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Oral Minoxidil: Do We Finally Have an Answer for Hair Loss?

By Dr Akira Tan
oral minoxidil singapore

Minoxidil has a fascinating history in the realm of combating male androgenetic alopecia, also colloquially known as male pattern hair loss. Its history is a tale of unexpected discoveries and transformative applications. 

In the 1950s, oral minoxidil was first developed to control high blood pressure, and was found to have a  peculiar side effect of promoting hair growth. This eventually led to its evolution as a topical hair loss treatment in the 1980s.  Today, low dose oral minoxidil is fast becoming a popular option for those unable to tolerate or cannot benefit from traditional topical minoxidil. 

This approach involves administering minoxidil orally in lower doses than traditionally used for hypertension, and has shown marked success treating hair loss with minimal side effects. 

As awareness about oral minoxidil for hair loss in Singapore grows, it’s safe to say this treatment offers a promising solution locally for those seeking to reclaim their hair and confidence.

This blog post will discuss in detail about how oral minoxidil works and its efficacy in combating hair loss. We will also explain why oral minoxidil could be a viable option even if topical minoxidil hasn’t worked for you, so you can choose the best therapy in conjunction with your physician.  

What is Minoxidil, and How Does It Help With Hair Loss?

Despite Minoxidil’s long history, its exact mechanisms in reversing hair loss are not fully elucidated. 

Minoxidil is thought to help with hair loss in the following ways:

1. Improved blood flow

Minoxidil relaxes and widens blood vessels (vasodilation), increasing blood flow to hair follicles. This ensures a more favourable environment for hair growth.

2. Extended growth phase

Minoxidil can prolong the active growth phase of the hair growth cycle (anagen phase). An extended growth phase allows hair to grow longer before it rests and enters the shedding phase, leading to longer and thicker hair over time.

How Effective is Oral Minoxidil for Hair Loss?

Studies on oral minoxidil have demonstrated clinical improvement in many subjects. For male pattern hair loss, 61% to 100% of participants experienced positive results with oral minoxidil treatment. Similarly, for those with alopecia areata, approximately 18% to 82.4% of subjects reported improvement after using oral minoxidil.

These findings highlight that oral minoxidil can be a successful hair loss medication, offering hope to those seeking effective remedies.

The 5 Cs of Choosing Oral Minoxidil

1. Convenience

The application of topical minoxidil can face some practical challenges. Many patients forget to apply the medication twice a day, which reduces its effectiveness. It is also often difficult to apply the product to the scalp without assistance from someone else. Lastly, carrying a spray can be quite cumbersome for those who travel frequently.

Oral minoxidil addresses all these concerns as it can be taken once a day. It circumvents the need for difficult scalp application and is much easier to pack for those on the go.

2. Cost-effectiveness

Oral minoxidil is significantly cheaper than topical foams/solutions for the same duration of use.

3. Contact Dermatitis Risk

One of the common reasons for a patient’s discontinuation of topical minoxidil includes itchiness/redness/flaking (contact dermatitis) of the scalp from the various chemicals (in particular propylene glycol) in the topical preparations. 

If that is you, oral minoxidil might be a friendlier option as it is taken orally. 

4. Cosmesis

Oral minoxidil will not stain clothing, bedding and hats since it does not need to be applied. 

5. Coverage

Oral consumption of minoxidil allows for better and more widespread follicular accumulation, leading to more even hair growth.

Note: In Singapore, topical minoxidil is still used as first line therapy for male pattern hair loss. 

Is Low Dose Oral Minoxidil Safe?

In Singapore, low dose oral Minoxidil is a special access route medication and requires a doctor’s prescription to supply.

Low dose oral minoxidil’s safety profile is well supported in the current literature.

The most prominent side effect (24%) is the growth of hair at areas apart from the scalp. However, it may cause cosmetic concern for those who do not want hair on the rest of their body. That being said, most patients enjoy the good hair growth on the scalp and are generally able to tolerate shaving or undergo laser hair removal to remove unwanted hairs.

The rest of the side effects are rare and happen in about 1-2% of patients which include leg swelling, postural blood pressure changes and heart rate changes. These effects are generally seen with higher doses (5mg or more per day) – similar to the dosage used for treating high blood pressure. 

This is why Minoxidil should only be prescribed by a doctor who can advise you regarding side effects. 

What is the Dosage for Minoxidil?

Topical minoxidil is recommended in 2% and 5% concentrations. Low Dose Oral Minoxidil for hair loss is available in capsules/tablets with a recommended safe daily dose of 0.25mg to 2.5mg daily. 

How Soon Can I See Hair Regrowth With Oral Minoxidil?

After starting Oral Minoxidil, initial hair loss is to be expected in the first 1-2 months. Subsequently, the first signs of hair regrowth can be observed at 4-8 months, with full effects stabilising after about 12-18 months. Individual responses can vary. It is important that patients do not stop the medication prematurely and to understand the expected duration to appreciate hair regrowth.

Does Stopping Oral Minoxidil Cause Hair Loss?

In the event that Minoxidil is ceased, the drug’s effects on the hair follicles will wear off, causing one to lose hair that was grown back to one’s baseline. 

Will Oral Minoxidil Work for Me if Topical Minoxidil Has Not?

If topical minoxidil has not yielded the results you were hoping for, it may be worth seeking guidance from a doctor. 

Your doctor can assess your condition and discuss potential reasons for the initial treatment failure. If appropriate, they can also tailor a treatment programme which can include low dose oral minoxidil. Often it is also useful to consider combination therapies and machine-based therapies such as microneedling or laser/light based therapies to attain even better results.  

Looking for Oral Minoxidil and Other Hair Solutions in Singapore?

If you have gotten unsatisfactory results from topical minoxidil and/or other hair loss solutions, oral minoxidil could be what you are searching for. 

At SL Aesthetic Clinic, our doctors will do an analysis to gauge the health of your hair and its needs before providing any solutions. Book your consultation today.

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