If you type “how to stop hair loss” into Google, chances are Minoxidil popped up in the first few results. Especially now, as this 90's drug has resurfaced again for its efficacy against hair loss. You probably know it as a blood pressure drug from the 70s or the liquid or foam to apply on the scalp  and has become almost a rite of passage for anyone noticing a receding hairline or thinning crown.

Yes, oral Minoxidil is having a moment. Originally developed in the 1970s as a blood pressure medication, it was only later that doctors noticed an unexpected (and welcome) side effect: hair growth. That led to the launch of topical Minoxidil, now widely available over the counter. But recently, dermatologists have been revisiting its oral form — and the results are turning heads. "Minoxidil taken orally is more effective as compared to its topical application at a dose higher than 1mg/day," says Dr Bindu Sthalekar, Founder & Chief Dermatologist at Skin Smart Solutions. She further explains that Minoxidil is converted to its active sulphate form by sulfotransferase enzymes. Deficiency of this enzyme is the main cause for the inefficacy of topical minoxidil. "Oral minoxidil can work at a lower activity of follicular sulfotransferase enzymes," she explains.

How does it work?

Minoxidil is a vasodilator — which means it helps widen blood vessels and improve blood flow. When it comes to hair, that increased circulation is believed to boost the activity of hair follicles and extend the anagen phase, or the active growth cycle of your strands. "Clinical studies indicate that oral administration may provide more consistent delivery all over the scalp with improved results.It is useful mainly for patients who do not respond well to the topical form or find its application inconvenient," says Dr Madhuri Agarwal, Celebrity Dermatologist and Founder of Yavana Aesthetic Clinic.

Unlike the topical version, which only targets the area it’s applied to, oral Minoxidil works systemically — meaning it reaches all parts of your scalp (and possibly your beard, brows, and even body hair). That’s a plus if your hair loss isn’t confined to one spot. "Minoxidil, a potassium channel opener, causes vasodilation and increased blood flow to hair follicles resulting in increased supply of nutrients and oxygen to them," adds Dr Sthalekar.

So, at what phase of hair loss is Minoxidil show results? Oral minoxidil demonstrates optimal efficacy in the initial to moderate phases of hair loss, where hair follicles remain functional. "It is highly beneficial for patients experiencing androgenetic alopecia (male and female pattern hair loss), those who have not achieved satisfactory results with topical treatments, patients suffering from diffuse hair thinning rather than complete baldness, and patients who find daily topical application a task," explains Dr Agarwal. Doctors also recommend consistent use of the medicine for three to six months to see results with maximum benefits often observed after 12 months. 

Are there any side effects?

Like any oral medication, there are things to watch out for. The most common side effect is excessive hair growth in unwanted areas (like your forehead or cheeks). It can also cause fluid retention, dizziness, or low blood pressure, especially in higher doses. "The side effects can be minimised by starting at a low dose and gradually increasing it under a doctor's guidance. Also the medicine should preferably be taken at night," says Dr Sthalekar. Oral Minoxidil is not sold over the counter and should only be taken under a dermatologist’s guidance. Adding to the, Dr Agarwal says, "These side effects are more likely to occur at higher doses specifically in patients with cardiovascular conditions. Hence it is a prescription medicine and should be taken only after consulting with a dermatologist."
 

The bottom line

Oral Minoxidil isn’t new — but it’s definitely trending again, and for good reason. It’s showing promise for men (and women) dealing with hair loss who want a no-fuss, once-a-day option. "Oral minoxidil is a good solution for patterned hair loss. However it cannot totally replace other treatments in use as each treatment works on different aspects of hair loss. Oral minoxidil can work as an excellent adjuvant to other treatments," concludes Dr  Sthalekar.