Minoxidil works. Clinical trials show it produces visible hair regrowth in 40 to 60% of men with male pattern hair loss when used consistently at the 5% concentration. It is FDA-approved, available over the counter, and remains one of only two medications with strong evidence for treating androgenetic alopecia.
This article is for informational purposes only and does not constitute medical advice.
What the Clinical Evidence Shows
Minoxidil has been studied more extensively than almost any other hair loss treatment. Originally developed as a blood pressure medication, its hair growth side effect was documented in the 1970s and led to FDA approval for topical use in 1988.
Key Clinical Findings
Large-scale trials involving thousands of participants have established these response rates for topical minoxidil 5% applied twice daily:
- 40 to 60% of men show visible regrowth (increased hair count and density)
- An additional 20 to 30% experience slowed hair loss without visible regrowth
- 10 to 20% show no measurable response
- Crown and vertex respond better than the frontal hairline
- Results peak at 12 months of continuous use
The 5% solution consistently outperforms the 2% solution. Men using 5% minoxidil see roughly 45% more hair regrowth compared to the 2% formulation.
Oral Minoxidil Evidence
Low-dose oral minoxidil (2.5 to 5mg daily) has gained significant clinical attention as an alternative to topical application. Multiple studies show stronger regrowth with the oral form, likely because systemic delivery provides more consistent follicle exposure than topical application.
Oral minoxidil requires a prescription and medical monitoring. The convenience factor is significant: one daily pill versus applying liquid or foam to your scalp twice per day. For pricing details on both forms, check the minoxidil cost guide.
How Minoxidil Works
Minoxidil promotes hair growth through two primary mechanisms.
Vasodilation and Blood Flow
Minoxidil opens potassium channels in blood vessel walls, increasing blood flow to hair follicles. This enhanced circulation delivers more oxygen and nutrients to follicles that are miniaturizing from DHT exposure. The improved blood supply can partially counteract the shrinking process.
Prolonging the Growth Phase
Hair follicles cycle through growth (anagen), transition (catagen), and resting (telogen) phases. In androgenetic alopecia, the growth phase shortens progressively. Minoxidil extends the anagen phase, giving follicles more time to produce longer, thicker hair shafts before entering the resting phase.
This is also why stopping minoxidil causes regression. Without the ongoing stimulus, follicles revert to their shortened growth cycles within 3 to 6 months.
Realistic Results Timeline
Setting proper expectations prevents discouragement during the early months.
Weeks 2 to 8: The Shedding Phase
Many users experience increased hair shedding during the first two months. This happens because minoxidil pushes weak, miniaturized hairs out of follicles to make way for new, stronger growth. The shedding looks alarming but is actually a positive sign that the treatment is activating dormant follicles.
Months 3 to 6: Early Regrowth
New hairs begin appearing, initially as thin, fine vellus hairs that gradually thicken over subsequent growth cycles. By month 4 to 6, most responders can see a measurable difference in density. The improvement is often more visible in photos taken under consistent lighting than in the mirror.
Months 6 to 12: Peak Results
Hair count and thickness continue increasing. By month 12, results are at or near their maximum. The crown typically shows the strongest response. Frontal hairline regrowth is more modest and less predictable.
Year 2+: Maintenance
After the initial regrowth period, minoxidil shifts to a maintenance role. Most men retain their gains for years with continued use, though some gradual decline may occur over time as underlying hair loss progresses. Combining minoxidil with finasteride produces better long-term stability than either treatment alone.
Who Gets the Best Results
Minoxidil is not equally effective for everyone. Certain factors predict a stronger response.
Favorable Factors
- Shorter duration of hair loss (under 5 years)
- Smaller area of thinning
- Miniaturized (thin, wispy) hair still present (follicles not fully dormant)
- Crown or vertex pattern loss (better than frontal)
- Norwood 2 to 4 stages respond best
- Younger age at treatment start
Less Favorable Factors
- Completely bald areas with no visible miniaturized hair
- Hair loss present for more than 10 years
- Advanced Norwood stages (6 to 7)
- Frontal hairline recession without crown involvement
Minoxidil vs Finasteride
These two treatments work through completely different mechanisms and are best used together. Finasteride blocks DHT (the cause of hair loss) while minoxidil stimulates growth (the recovery). Finasteride is generally more effective as a standalone treatment, halting loss in 80 to 90% of men, while minoxidil produces regrowth in 40 to 60%.
Many dermatologists recommend starting with finasteride first, then adding minoxidil after 6 months if additional regrowth is desired.
Assess Your Candidacy
The likelihood of minoxidil working for you depends heavily on your current stage and pattern of loss. Upload a photo at myhairline.ai/analyze to get your Norwood classification and a personalized assessment of which treatments are most likely to produce results for your specific situation.