Oral minoxidil - a review

This was a lecture given at a meeting organised by "The Hair Research Society of India". It looks at the use of oral minoxidil in various hair disorders.
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[@nancybryson5488]

I have no questions but want to say how generous you have been to graciously answer all these questions from hair-loss sufferers. Only rarely have I seen such kindness and consideration from doctors, especially when they are not directly profiting. Blessings upon you, sir.

[@DiscoverDermatology]

Thank you for your very kind words! Always a pleasure to help others.

[@YellowRoses10]

I agree

[@Valen_Wolf]

Once again.. great information. I'll share this one for sure!

[@DiscoverDermatology]

Thank you, glad you found the information helpful!

[@Merth667]

Fascinating. Thanks for the upload!

[@DiscoverDermatology]

Thanks for your kind words and glad it was helpful!

[@toddr33]

Outstanding presentation. Thank you.

[@DiscoverDermatology]

Thanks for your kind words!

[@kaiser-ki6wp]

Excellent. Thank you.

[@DiscoverDermatology]

Thanks for your kind remark!

[@nicolasj8550]

great talk thank you for posting!

[@DiscoverDermatology]

Welcome, glad you found it helpful!

[@deepesh-qt6iz]

Excellent lecture,thank you sir

[@DiscoverDermatology]

Glad it was helpful! Here is a more update lecture on the same topic kzbin.info/www/bejne/ZpTUeYCNbM2mna8

[@dulidp1]

very very useful and nicely done presentation

[@DiscoverDermatology]

Thanks Duli!

[@Druttam]

Thank you sir for this great video

[@DiscoverDermatology]

You're welcome, glad it was helpful

[@RohanYesudian]

This was a great talk!

[@DiscoverDermatology]

Thanks Ro!

[@drcagrituran25]

Excelent presentation

[@DiscoverDermatology]

Thank you!

[@ashwajitsingh007]

Amazing as always sir, hope you are doing well. Wanted to ask one question, along with oral minoxidil do you not give your patients anything else? Maybe finasteride topically or redensyl ? And what are your opinions on redensyl?

[@DiscoverDermatology]

Thanks for the kind words as usual Ashwajit. I usually use topical minoxidil first and if there is no benefit, tend to use oral minoxidil. I sometimes use oral Spironolactone in women and oral finasteride in men. I have not had much success with topical agents mainly because compliance is difficult for most and invariably they cause cutaneous side effects eventually that makes it difficult for patients to use ling term. I do not have much knowledge about Redensyl but found one randomised study that suggests it may be helpful. I will probably use it only when more evidence emerges of its effectiveness.

[@MyLifeInDebt]

This was such a great presentation. Wondering if anyone reading this knows why so many of us with hair loss have a red/pink scalp. Is this from DHT or Sebum?

[@DiscoverDermatology]

Thats a great question. I suspect there may be an element of rosacea to even sensitive skin as this may be an underlying reason for hair loss. This is particularly prominent in those with fair, white skin. Here is a video on how those with rosace have sensitive facial skin. kzbin.info/www/bejne/apKphHSBpdd5oJI

[@thegreaterconundrum]

How do you feel about some people reporting "loss of collagen" or increased aging in the skin? Some report more wrinkles, under eye bags, etc. from oral minoxidil. I'd be interested to know if you think that is possible, what how it might work. Thanks!

[@DiscoverDermatology]

There is no good literature review that suggest that skinnageing occurs with oral minoxidil. There may be anecdotal reports but this is not true science. If there are concerns about skin ageing, then following a few good life style factors may be helpful Here are a couple of videos on in kzbin.info/www/bejne/maLZnqdsl76KfKs kzbin.info/www/bejne/eXOVdWaEirmteqs

[@timberwolvesxx7250]

thankyou Dr for this informative presentation. I am still yet to decide whether to start this medication. As a fit young male, i am reluctant to interfere with my blood pressure.

[@DiscoverDermatology]

It’s usually very safe as only low doses are required. You need to take into consideration the length of treatment as it may need to be continued indefinitely. So if you are young, it may be many years.

[@sagarbadiger5554]

​@@DiscoverDermatologyhello sir , what is the result seen when we stop using the oral minoxidil ? Is the hair shed at an accelerated pace?

[@DiscoverDermatology]

@@sagarbadiger5554 The hair that regrows with oral minoxidil will usually be shed when it is stopped. It is not an excess of hair loss or accelerated. Only what is gained is usually lost.

[@sagarbadiger5554]

@@DiscoverDermatology okay ! Thank you sir , Another question , i always wonder why we are prescribed topical minoxidil instead of topical finesteride itself. When topical finesteride can actually block DHT while topical minoxidil can just increase vasodilation or may also have an effect on DHT blockage to some extent only. I would like to hear your response on this. Thank you😊

[@DiscoverDermatology]

@@sagarbadiger5554 Most of the data we have for hair loss is for topical Minoxidil. In fact there are very few good studies on topical finasteride for alopecia. So if we practice evidence based medicine, we need to try topical minoxidil rather than topical finasteride. Once the evidence for topical finasteride increases in the future, we can switch to that agent.

