Topical minoxidil is an FDA-approved treatment for male and female pattern hair loss, also known as androgenic alopecia (AGA).
Despite its popularity, not very many people continue using topical minoxidil for the long-run. In fact, one clinical study found that by the one-year mark, 95% of topical minoxidil users voluntarily quit applying the drug – with more than 2/3rds of them citing “low effect” as their rationale.https://pubmed.ncbi.nlm.nih.gov/17917938/
So, what sort of hair regrowth can we expect from minoxidil? Why do so many people quit using the topical? And what can we do to maximize minoxidil’s hair growth-promoting effects, and in doing so, set ourselves up for sustainable hair regrowth years into the future?
What Is Minoxidil?
Topical minoxidil is the only medication approved by the FDA for the treatment of androgenic alopecia (AGA) in both males and females. Since its use as an anti-hypertensive drug in 1979, researchers have long-noted a nearly universal “adverse event” in oral minoxidil users: unexpected new hair growth along the limbs, chest, face, and scalp.https://pubmed.ncbi.nlm.nih.gov/7030707/
This led to to the reformulation of minoxidil as a topical, and subsequent clinical trials to test its efficacy on treating AGA. In 1988 and 1992, 5% and 2% minoxidil became commercial available as an over-the-counter hair growth treatment for men and women, respectively.
How Does Minoxidil Work?
Researchers aren’t totally sure how minoxidil regrows hair.
Having said that, they suspect that minoxidil may work through at least one (or all) of the following mechanisms:
- Opening potassium ion channels – which increases blood, oxygen, and nutrient transport to balding regions (i.e., increased microcirculation)
- Modulation of prostaglandin analogues (i.e., decreased inflammation)
- Anti-androgenic activity in hair follicle sites (i.e., decreased dihydrotestosterone (DHT) – the hormone causally linked to baldness).
How Much Regrowth Should We Expect From Minoxidil?
For more information on these topics, see this article: Minoxidil: How Long Do Results Last (Even After Quitting)?
Rob English is a researcher, medical editor, and the founder of perfecthairhealth.com. He acts as a peer reviewer for scholarly journals and has published five peer-reviewed papers on androgenic alopecia. He writes regularly about the science behind hair loss (and hair growth). Feel free to browse his long-form articles and publications throughout this site.