Is Oral Minoxidil Safe to Treat Hair Loss? experts explain

For many years, trichologists and dermatologists have prescribed various lotions and cosmetic procedures to treat baldness. However, recently, the use of a drug has gained popularity due to the positive results with regard to hair growth and density increase: the minoxidil.

However, despite the positive results – which have already been shown in studies -, there is still controversy among health professionals regarding the indication of minoxidil to treat androgenetic alopecia (also known as hereditary baldness). This is because the drug, in its oral form, is, in fact, indicated for the treatment of high blood pressure.

But, after all, is it safe to use minoxidil as an alternative for baldness? See below for all the details about the drug and what experts say about this other use of the drug.

What is minoxidil and what is it used for?

Minoxidil is a vasodilator antihypertensive drug, that is, it dilates blood vessels, acting to reduce systemic arterial hypertension. Its use is associated with the treatment of high and severe blood pressure, which is not reversed with the usual medications.

The drug was created in the 1970s and, over the years, it was possible to notice that its formula stimulates the growth of hair in various parts of the body. As a result, the manufacturer has developed a topical lotionable to treat baldness when applied directly to the scalp.

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However, because it is a solution that must be used for life, in addition to leaving the hair oily, many patients end up giving up on the treatment. As a result, some doctors in the United States began testing the administration of oral minoxidil, in lower doses, to treat baldness.

“It is not a first-line medication for this purpose, but due to the side effects of hair growth on the body, minoxidil has been used in androgenetic alopecia”, explains João Rocha, physician on the Cardiology team at Grupo HealthSculp.

In addition to this condition, the drug is also associated with the treatment of telogen effluvium, which is the transient hair losscaused by other factors such as nutritional deficiency, infections or use of certain medications.

Minoxidil for hair: does it really work?

The use of minoxidil for hair loss, in low doses in its oral form, has already been evaluated by some scientific studies. One of them, published in the journal Dematology and Therapyanalyzed the efficacy and safety of the drug for the treatment of male androgenetic alopecia.

The analysis followed 30 men, ages 24 to 59, who were treated with five milligrams of minoxidil for 24 weeks. According to the authors, there was a significant increase in the total hair count, with a safe outcome in healthy individuals.

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Another study, this time published in the F1000 Research, evaluated the use of oral minoxidil in females diagnosed with telogen effluvium. The research followed 36 women who were treated with the hypertension drug for six months, daily. According to the results, minoxidil reduced hair loss within six months of using the drug.

However, it is important to emphasize that the authors of both studies emphasize that More research should be carried out to confirm these effects.. Another point of attention indicated by specialists is that the use of the drug for this purpose must be controlled and done only under medical supervision.

Minoxidil: how to use?

The use of oral minoxidil to treat baldness is done in lower dosages than treatment for hypertension. While the dose for high blood pressure is 10 mg per day, they are prescribed 0.25 mg to 5 mg to treat alopecia. The indication should also be made after diagnosis of the condition and when other topical treatments have not shown effective results.

“First, we need to diagnose androgenetic alopecia in the patient, indicate the appropriate treatment and, depending on the response, it is then possible to associate oral minoxidil”, explains dermatologist and trichologist Simone Neri.

What experts say about minoxidil for hair

Despite scientific studies and the indication in smaller dosages, the use of minoxidil for hair, in its oral form, is not approved by Food and Drug Administration (FDA)the regulatory body of the United States, nor by the National Health Surveillance Agency (Anvisa)the regulator in Brazil.

Therefore, there are differing opinions from health professionals regarding the recommendation of the drug for this purpose. Recently, the Brazilian Society of Trichology (SBTri) has positioned itself against the use of oral minoxidil for the treatment of alopecia.

“The Loniten [nome comercial do minoxidil] It is a very potent antihypertensive with specific indications. As a doctor and trichologist, I absolutely contraindicate it”, says physician and trichologist Luciano Barsanti, president of the Brazilian Society of Trichology (SBTri) and Medical Director of Instituto do Cabelo, in an official note.

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In an interview with MinhaVida, Barsanti reinforced his position, even when the drug is used in low doses. “People react to medication in different ways. In addition, the dosage should vary according to the patient’s weight, but this is not the case. The risk is there,” she says.

On the other hand, the Brazilian Society of Dermatology (SBD) took a position stating that oral minoxidil may be indicated for selected patients with alopecia, provided it is done after a medical evaluation.

“Its judicious use, isolated or associated with other approaches, occurs by medical indication. Clinical and cardiological evaluation of the patient may be necessary prior to its use. In fulfilling their role, the dermatologist will make the indication, prescription and follow-up of the treatment”, says an official statement from the entity.

Dermatologist and trichologist Simone Neri, who is not a spokesperson for SBD, agrees with the position. “Of course it’s not for every patient which should be indicated, but I had patients with severe androgenetic alopecia who, even with hormone blockers, did not have good results. With the use of oral minoxidil, a good improvement was obtained,” he comments.

Minoxidil: side effects and precautions

Like any other medication, the minoxidil has side effects associated with its use to treat baldness. According to the doctor João Rocha, it is possible to cite arterial hypotension (drop in blood pressure), accompanied by malaise, dizziness, drowsiness, nausea and tachycardia as some of the adverse reactions of the use of oral medicine.

Trichologist Luciano Barsanti, on the other hand, says that at the Instituto do Cabelo, where he carries out about twenty consultations daily, he sees about three patients a day with side effects caused by the use of the drug to treat alopecia.

“Tachycardia, arrhythmia, dizziness, drop in blood pressure when getting out of bed or chair, all these are common complications of oral minoxidil use”, he comments. “I have also treated a patient with tinnitus who improved after discontinuing the use of this drug”, he adds.

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Therefore, medical evaluation before starting treatment with oral minoxidil is essential. “As it is an anti-hypertensive drug, if the patient has a heart disease, its use is not indicated”, says Simone. “In addition, when the person has adverse reactions, the right thing is to stop using it immediately”, she reinforces.

In addition self-medication should be avoided. “This is fundamental because there are several advertisements for oral minoxidil on social media. It is important that people take care, avoid self-medication and that, if they receive a prescription for oral minoxidil, that they listen to the opinion of a cardiologist as well”, says Luciano.

In the case of women who suffer from androgenetic alopecia, one of the main side effects of using oral minoxidil is the appearance of hair on the face. “This can be a nuisance for women, so we always warn patients beforehand”, adds Simone Neri.

If I stop taking minoxidil, will my hair fall out again?

This is one of the main questions about the drug, but the answer is: Depends on the cause of hair loss. According to dermatologist Simone Neri, if the patient suffers from androgenetic alopecia, if the use of the drug is suspended, the tendency is for the threads to return, yes, to become thinner and to fall out.

On the other hand, the specialist points out that, in cases of telogen effluvium, which is a transient fall, oral minoxidil can be suspended without harm. Therefore, this can vary greatly from patient to patient – which further reinforces the need for medical monitoring during and after the use of the drug.