[@nagarajarao.k.v.8761]

Dear doctor whether Severe skin lichen amyloid can cause blocking of skin tissue and failure I taking DMSO solutions as per consulting with doctor nothing worrking on skin and here doctor told difficult to treat jagannath Bangalore indian

[@DiscoverDermatology]

Yes, lichen amyloid is difficult to treat. We do not encounter it often in the UK. I have not used DMSO myself but have read about its effectiveness for some skin conditions.

[@iamnoone78647]

Sir what do think bout using topical and oral if patien has side effects , for eg . Patient having side effect at 5 mg will mostly not have side effect on 2.5mg oral with topical

[@DiscoverDermatology]

Yes that is certainly a good strategy of mixing lower doses of oral minoxidil with other topical agents. Fortunately, the way I have tittered up the dose of oral Minoxidil, I have hardly experienced any major side effects,. I find that topical agents are difficult for most patents to use and compliance is definitely lower with topical than with oral agents.

[@sidinfinity]

Really informative and well explained Sir. I am currently at 1st stage of male pattern baldness. I haven't taken any kind of minoxidil yet. I have just started taking 1mg Finastride. And I am reluctant to use topical solution as we know it's very inconvenient and less practical. So Doctor will you suggest me to directly take oral minoxidil as the dosage proscribed in the video or not. Can I use both finastride and oral minoxidil simultaneously? And secondly please suggest a brand of oral minoxidil which is available in India. Thank you.

[@DiscoverDermatology]

Oral Minoxidil is certainly an option in addition to oral finasteride. In fact it probably has less side effects compared to finasteride. Both can be taken together. The brand in the UK is called Loniten and I think it’s available in India too.

[@sidinfinity]

@@DiscoverDermatology Thank you for your reply.

[@himanshubiyani4723]

​@@sidinfinitybrother did u start medication I am from India too we get lonitab I am taking it. Hwz ur progress

[@sidinfinity]

@@himanshubiyani4723 i have found a cheaper alternative to it ( Minosilk) . I have completed 8 months of medication and the results are fabulous. There is a shading period in the initial months but later on the density and the volume shows up.

[@benpeterson7530]

Do you have any info on how it reduces the androgenic effects? Is there a mechanism of action that is understood? I just thought of minoxidil as a growth stimulant, but not so much as an androgen inhibitor.

[@DiscoverDermatology]

That is a very good question. Here is the mechanism that was described in one of the review articles. Minoxidil leads to hair follicle potassium channel activation, prolonging the hair cycle anagen or growing phase. This could also inhibit the androgen effects on the androgen-sensitive hair follicles.

[@sidinfinity]

Please guide on the best timing to take Finastride and Oral Minoxidil Tablets. Thank you.

[@DiscoverDermatology]

Oral minoxidil is usually taken after meals in the evenings. I am not sure about finasteride. I think it can be taken at any time.

[@sidinfinity]

@@DiscoverDermatology Thanks for the guidance

[@toddr33]

One last question: I am taking 2.5 mg of oral Minoxidil. I am also applying topical minoxidil twice a day. Do you think that would be equivalent to taking 5mg of oral Minoxidil? I would like to continue with both. I just want to maximize the dosage within smart safety limits. My goal would be between the results of 4mg and 5 mg of oral Minoxidil while making sure I am staying safe with the dosage.

[@DiscoverDermatology]

I dont think there are numerical equivalents to topical and oral minoxidil. We know that they are both helpful for hair growth but what strength of topical and oral minoxidil that is needed for each person is unique. Your suggestion of using both in combination is a good one. You yourself will figure out the dose of the topical and oral minoxidil that you need for your body.

[@madangowda8204]

@DiscoverDermatology hi sir, I am a gym person and badminton athlete, so can I use oral minoxidil? since it increases blood pressure

[@DiscoverDermatology]

Minoxidil can be used in those who are athletes too

[@wrightvcx2249]

Sir, great talk, your English is impeccable and your way of presentation is really great. I have one question: I have been using 10% Mintop for the last 4 years. Initially, in the first 2 years, the effectiveness was good and it worked really well. But lately, for the last 1.5 years, Mintop has stopped working completely. I have also been taking 1 mg Finasteride during the same time period. Would Oral minoxidil be helpful for a person like me? Progressive dosage from 2.5mg to 5mg? I had regularly applied Mintop on my scalp twice a day for 4 years without fail. I have more hair loss on the front than on the top. My hairline clearly receded in the last 1 year. I tend to have a resting heart rate of about 80-85 bpm.

[@DiscoverDermatology]

Yes, if topical Minoxidil has stopped working, oral Minoxidil is certainly worthwhile in the dosing regimen that was mentioned in the video. Thank you for your kind comments.

[@wrightvcx2249]

@@DiscoverDermatology Thank you

[@sagarbadiger5554]

​@@DiscoverDermatologyexcellent presentation sir, In his case does oral minoxidil really help him ? I am afraid that it doesn't work because topical minoxidil has stopped working for him, only the dosage of finesteride or dutasteride could help him , please respond to this, Could you also say something about trying oral minoxidil first then topical minoxidil. Thanks in advance 😊

[@DiscoverDermatology]

@@sagarbadiger5554 Yes, oral Minoxidil can help even if topical minoxidil fails. This is because there is an enzyme called sulphotransferase that will indicate if topical minoxidil will work or not. Here is a study on it. www.ncbi.nlm.nih.gov/pmc/articles/PMC9326921/ Oral Minoxidil bypasses this and therefore it may be useful even if topical Minoxidil fails. Oral finasteride and dutasteride can also be used, as you rightly mention.

