I'm not one for mess—especially when it comes to my hands. Something about sticky fingers makes me queasy. Finger foods are a nightmare, and certain hand creams give me an instant ick. So when it comes to boosting my hair growth, Rogaine or topical minoxidil—a first-line FDA-approved treatment for hereditary hair loss that increases blood flow to the scalp and stimulates hair growth—was always out of the question. Just the thought of that foam in my hands sends instant shivers down my spine.
But last year, I started hearing buzz about an ingestible therapy for hair growth: oral minoxidil, a pill counterpart to the messy topical. "Oral minoxidil helps grow hair longer and thicker by increasing blood flow to the hair follicle," says board-certified dermatologist Tracy Evans, MD. This, in turn, brings more oxygen, nutrients, and growth factors essential to hair growth to the area. As a result, it shortens the rest phase of the hair cycle and prolongs the active growth phase, explains board-certified dermatologist Ellen Marmur, MD.
While it might sound like a no-brainer (who wouldn't rather take one small pill a day to promote hair growth?), I wouldn't recommend taking the medication without doing your due diligence. It's key to seek out a trusted provider and be hyper-aware of the side effects, which are, candidly, more serious than those that accompany the topical version. Ahead, I spoke with Dr. Evans, Dr. Marmur, and board-certified dermatologist Elizabeth Houshmand, MD, to learn everything you need to know about oral minoxidil.
What Is Oral Minoxidil?
Just like the topical version (minoxidil is available in hair serums from Nutrafol, Vegamour, and The Ordinary), oral minoxidil is proven to be effective in both men and women. That's not how it started, though. "It was actually originally prescribed to treat high blood pressure," says Dr. Houshmand. But once doctors realized increased hair growth was a side effect of the drug, they began prescribing it in low doses (think: one pill a day) to stimulate hair follicles and improve hair density.
It's important to note that, unlike topical minoxidil, oral minoxidil is not FDA-approved for hair loss. That doesn't mean it won't help with hair growth; think of it like masseter Botox. Botox isn't FDA-approved to treat chronic jaw pain, but it's still widely recognized as an effective treatment. It simply means that, when used for hair growth, oral minoxidil is prescribed off-label under a physician's supervision.
What's the Difference Between Oral Minoxidil and Topical Minoxidil?
The key difference, according to Dr. Houshmand, is systemic absorption. Topical minoxidil, like Rogaine, is applied directly to the scalp (or desired area of hair growth) and mainly affects the hair follicles in that particular area. By widening blood vessels in the area of application, topical minoxidil boosts the flow of nutrients, blood, and oxygen, extending the hair growth phase. That targeted treatment can leave behind residue, a sticky or greasy feeling, and potential scalp irritation.
On the other hand, Dr. Marmur says oral minoxidil works from within, as it circulates in the bloodstream and reaches all hair follicles. Whereas topical minoxidil only effects follicles in the areas in which it's applied, oral minoxidil works on all hair follicles across the entire body.
According to Dr. Evans, both oral and topical minoxidil are equally efficacious at boosting hair growth in several studies, so the choice ultimately comes down to personal preference, cost (oral minoxidil is typically cheaper), and tolerability.
"Some people choose the oral form because it’s easier, leaves no residue, and no need for daily scalp application, while others stick with topical to minimize exposure," Dr. Marmur explains. Keep in mind that oral minoxidil requires a prescription (which you can get from your dermatologist and is covered by insurance with your standard co-pay). In contrast, topical minoxidil is available over the counter.
What Are the Risks of Oral Minoxidil?
Nothing is without its risks, including oral minoxidil. "Because oral minoxidil lowers blood pressure, it can interact with other blood pressure medications, making it a poor choice for those with a history of cardiac problems and those with heart, liver, or kidney disease," warns board-certified dermatologist Morayo Adisa, MD. She also suggests that pregnant, nursing, or women planning to get pregnant avoid the medication.
Whereas topical minoxidil only effects follicles in the areas in which it's applied, oral minoxidil works on all hair follicles across the entire body.
Minoxidil is known to increase hair growth, but unlike a topical—which only causes hair growth where it's applied—the oral form can cause hair growth in unwanted places, like the face or certain parts of the body, Dr. Adisa adds. Paradoxically, "it may cause temporary hair shedding for some as the medication shifts hair into a new growth cycle," says Dr. Evans.
According to Dr. Marmur, other potential side effects include swelling, rapid heartbeat, headaches, and dizziness. For these reasons (and as general best practice), it's important to start under a doctor's guidance and stick to a dose suited to your health and needs.
When Will I See Results From Oral Minoxidil?
"You should see visible results after three to six months of consistent use," says Dr. Marmur. That's around the time it should take for new, thicker hairs to emerge and replace old ones. She suggests combining oral minoxidil with supportive topicals, such as Olaplex shampoo or hair growth serums, for the best results. Meanwhile, Dr. Evans recommends pairing the medication with Biotin, a vitamin that promotes hair (and nail!) growth, and, for more severe cases, platelet-rich plasma (PRP) treatments injected into the scalp. (To catch you up to speed: PRP is a treatment where your blood is drawn, placed in a centrifuge to isolate growth factors, and re-injected into your scalp to stimulate your hair follicles and promote growth.)
Even better? The FDA is planning to consider a new time-release oral minoxidil option, VDPHL01, which could be available by 2027. If all goes according to plan, hair loss might just become a relic of the past.
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