Minoxidil: tablet or lotion?
The same medicine, taken two ways. How they compare on results, side effects and how you get them.
How long before you can judge it
One figure = one month.
- Lotion or foam6months
- Low-dose tablet6months
All options stay on the page. Choose one to bring it forward.
| — | Lotion or foam | Low-dose tablet |
|---|---|---|
| How you use it | On the thinning area of the scalp, once or twice a day. | One small tablet a day, at a dose a doctor sets. |
| How it works | Works where you put it. Little reaches the rest of the body. | The same medicine reaches the follicles through the blood, so it works on the whole body. |
| When you can judge it | A shed is possible in the first 8 weeks. Judge at 6 months. | Judge at about 6 months, as with lotion. |
| How sure we can be | Good: several large trials. Recommended for men and women by the 2017 European guideline, after decades of trials. | Some: smaller or fewer trials. Newer evidence. A 24-week trial in men found 5 mg no better than 5% lotion; larger trials are needed. |
| Common downsides | Itchy or flaky scalp, more often with 5%; stray hair where the product runs; a daily routine. | Unwanted hair on the face and body is common; rarely light-headedness, swollen ankles or a fast heartbeat. |
| Where you get it | Pharmacy, no prescription. | Prescription only. It is off-label: the tablets are licensed for blood pressure. |
| How you pay | Small monthly cost. | Tablets cost little; add doctor visits and check-ups. |
| Read the guide | Lotion or foam | Low-dose tablet |
Where this comes from
Numbered in the order the guide first cites them.
- 1
The 2017 European guideline recommends topical minoxidil for women and men and finasteride 1 mg for men, suggests low-level laser as an add-on, makes no recommendation on PRP, and advises judging results at 6 months. Its own expiry date was June 2020, and we found no newer version.
Kanti V, Messenger A, Dobos G, et al. (2017). S3 – European Dermatology Forum Guideline for the Treatment of Androgenetic Alopecia in Women and in Men. European Dermatology Forum, S3 guideline (literature to Oct 2015, expiry 06/2020)
- 2
In 393 men over 48 weeks, minoxidil 5% gave 45% more regrowth than 2%, with more scalp itching and irritation.
Olsen EA, Dunlap FE, Funicella T, et al. (2002). A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol 2002;47(3):377–385
- 3
Across trials in women, minoxidil nearly doubled the chance of moderate or marked regrowth compared with placebo, 2% and 5% did about the same, and finasteride 1 mg did no better than placebo.
van Zuuren EJ, Fedorowicz Z, Schoones J (2016). Interventions for female pattern hair loss. Cochrane Database Syst Rev 2016;(5):CD007628
- 4
In a 24-week trial in men, oral minoxidil 5 mg was not better than topical minoxidil 5%, and 49% of men on the tablet grew unwanted hair elsewhere on the body.
Penha MA, Miot HA, Kasprzak M, et al. (2024). Oral Minoxidil vs Topical Minoxidil for Male Androgenetic Alopecia: A Randomized Clinical Trial. JAMA Dermatol 2024;160(6):600–605
- 5
A review of 17 studies with 634 patients found oral minoxidil an effective, well-tolerated option for healthy people who struggle with topical minoxidil, but says larger randomised trials are needed.
Randolph M, Tosti A (2021). Oral minoxidil treatment for hair loss: A review of efficacy and safety. J Am Acad Dermatol 2021;84(3):737–746
- 6
In 1404 people taking low-dose minoxidil tablets for hair loss, the most common side effect was unwanted hair growth (15.1%); 1.7% stopped because of side effects such as light-headedness, fluid retention or a fast heartbeat. The study looked back at records and had no control group.
Vañó-Galván S, Pirmez R, Hermosa-Gelbard A, et al. (2021). Safety of low-dose oral minoxidil for hair loss: a multicenter study of 1404 patients. J Am Acad Dermatol 2021;84(6):1644–1651
- 7
Across 23 studies in men, dutasteride, finasteride 5 mg and topical minoxidil 5% added about 15 to 19 hairs/cm² over placebo at 24 weeks, but the evidence was rated low quality for several comparisons.
Gupta AK, Venkataraman M, Talukder M, et al. (2022). Relative Efficacy of Minoxidil and the 5-α Reductase Inhibitors in Androgenetic Alopecia Treatment of Male Patients: A Network Meta-analysis. JAMA Dermatol 2022;158(3):266–274