There’s a moment every woman secretly dreads: watching more strands gather in the shower drain than you care to admit. Sometimes, it can start as a trickle—occasional hair fall that can be explained away by stress or seasonal change. But sometimes, hair loss is more than that. That’s where a discreet little pill—oral minoxidil—may be able to help.
“Oral minoxidil is a prescription heart medication used off-label in low doses to treat hair loss,” says dermatologist Ritu Saini, MD. “The way it works is by dilating blood vessels, thereby allowing nutrients better access to the hair follicles and stimulating growth factors. It is also thought to have an anti-androgen effect, meaning it can reduce the conversion of testosterone to dihydrotestosterone, which has been connected to both male and female pattern hair loss.”
More and more dermatologists are writing prescriptions for low-dose oral minoxidil to restore hair loss and hair growth. Because it’s taken as a pill, it works from within, giving hair follicles a steadier boost. Dr. Saini says she suggests the topical or oral route depending on how advanced a patient’s hair loss is. “If it is more about the prevention or early stages of hair thinning, I will often start with the topical version of minoxidil. However, if the patient is motivated for more aggressive treatment, I will discuss the risks and benefits and can consider the oral version.”
And there are a few risks: With oral minoxidil, you may notice unwanted hair growth in other areas of your body, dizziness or lightheadedness (this is a blood pressure medication, after all), and a more dreaded side effect, an initial period of increased hair shedding. On the other hand, topical minoxidil is incredibly toxic to cats and dogs, and even licking it could cause them great harm, which makes the oral version a more popular choice a lot of the time.
If you start taking oral minoxidil, it can take up to six months to see results. “Both topical and oral minoxidil are effective,” Dr. Saini adds. “However, many patients feel the pill is easier to take and are thus more compliant.”
A 2024 double-blind, placebo-controlled randomized clinical trial on men comparing 5 mg oral versus twice-a-day 5% topical found the versions equally effective when it came to hair growth, but complaints about the side effects listed above for those who took the pill version. Earlier this year, it was found that when oral minoxidil was combined with finasteride (another hair loss drug), there is a 92% increase in hair growth; so if you’re looking to go the oral route, maybe two drugs are better than one.
Hair loss can be a debilitating experience, regardless of how you choose to deal with it. But you do have science-backed options.