[@sagarbadiger5554]

@@DiscoverDermatology that's amazing sir , i was a bit hesitant towards minoxidil so my doc prescribed me a stronger serum(contains - Redensyl, Procapil, Anagain and Noacinamide) and along with that 2.5mg oral minoxidil alternate days. I have a small area at the frontal crown area where i can see the density has dropped. Is it advised to continue this prescription or use topical minoxidil the specific area of the scalp first(which i never used). And to the previous question, what is your suggestion on using topical finesteride in early stage to fight DHT in scalp instead increasing vasodilation with topical minoxidil. Your response will definitely bring confidence in me. Thank you 😊

[@ElCapi616.]

Thank you for your video and the information provided, very helpful I’d like to make some critical questions for me Im 20 M, Im making 1 year of treatment, topical minoxidil, shampoo and oral minox, started from .5mg to 2.5 now, I’ve never experienced obvious or extreme side effects, some times I had tachycardia but I consumed weed, does oral minoxidil has interactions with marijuana? Also, I’m a very apprehensive person when talking about health issues, so I think it could be caused by mere anxiety and panic, but it doesn’t remove my concern about oral minox safety (specially mixed with weed bc I never found info) Also, my most crucial concern is about pericardial effusion… some people on reddit talked me about this, so I researched and there are articles that suggest that the use of Oral Minoxidil must be limited because it caused Pericardial Effusion in a healthy young women patient, can you provide me some info about this? Thank you Again!!

[@DiscoverDermatology]

From my reading, there has been only one case of pericardial effusion with oral minoxidil in the literature when used for hair growth. The low doses used makes this side effect most unlikely. Even in this case report, amazingly, the authors restarted oral minoxidil after the pericardial effusion settled and it did not recur again! I am not sure about the interaction with weed, but generally, the consumption of weed is not recommended with any medical treatment.

[@finndvhdhdueueue7801]

I am currently taking 10mg/day and I have some hypertrichosis. If I want to have the amount of hypertrichosis I would have with 5mg do I have to stop OM for a few month and than reduce to 5mg or can I just switch now and the hypertrichosis will decrease?

[@DiscoverDermatology]

Hypertrichosis is dose dependant. Reducing the dose of minoxidil to 2.5mg with also reduce the hypertrichosis. So, the lower the side, the lesser the hypertrichosis.

[@sirmor7551]

Thanks doctor... Just need to know can we use redensyl before trying oral minoxidil...

[@DiscoverDermatology]

Not sure what redensyl is?

[@mernagobran9952]

On 2.5mg. Would it cause initial shedding? For how long? I have ab autoimmune telogen effluvium

[@DiscoverDermatology]

Any dose can cause initial worsening of hair shedding before stabilising. It can take about 6 to 8 weeks to settle. This video tyres to explain the hair cycle and why hair shedding occurs kzbin.info/www/bejne/eGSoe4yQpdmLj8U

[@andreashutasoit8112]

Hello Doc, I'm from Indonesia. To be honest, I have a lot of questions regarding the mysteries of DHT, baldness and minoxidil. 1. Is there a link between extreme itching in the head and DHT accumulation? Because I experienced that even though I didn't have dandruff at all. 2. Is dermaroler on the scalp useful for forming lost/shrinking hair follicles? 3. Can I replace my 1 mg finasteride consumption with 0.5 mg dutasteride every day? Because during the 5 months of using finasteride 1 mg, I didn't feel any change in my hair loss. Why did it happen? Is my DHT really too high that it can't be treated with just 1 mg of finasteride? And are there any major side effects if I take dutasteride 0.5 mg every day? 4. Please give an accurate answer, is it true that frequent masturbation in men can cause hair loss which leads to baldness? Or is it just a myth? If so, how does masturbation relate to baldness? I will be very grateful and happy if the doctor is willing to answer questions that I have been struggling with all this time. Please explain, thank you doctor

[@The_Voice_of_Reason748]

DHT is not a mystery

[@wassierehman8821]

Doctor I’ve heard that it could increase fluid around the heart and cause pericardial effusion, which can be risky. I’m considering starting with 2.5 mg but I want to be sure it’s safe for me. My Bp is usually 115/78, which is normal. I’ve recently got a hair transplant and my doctor prescribed me this but again I want to weigh the cost and benefit to proceed. Are there any serious risks?

[@DiscoverDermatology]

Pericardial effusion is a very rare side effect. It has been reported only two or three times in the literature, so it is exceedingly unlikely.

[@rossclaybrook9358]

Hi I’m one of your patients I’m just wondering If noticing a bit more shedding after upping the dose is normal?

