortly after beginning the protocol and normalized by the fourth month. She reported visible improvement within one year, and by the end of the second year, she had notable improvement in ponytail thickness and part density. She also reported that her hair looked and felt close to pre-loss baseline. The user did not report any significant side effects.

Case 4: Female (24), Oral and topical minoxidil (9 months topical 5% foam; 6 months oral 0.625 – 1.25 mg nightly)

This 24-year-old began minoxidil monotherapy with 5% foam nightly, before adding oral minoxidil 0.625 mg three months later, and titrating to 1.25 mg nightly the following month. She continued both nightly for six months. She did not note any noticeable shedding on the foam, nor after incorporating 0.625 mg orally. She reported steady baby hairs and a reduction in hair loss at ~6-9 months alongside thickening compared to the baseline, and mentioned that her hair felt and looked much closer to its pre-loss condition overall. She also reported faster growth of facial/body hair (hypertrichosis), water retention, and bloating after salt meals, and occasional stronger heartbeat at night, after incorporating oral minoxidil, though this last symptom did resolve.

Case 5: Male, oral minoxidil (6 weeks shown; 5 mg daily) and weekly microneedling

This male Redditor used oral minoxidil 5 mg once daily in addition to microneedling once weekly with a pen device. The poster also noted no side effects from finasteride, implying that they might have used it alongside the other treatments. He reported an initial shedding phase at around week 3 and rapid visible coverage by week 6 into treatment. In commenting on the progress to date, he noted fuller coverage compared to baseline and said his beard was slightly thicker without any apparent increase in body hair. He did not report any side effects.

Case 6: Female, oral minoxidil + spironolactone (1 year; 1.25 mg oral minoxidil daily, 50 mg spironolactone daily)

The poster took oral minoxidil 1.25 mg once daily, in addition to spironolactone 50 mg once daily (started at 100 mg but reduced the dose due to drowsiness). She noted visible improvement after about 5 months of consistent use, with shedding slowing markedly around weeks 7-8. At the one-year mark, she reported noticeably fuller hair at the part and temples, with ongoing gradual thickening, and “good hair days”. She reported increased body and facial hair from oral minoxidil, which she managed by waxing, and did not report any noticeable weight gain or low-blood-pressure symptoms. 

Case 7: Female, oral minoxidil monotherapy (6 months; 1.25 mg daily, titrated from 0.625 mg)

This female Redditor took oral minoxidil 1.25 mg once daily for six months, having started from the initial dose of 0.625 mg. She supplemented with vitamin B12 injections every two weeks for pernicious anemia, daily shampooing, higher protein intake, and therapy/stress management. She reported steady improvement in hair through month 6, despite a brief “dread shed” in the initial month. Unfortunately, the images don’t show the same hair pulled back, so we can’t see exactly how much improvement was gained. She did report increased facial hair, which she has been managing by shaving/dermaplaning.

Case 8: Female, oral minoxidil monotherapy (1 year; 1.25 mg daily)

This user took oral minoxidil 1.25 mg once daily for one year. She also used Nizoral shampoo on the same timeline. Her hair loss was first diagnosed as telogen effluvium that did not resolve, and she now suspects AGA. She reported modest shedding in the first 2 months, then gradual thickening over the year. The photos showed some improvement, but the patient stated that she is not fully back to baseline. Regarding side effects, she noted increased body hair growth and mild dizziness in the first month that resolved.

Case 9: Male, self-made oral minoxidil (3 months; ingested diluted topical solution)

This male Redditor switched from applying topical minoxidil to drinking a diluted solution mixed with water. He reported taking “a few drops” per dose, having discontinued application of the topical preparation to the scalp. At the three-month mark, the Redditor reported clearly greater overall density and said results were still improving. He did not report any side effects, except for some extra body hair. 

We should mention that we do not recommend ingesting topical minoxidil – if oral therapy is pursued, it is advised to use a prescribed oral dose under medical supervision to control dosing and avoid health risks.

Case 10: Female, oral minoxidil monotherapy (12 months; dose not reported)

This user reported taking oral minoxidil at an unspecified dose for about one year. The photos show modest improvements around the parting. The poster did not report any side effects. Notwithstanding the sparse information provided by this Redditor, multiple commenters observed hair thickening and density gains in the before-and-after photos.

