Low dose oral minoxidil

While there are any number of underlying causes for hair loss that affect women, the vast majority of cases can be attributed to one of two conditions. Sometimes these two conditions overlap with both of them contributing to an individual’s noticeable hair loss.

The most common cause is called female pattern hair loss (FPHL). It is a chronic, progressive hair loss that can start at any age and presents as progressive thinning of the hair, particularly at the top and front of the scalp. The cause is not entirely clear but is believed to be multifactorial, including possibly genetic predisposition and hormonal factors. The earlier treatment is begun the better likelihood of slowing progression and seeing regrowth.

The other common hair loss condition is called telogen effluvium (TE). The condition is characterized by an increase in the amount of shedding that one normally experiences. The condition represents the early release of hairs that are in the resting phase of the hair growth cycle. It’s typically brought on by some sort of trigger event. Most commonly this happens after childbirth with about 30-50% of postpartum women experiencing it. Other potential triggers include major life stressors, hospitalization, illness (e.g., COVID), surgery, and certain medications.

TE also has a specific chronic form that typically affects women 30-60 years of age. There is no identifiable trigger to the increased hair shedding for chronic TE. It can run a course over months and years with the shedding fluctuating in terms of severity. Even if it’s been going on for years there is no progressive change in density that is noticeable to an observer, but the individual affected may note decreased volume.

Ro offers access to treatment for both of these hair loss conditions.

Oral minoxidil, an oral medication that is FDA approved to treat high blood pressure. The typical dosage range used to treat hypertension is 10-40 mg/day. Although not indicated for treatment for hair loss in women, healthcare providers have the discretion to prescribe a medication for a non-approved use (“off-label”) if they believe it is an appropriate course of treatment for a particular patient. For hair loss, oral minoxidil is used at much lower dosages, with 0.25 - 2.5 mg being the typical dosage range used for females. As such, the treatment is often referred to as “low dose oral minoxidil.”

Hair Solution Rx, a customized topical with dermatologist-backed ingredients that address hair loss from a number of angles to optimize topical treatment (ie., topical minoxidil but better). Hair Solution Rx is a compounded drug that contains minoxidil, tretinoin, and melatonin.
As there is no additional benefit to taking both oral minoxidil and the topical formulation, it is not recommended to use both.

The active ingredient in oral minoxidil is the same as the one in topical minoxidil (generic Rogaine). While topical minoxidil is FDA-approved to treat hair loss and is available without a prescription, oral minoxidil for hair loss is considered “off-label” and requires a prescription. Oral minoxidil is FDA-approved (at higher doses) to treat high blood pressure. Doctors began prescribing low-dose oral minoxidil tablets as a convenient, once-a-day, non-hormonal hair loss treatment because in clinical trials studying higher doses of oral minoxidil for high blood pressure, a large percentage of patients experienced “elongation, thickening, and enhanced pigmentation of body hair,” including on the scalp.

Healthcare providers have the discretion to prescribe medications off-label if they believe it is an appropriate course of treatment for a particular patient. Learn more about off-label treatment here.

The jury is still out on exactly how minoxidil works with regards to hair loss. While the exact mechanism is not completely understood, it’s thought to increase the length of the growth phase of hair follicles and increase the size of hair follicles, which is thought to promote hair regrowth and increased density.

Minoxidil is also thought to relax smooth muscle in blood vessel walls, causing them to widen and increase blood flow. This may be another way that minoxidil works to stop or slow hair loss and promote hair regrowth and increased hair thickness

With both oral minoxidil and topical Hair Solution Rx, which is formulated with minoxidil, while the timeline for results may vary, some users begin to see results as soon as 3 months, but those represent the minority. Typically, it takes 6–12 months to see the full benefits.