[@DiscoverDermatology]

Hi Ross, yes we can sometimes get a bit of shedding before the hair starts to get thicker. It can also occur when the dose of changed so it’s a normal effect of the medication

[@sidharth4948]

Sir what is it's half-life? Does it need to be taken everyday? Also is it effective for stage 1/2 male pattern?

[@DiscoverDermatology]

Most studies mention a half life of about 3 to 4 hours. It is usually taken every day, preferably at night after food. It seems to be effective for almost any stage of hair loss.

[@drlokhandesskinandorthoped8512]

hello doc few pts dont show reponse to local minoxidil but same pts shows excellent response to oral minoxidil . is it possible that such pts must be having low levels of sulphotransferase. could you plz help me out with any published paper regarding same for my research purpose

[@DiscoverDermatology]

You are right, the local suphotransferase in the hair follicle can inactive topical minoxidil. Here is an article that gives more information. www.biomediclaser.org/files/BJD150MinoxidilMech.pdf

[@drlokhandesskinandorthoped8512]

@@DiscoverDermatology thanks so much sir

[@RahulDas-lg3ve]

Lonitab vs loniten .... Which one is a better oral minoxidil brand????

[@DiscoverDermatology]

The one we have in the UK is Loniten, so Im not sure about Lonitab, sorry.

[@aldopotter9359]

Hello doctor, i know this new usage of the medication is quite new in the medical practice and long term side effects hasn't been tested yet, i've read on the internet that even low dose of this medication may cause not only perdicadial edema but heart clots and strokes as well. Is there any study that has shown this is true?

[@DiscoverDermatology]

The side effect profile is actually very good. I hardly see any side effects even though I have used it for about 4 years. The adverse effects you mention are only a couple against the many thousands who take it. Remember that even simple tablets like paracetamol can cause side effects. So minoxidil is not without side effects but the doses we use rarely causes them.

[@aldopotter9359]

It makes sense, thank you for taking the time and expertise to answer my question 😊

[@arsalanfarooqui4427]

Also doc, I have seen no results and no shedding from topical minox 4 months Should I give the medication a year to assess whether it will work fully or not

[@DiscoverDermatology]

Usually about 6 months is sufficient to know if a medication is helping hair conditions.

[@escanorsheikh4245]

Hello sir , I have been on tropical minoxidil for about a year and it didn't show any result...I have changed 2 brands thinking that it might cause any change but it didn't ...should I switch to the oral form? and if yes ,how much dose for starting? Thank you.

[@DiscoverDermatology]

If topical minoxidil is not helpful, then oral minoxidil is certainly an option. This video explains the dosages and side effects. kzbin.info/www/bejne/gKbVe36VqLh9d7s

[@dineshfilms566]

Sir wich tablet is best in monoxidil-minogain or lonitab

[@DiscoverDermatology]

In the UK, we have only lonitab, so I do not have much information on minogain Im afraid.

[@Druttam]

After how many days or weeks we can increase the dose of ora minoxidil from 2.5 to 5mg?

[@DiscoverDermatology]

Usually every 3 months. I tend to increase by 1.25mg at a time

[@arsalanfarooqui4427]

After a hair transplant, is it okay to revert back to topical minoxidil and quit the oral. I don't think after transplant oral would be needed.

[@DiscoverDermatology]

Yes, topical and oral can both be considered after a hair transplant too

[@CLombardi11]

Is there a way to supplement Collagen since the medication lowers the bodies amount?

[@yanhlen9067]

where you found this about collagen?

[@DiscoverDermatology]

There is no scientific evidence that oral minoxidil lowers collagen. The best way to get the nutrition for the skin right is through the diet rather than supplements. Here is a video on it. kzbin.info/www/bejne/maLZnqdsl76KfKs

[@thibstube9196]

Doctor, I take propranolol for work on occasion when I need to speak in front of large audiences, is this something that will interact with oral minoxidil in a negative way?

[@DiscoverDermatology]

There is no specific interaction as you take the medication only occasionally

[@thibstube9196]

@@DiscoverDermatology Thanks so much!

[@ragnarlodbrok1233]

I have zero family history of hairloss on either parents side. I have had my blood work done and everything came out normal, I exercise and my diet, sleep is very good. Still I'm receding in male pattern baldness. I'm 23, hair fall started at 21 and I'm probably between a norwood 1.5 or norwood 2 now. Why am I receding despite zero family history of baldness?

[@DiscoverDermatology]

Family history is only part of the reason for hair loss. There are some factors causing hair loss that have still not been completely explained and research is being done. The main factors for hair loss have been summarised in this video but it is still not comprehensive as there are unknown factors that are being investigated kzbin.info/www/bejne/f4G7g6uCbNdnjcU

[@JamesBonsor]

What about it causing prolactin levels to increase, is this not a problem?

[@DiscoverDermatology]

It is a not a common problem as the doses used for hair conditions is very small compared to its use in high blood pressure.

[@johny3754]

Sir,I am facing increased hair shedding when i switched on to oral minoxidil, though i have been using topical minoxidil for last 3 years.That is why i am bit worried.Should i discontinue topical minoxidil?Right now i am using both minoxidil for 1 month!

[@Abhianand420]

There is always a more shedding due to oral minoxidil as compared to topical... The shedding continue till 2-3 months, then it stabilize...