Strategies to Optimize Oral Minoxidil Response

To maximize the benefits of oral minoxidil, consistent use and patience are essential as optimal regrowth often takes 6-8 months to fully manifest. Combining oral minoxidil with other treatments like finasteride or dutasteride, platelet-rich plasma (PRP), or low-level laser therapy (LLLT) can improve results for those who do not respond sufficiently to minoxidil alone. Recent studies support the efficacy of combination regimens, particularly oral minoxidil plus finasteride, with one retrospective study finding significant and clinically meaningful improvements.^[7]Johnson, H., Huang, D., Clift, A.K., Bersch-Ferreira, A., Guimaraes, G.A. (2025). Effectiveness of Combined Oral Minoxidil and Finasteride in Male Androgenetic Alopecia: A Retrospective Service … Continue reading 

People using oral minoxidil, especially at 2.5 mg or more and in combination with other treatments, should keep an eye on potential side effects. This can help catch rare but potentially serious side effects like edema or changes in blood pressure. Regular follow-ups can ensure that any adverse effects are detected early and that the regimen can be safely adjusted to maintain a balance between safety and efficacy. This patient-tailored management increases the likelihood of achieving the best possible outcomes while minimizing health risks.

Probable Regrowth Timeline

Based on the available evidence, the expected regrowth timeline for oral minoxidil is around 8 months.

Months 0-3: Possible increased shedding; no visible gains

• Temporary shedding can occur as follicles transition into a new growth cycle.
• This process often resolves within the first 4-8 weeks and is seen as an early sign that the treatment is starting to take effect.

Months 3-6: First positive density changes for many

• Early visible improvements, such as reduced shedding and appearance of fine new hairs, can be expected.
• Thicker, darker regrowth starts to become apparent for most users during this period.

Months 6-8: Maximal visible benefits

• Cosmetic changes peak, with stronger hair, increased density, and the greatest coverage observed. 
• This is the period of maximum regrowth for most individuals. 

Months 8-12+

• Further gains plateau.
• Continued daily use is needed to maintain improvements.
• Some might consider combination treatment at this point to increase growth outcomes.

Safety and Side Effects

While oral minoxidil can avoid local irritation occurring with the topical formulation, some safety concerns do remain.

Oral minoxidil use does carry a risk of cardiovascular issues like pericardial effusion, especially at the high doses used for blood pressure control. At hair loss doses (0.25 – 5 mg), such events are rare and tend to be individual rather than predictable. 

The majority of side effects, such as excess body hair, mild ankle swelling, lightheadedness, or palpitations, are mild and usually resolve with dose adjustments or stopping the medication. 

Large safety studies have shown that serious side effects are exceedingly rare in otherwise healthy individuals taking low-dose oral minoxidil, with only a small percentage discontinuing treatment due to adverse effects. 

A gradual dose escalation is recommended to minimize side effects with oral minoxidil. Recent studies have shown that a 2.5 mg daily dose is as effective as 5 mg for treating male pattern hair loss, but with a better safety profile, and this supports 2.5 mg as a preferred starting dose for men.^[9]Fonseca, L.P.C., Miot, H.A., Chaves, C.R.P., Ramos, P.M. (2025). Oral Minoxidil 2.5 mg vs 5 mg for Male Androgenetic Alopecia: A Double-Blind Randomized Clinical Trial. Journal of the American … Continue reading 

If you want to use a higher dose, sublingual minoxidil may be beneficial for reducing the risk of cardiovascular side effects.^[10]Gupta, A.K., Bamimore, M.A., Williams, G., Talukder, M. (2025). Comparative Efficacy of Minoxidil and 5-Alpha Reductase Inhibitors Monotherapy for Male Pattern Hair Loss: Network Meta-Analysis Study … Continue reading 

Practical Takeaways

• Oral minoxidil is an effective and generally well-tolerated alternative for people who cannot use topical minoxidil or do not respond to it.
• Clinical trial results typically show stabilization or modest regrowth. Hyper-responder cases seen online are possible but not common. 
• Careful dose selection (0.25 – 2.5 mg daily) minimizes side effects while maintaining efficacy.
• Consistent, long-term use is key; optimal results generally take 6-8 months to appear and require ongoing treatment to maintain gains.
• Combining oral minoxidil with other therapies such as finasteride, dutasteride, PRP, or LLLT may improve outcomes for partial responders.

Final Thoughts

Oral minoxidil use is growing, but should be recognized as an off-label option (albeit backed by a solid body of emerging evidence.. Most users can expect stabilization or noticeable yet modest regrowth rather than dramatic transformation. The best outcomes come with realistic expectations, consistent use over several months, and regular medical supervision to ensure safety. By focusing on average, evidence-based results rather than rare hyper-responder anecdotes, patients can make balanced decisions and maintain long-term adherence to their treatment plan.