Oral minoxidil treatment for hair loss: A review of efficacy and safety

J Am Acad Dermatol. 2021 Mar;84(3):737-746. doi: 10.1016/j.jaad.2020.06.1009. Epub 2020 Jul 2.


Background: Although topical minoxidil is an effective treatment option for hair loss, many patients are poorly compliant because of the necessity to apply the medication twice a day, undesirable hair texture, and scalp irritation.

Objective: In recent years, oral minoxidil at low dose has been proposed as a safe alternative. This study reviewed articles in which oral minoxidil was used to treat hair loss to determine its efficacy and safety as an alternative to topical minoxidil.

Methods: PubMed searches were performed to identify articles discussing oral minoxidil as the primary form of treatment for hair loss published up to April 2020.

Results: A total of 17 studies with 634 patients were found discussing the use of oral minoxidil as the primary treatment modality for hair loss. Androgenetic alopecia was the most studied condition, but other conditions included telogen effluvium, lichen planopilaris, loose anagen hair syndrome, monilethrix, alopecia areata, and permanent chemotherapy-induced alopecia.

Limitations: Larger randomized studies comparing the efficacy/safety of different doses with standardized objective measurements will be needed to clarify the best treatment protocol.

Conclusion: Oral minoxidil was found to be an effective and well-tolerated treatment alternative for healthy patients having difficulty with topical formulations.

Keywords: alopecia; alopecia treatment; androgenetic alopecia; efficacy; hair loss; minoxidil; oral minoxidil; safety; systemic minoxidil.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Alopecia / drug therapy*
  • Drug Administration Schedule
  • Humans
  • Medication Adherence
  • Minoxidil / administration & dosage*
  • Minoxidil / adverse effects
  • Treatment Outcome


  • Minoxidil