[@hosamalabrach7511]

Hi Doctor, thank you for sharing this great information. I have started the oral minoxidil Lonitab 2.5mg. After 12 days taking the tablet I started to feel chest pain and I feel tired all the time then I stop it for 2 days and now I feel better however, any advice to continue with low dose pls advise thank you 🙏

[@DiscoverDermatology]

It is unusual to get side effects in low doses. One option may be to use half the dose and then after a month try increasing the dose. The body may then be able to slowly adapt to the medication. If there are persistent side effects then it needs to be stopped.

[@hosamalabrach7511]

@@DiscoverDermatology Thank you doctor for your kind reply and advice 🙏🙏. Now I have started to take the 1.25mg minoxidil tab with propecia1mg and I’m still using the minoxidil topical 5%. Is smoke effect the hair?

[@DiscoverDermatology]

@@hosamalabrach7511 Generally smoking and environmental pollution (smoke) is not beneficial for the skin. Here is a video on how various life style factors can help the skin. kzbin.info/www/bejne/eXOVdWaEirmteqs

[@hosamalabrach7511]

@@DiscoverDermatology Thank you again doctor for your advice 🙏

[@hosamalabrach7511]

Hi Doctor, good evening, would like to ask you is sublingual minoxidil better and safer then oral minoxidil and can I take 2.5mg minoxidil sublingual thank you.

[@DiscoverDermatology]

Great question. Sublingual minoxidil will probably work faster as it is directly absorbed by bypassing the gut. However, it may also cause a more prominent reduction in blood pressure. It may be better to try 1.25mg for the first 2 weeks and if there is no side effects it can be increased to 2.5mg.

[@hosamalabrach7511]

@@DiscoverDermatology thank you doctor for ur reply 🙏🙏

[@salilmishra5137]

😊​@@DiscoverDermatology

[@toddr33]

Can I still use both topical and oral, until I get to 4mg or higher on oral?

[@DiscoverDermatology]

Yes, both can be used together. Once the oral medication kicks in, we can probably stop the topical Minoxidil.

[@johny3754]

Hello sir,I am 32 years old and have been facing hairfall all of a sudden since covid lockdown.Never faced any hairfall until lockdown and i used to have good hair.After visiting to a doctor,he told me that i had telegon efflovium and gave me minoxidil 1ml two times a day but after several months i saw some thin new hair.I felt like hair condition is not same as before.Whenever i tried to stop it,i had serious hairfall.After 1.5 years,my doctor gave me finasteride 1mg per day and told me that i have androgenetic alopecia.Currently,i have many thin hairs throughout my scalp and hairs from backside are also thinning,It's like whole part is thinning from back to front. My current medication is minoxodil topical 1ml just at nightl and 1mg finasteride daily. To be honest,can't see any improvement right now.Should i change to oral minoxidil or finasteride dosage?Can i get any benefits from prp?

[@DiscoverDermatology]

From the history it is likely that the topical minoxidil is not as effective you would want it yo be. Oral Minoxidil is certainly worth trying in this scenario. I do not do prp so, so cannot give you much information on it. Oral finasteride is also a good treatment and can be combined with oral minoxidil.

[@johny3754]

​@@DiscoverDermatology Dear sir, Having hair thinning throughout the scalp suddenly after telegon efflovium,what kind of hairloss it can be sir?Should i use both oral minoxidil and topical, or should i stop topical first ?Sir,it will be helpful if you suggest me dosage of finslasteride.

[@exo5860]

Hey i have eyebrow loss dud to seborreic eczema, im taking now isotretinoin to cure it, how minoxidil per day would u suggest for eyebrow regrowing? Much Regards

[@DiscoverDermatology]

There isn't much literature specifically on eyelid g=hair growth, The doses that thicken the scalp hair will probably work for the eyebrows too.

[@exo5860]

@@DiscoverDermatology ok thanks a lot my dermatologist said the eyebrows would grow back again after the sd is heales from the isotretinoin could that be the case? Maybe i should use some eyebrows serim because i did read minoxidil causes the other hairs such as facial or backhair to grow too…

[@DiscoverDermatology]

I agree with the dermatologist that treating the underlying cause of hair loss will help hair growth. So, if seborrhoeic eczema is the cause for reduced hair, there is a chance of regrowth without any other treatment. @@exo5860

[@sagarbadiger5554]

Hi doctor, I'm from india My doctor has prescribed Tricosilk Pro solution once daily , Arcolane lotion Multivitamin tablets and minoil My hair thinning has happened at a noticeable stage and i have not started the prescription yet , would yo recommend this prescription and i want to know if this solution can delay the hair thinning(at follicular level). Thank you ❤

[@DiscoverDermatology]

If topical minoxidil is ineffective then oral Minoxil is worth a go. Look out for the video I have done for this week as it explains a bit more on why tocjial minoxidil does not always work.

[@sagarbadiger5554]

@@DiscoverDermatology yes doctor i have watched your video , but it's better to use topical minoxidil than not to use it at all right ? I am prescribed tricosilk Pro lotion which contains 5% min and 0.1% fin , do you suggest to use it ?

[@DiscoverDermatology]

@@sagarbadiger5554 There is no harm is using both but the oral is much more likely to work compared to topical. Look out for the video this Friday that explains the reason why topicals do not work for most.

[@PAWANSINGH-pl2dw]

Sir... If we talk about topicL minoxidil ... Can we use alchol free topical minoxidil

[@DiscoverDermatology]

Yes, the foam usually causes less irritation compared to the solution.

[@aldopotter9359]

Does the medication can increase blood pressure?

[@DiscoverDermatology]

Its usually the opposite. It reduces blood pressure, particularly when the higher doses.

[@akhilkatiki3111]

Hi Doctor, I have been using oral minoxidil 1.25 mg for two months and had side effects like aging and also hair texture has been changed causing the hair to break more easily. Can i stop using oral minoxidil? please advise

[@yanhlen9067]

what aging you saw?

[@dijinkp9526]

Good day dr... Very informative video... I am using oral minoxidil 2.5 mg at night. I want to increase the dose of minoxidil to 5 mg as per the protocol suggested by you... My doubt is that if i decrease the dose to 2.5 mg after few months of having 5 mg, will my hair diameter and thickness get reduced???

[@DiscoverDermatology]

We do. not know the long term effects of dose reduction with Minoxidil. Generally, we try to maintain it at a dose that gives an adequate response to the patient. If 5mg gives good hair density and causes no side effects, it may be helpful to stay at that dose and not change it.

[@dijinkp9526]

Thank you so much dr

[@tariqghaffar6298]

Which Oral Minoxil you recommend? both branded and generic. Thanks

[@DiscoverDermatology]

I have no specific favourite brands. The commonest one available in the UK is Loniten, so I am quite happy with it.

[@Roy20476]

Hey doctor, i am using 2.5 mg oral minoxidil and feeling tired since I started 3 days ago. My blood pressure now is 135/61. The tiredness should go away?

[@DiscoverDermatology]

Its still early days. Your body will take a week or two to adjust to any medication. Blood pressure seems ok.

[@Roy20476]

@@DiscoverDermatology thanks doctor

[@abhijeet5076]

Sir will it be a problem if my doctor priscribes me 5mg directly instead of increasing the dose gradually? And what effect does caffeine intake has on oral minoxidil

[@DiscoverDermatology]

Generally, for a long term conditions, we start medications in lower doses and work up. This is to ensure that there are no side effects. Also, the lower starting dose of 2.5mg itself may work very well. So starting at 5mg is possible, but usually not used in practice. As far as I am aware, there is no interaction between caffeine and oral minoxidil.

[@abhijeet5076]

@@DiscoverDermatology Thank you sir

[@abhijeet5076]

Sir I'm using a hair serum from the past 3 months along with oral Minoxidil 5mg and finasteride 1mg The hair serum with composition (Aquaxyl+Auxina Tricogena+PROCAPIL+Vitamin F Forte) is causing problems in my upper back shoulders and neck while applying Do you think just the oral medications will do the work without applying the serum?

[@Druttam]

Do we get paradoxical hair loss initially like topics minoxidil?

[@DiscoverDermatology]

Usually it takes a few weeks. So there may be apparent thinning for the first 4 weeks, so can continue with topical minoxidil and then stop using the topical agent and continue with the oral minoxidil

[@Druttam]

@@DiscoverDermatology But both topical minoxidil also causes shedding initially sir.

[@DiscoverDermatology]

@@Druttam The usual practice is to commence topical Minoxidil first. This can be tried for 4 to 6 months. If this is ineffective, then we add in oral Minoxidil, wait for 4 to 6 weeks for the oral medication to kick in, than stop topical Minoxidil. I rarely start both at the same time because it can cause hair shedding a few weeks later, as you rightly mentioned.

[@arshsingh8686]

i am using minoxidil topical solution and finestrid from last 9 months result were good but i want more results can i add oral minoxidil to increase the result?

[@DiscoverDermatology]

Yes, oral minoxidil can be used if topical minoxidil alone does not give the desired result.

[@SkiBeachCamp]

Would you recommend 2.5mg twice a day or 5mg once a day? Thanks.

[@DiscoverDermatology]

Most studies suggest 5mg once a day. We tend to take tablets more regularly once a day as we are unlikely to forget.

[@SkiBeachCamp]

@@DiscoverDermatology Thank you!

[@bhoot9356]

Hello doctor....is there any way to turn the vellus hair coming on cheeks as hypertrichosis as you mentioned to terminal hairs....i really want good thick beard for me and want to use it for that purpose.

[@DiscoverDermatology]

There is some evidence from practicing clinicians that in men, the hairs induced by minoxidil in the beard area tend to be terminal rather than vellus

[@bhoot9356]

Thank you for you reply doctor.....happy to know about this info.

[@Merth667]

I've been on oral minoxidil for about 3 months now (5mg daily) and it has significantly thickened up my beard. I also got very thick eyebrows and eye lashes. I'm very happy with the hypertrichosis :D

[@DiscoverDermatology]

@@Merth667 Thats an excellent response in a short period of time!

[@Merth667]

@@DiscoverDermatology I think so too. My family has been commenting on it every time I see them, that's how I first noticed myself. I'm still waiting for the significant hair gains. I see baby hairs on the hairline but not enough to make a significant cosmetic difference. Thanks a lot for the video btw, I link it to people who have concerns about the safety and efficacy of the drug. Such information coming from an experienced clinician is very valuable.

[@Druttam]

What’s the minimum age for starting oral minoxidil?

[@DiscoverDermatology]

I tend to use it in those who are very keen for hair growth irrespective of the age. There is no lower age limit as it has been used for childhood hair conditions too

[@tallntop6476]

Sir my 2nd stage hairline Please consult dose oral minoxidil

[@DiscoverDermatology]

Here is a video that mentions the dosage and potential side effects of oral minoxidil kzbin.info/www/bejne/gKbVe36VqLh9d7s

[@chetnasethi2532]

Can female take oral minoxidile for hair regrowth ..if yes in what dosage

[@DiscoverDermatology]

Yes it is helpful for females and males. Most studies use doses between 0.675mg a day to 2.5mg a day. Here is a video that discusses the dosage of oral minoxidil. kzbin.info/www/bejne/gKbVe36VqLh9d7s

[@vp4764]

Doctor, can i take oral minoxidil at night & caffeine 200mg pre workout at morning ?

[@DiscoverDermatology]

Yes, that should work out fine. Caffeine will not interact with the actions of minoxidil on the hair. In fact it has been used to stimulate hair growth too. Here is a video on that topic. kzbin.info/www/bejne/eGbMXmmBgZdgjtk

[@vp4764]

@@DiscoverDermatology thanks for the response doctor

[@Druttam]

Can we combine oral minoxidil with topical minoxidil?

[@DiscoverDermatology]

Yes, but I tend to slowly withdraw the topical Minoxidil after a couple of months.

[@pranavvaidya4596]

Hi Sir, very insightful talk. I am 26 year old from India with a history of male pattern baldness as my uncle and father both are bald. I started using minoxidil in 2018 it's been effective for me till last year. From last year I started experiencing hair thinning with huge extent. I was using regain 5 % for around 2 years , before that mintop , hair 4u were the brands doctor recommended. Fur to hair thinning I thought of going for prp sessions , I took 3 prp sessions last year but they proved no better, rather my hair thinning increased. So thought I should change the minoxidil brand as the efficacy might be not like initial so I switched to hair 4u 5% and folliserum procapil one time. This change of brands has increased hair loss , might be due to hair shedding. Could you please suggest does changing brand is helpful? And should I parallely start taking oral minoxidil as it's been more than 4 years with topical minoxidil? FYI I have been using finesteride as well since last 2 years

[@DiscoverDermatology]

Oral Minoxidil is certainly an option if topical Minoxidil is not effective. I am not sure of the brand names you mention, but there is evidence that changing brands may change its effectiveness. I am doing a video on sublingual Minoxidil this week which explains why topical minoxidil is not always effective, so look out for it!

[@pranavvaidya4596]

​@@DiscoverDermatology thank you doctor

[@pranavvaidya4596]

​@@DiscoverDermatology just one more query on this. Does using the same brand of minoxidil for 2 years continuously causes a tolerance against it and reaches plateau? And so changing the brand at this point in time causes shedding which is a positive sign that drug is triggered for shedding off weak hair and grow new hairs in 3-4 months?

[@DiscoverDermatology]

@@pranavvaidya4596 I guess it is possible that changing the brand may help. Tolerance may also be an issue though there is no long term data on this. Increasing the dose may also be an option rather than changing brands. Shedding of hairs can occur at anytime during treatment so that could settle with time too.

[@mrinaldas4533]

Your update now?

[@tallntop6476]

Hello sir please im started minoxidil oral dose male 2.5

[@DiscoverDermatology]

For males, most dermatologists use 2.5mg a day as a starting dose. Here is a more comprehensive video on the subject. kzbin.info/www/bejne/ZpTUeYCNbM2mna8

[@BenSSSSSS]

I've been on 2.5mg daily for the first 3 months and increased it to 5mg daily for the next 2 months. So far no results or shedding. How long do I continue to use it until I give up?

[@DiscoverDermatology]

It takes about 3 ro 4 months to work, so if there is no response in the next 2 months, it unlikely to help.

[@BenSSSSSS]

@@DiscoverDermatology I will continue take it up to 12 months as I have read it can take between 6-12 months to see results

[@DiscoverDermatology]

@@BenSSSSSS Yes, thats a good plan too.

[@DOCFIT_09]

​@@BenSSSSSShey bro did you got any results?

[@menhajahmed8262]

Is it better to take 2.5mg twice a day or 5mg daily of oral minoxidil? Also, great presentation

[@DiscoverDermatology]

There are no studies comparing once or twice a day dosage for minoxidil. I tend to ask patients to use it once a day as it is better for compliance.

[@menhajahmed8262]

Thank you for your advice

[@tapasmajumder9302]

Sir, i have little thinning on my donor area. I have tried topical minox, multivitamin , biotin but didn't work. But, recently i talked with a trichologist and he found that i have Diffuse unpattern hairloss( thinning over donor area). He prescribed me topical minox+finaesride solution(5%+0.25%), Tab lonitab ( oral minoxidil)/2.5 mg alternate day and Duman(Dutastride 0.5 mg ) once a week as i have some morning erection issues. Now sir, i am very afraid to take Dutastride. So, i just want to Oral minoxidil instead of Dutastride to keep my hairloss in check.

[@DiscoverDermatology]

Oral minoxidil on its own is a useful treatment option. Here is a video on the dosage and effectiveness of the oral minoxidil mono therapy. kzbin.info/www/bejne/gKbVe36VqLh9d7s

[@tapasmajumder9302]

@@DiscoverDermatology So I can start the treatment like this Topical at night and 2.5 mg oral on alternate days before bed and derma roller once a week

[@DiscoverDermatology]

Sounds reasonable. I do not have any experience with derma roller though. @@tapasmajumder9302

[@tapasmajumder9302]

@@DiscoverDermatology thanks sir for replying. If I take oral minoxidil for a long time, will it work in the long run without the addition of DHT blocker.

[@DiscoverDermatology]

There are no long term studies with oral minoxidil yet as it has been used only for the last 3 or 4 years. We may learn more about it with time. @@tapasmajumder9302

[@nurnabella4709]

hi can i take oral minoxidil together with topical minoxidil?

[@DiscoverDermatology]

Yes, the combination can be used. However, just one of either oral or topical Minoxidil would probably be sufficient.

[@ThaSpeedsterZ]

Started taking it a week ago. 1.25mg.. Wish me luck

[@DiscoverDermatology]

All the best!

[@DiscoverDermatology]

@@ITZME11592 It usually takes about 3 months before any significant change is noted.

[@zenguddu]

Alcohol consumption?

[@DiscoverDermatology]

Occasional alcohol consumption is fine, as long as it is within the recommended 14 units/ week.

[@zenguddu]

@@DiscoverDermatology thanks for replying sir

[@Man-u-flex]

This does not solve the dht problem though

[@DiscoverDermatology]

Thats right, its only part of the management strategy. Here are other factors that need to be addressed: kzbin.info/www/bejne/f4G7g6uCbNdnjcU

[@Kyle_Bu]

I'm sure the doctor is aware. This presentation is just about oral minoxidil

[@tallntop6476]

Dr. Please reply me

[@sherifdoc]

, just wanted to share my experience and hear any feedback. I have been on 1.25 mg oral for 4 months then increased to 2.5 mg daily for the past 2 months. Since I started, I lost my libido and erection. Never get horny. I also feel tired and eyes bags. I monitor my BP which changes very tiny (2-3 mmhg) within one or two hour after the pill. Also. My lab tests of prolactin, total and free testosterone are normal. Started to think it’s cardiovascular effect and also may be anti androgenic effect… not sure though, but I miss the feeling of being sexually aroused and not being tired. Any thoughts ?

[@DiscoverDermatology]

This is not a side effect I have come across before. I have used it for about 3 years now and none of my patients have mentioned the adverse effects you have experienced. Tiredness can occur with higher doses but tends to settle. A BP change of a few mm every hour is normal. It tends to reduce in the evenings and nights anyway and increase with stress.

[@sherifdoc]

@@DiscoverDermatology I’m not seeing any hair improvements after 5-6 months of using oral minoxidil (1.25 mg daily for 4 months then 2.5 mg daily for the following 1 -1.5 month). Topical minoxidil worked for me in the past but I switched to the oral pills because of hair dryness. I expected the oral to work, based on all the positive feedbacks we have been hearing. However, this isn’t the case for me, not sure why !!! I feel my hair lost density and oral minoxidil never regained it…Any thoughts ?!!

[@DiscoverDermatology]

@@sherifdoc It is surprising that topical Minoxidil helped you but not oral Minoxidil. Its usually the other way round! If you are male then the dose is low as you can increase Minoxidil up to 5mg a day. If you are female, then we have to accept that oral Minoxidil is not the right medication for your skin if there has been no improvement even after 6 months. It may be worthwhile using 2.5mg for at least another 2 months though.

[@sherifdoc]

@@DiscoverDermatology I’m male. And honestly, I was kinda satisfied with 1.25 my daily for 4 months, noticed improved hair quality, then 1 months ago I increased to 2.5 mg hoping that density would get better, surprisingly all in a sudden within few weeks I noticed spaces in my scalp and the density dropped, although I did not notice hair shedding. Not sure what is going on !!!!

[@DiscoverDermatology]

@@sherifdoc One option may be to stick to the dose that worked before? Maybe revert back to 1.25mg? Our body responds to medications in unique ways. If a lower dose has been helpful, you could continue with it.

[@davidwalsh9850]

How do i do the enzyme test to see if the 2-5% oral Minoxidil will work for me? I can't seem to where to do this test. Can anyone help

[@DiscoverDermatology]

The enzyme test in only available in academic studies and not commercially. So it is unlikely it will be done unless you are part of any research.

[@mikemichael5591]

Does oral minoxidal affect libido or erection like propecia

[@DiscoverDermatology]

Not to my knowledge and the current literature