Minoxidil: The Complete Guide for Men (2024)

Minoxidil is the most widely used hair loss treatment in the world. It’s one of only two treatments approved by the FDA (and licensed in the UK) for male pattern baldness. It works. But “works” comes with caveats.

This guide covers everything: the mechanism, realistic results, who it’s best for, side effects, and how to use it properly.

How Minoxidil Works

The honest answer: we don’t fully understand the mechanism. What we know is that minoxidil is a potassium channel opener that causes vasodilation — it widens blood vessels and increases blood flow to hair follicles.

The working hypothesis is that this increased blood flow delivers more oxygen and nutrients to miniaturised follicles, partially reversing the miniaturisation caused by DHT (dihydrotestosterone). It may also extend the anagen (growth) phase of the hair cycle.

What it doesn’t do is block DHT. That’s finasteride’s job. Minoxidil works differently and can be used alongside DHT blockers for a synergistic effect.

Who Minoxidil Works Best For

Minoxidil is most effective for:

• Men in the early to mid stages of androgenic alopecia (male pattern baldness)
• Thinning at the crown (vertex) — this is where clinical trials showed the strongest results
• Men who still have some active follicles in the thinning areas

It’s less effective for:

• Completely bald areas where follicles are gone
• Hairline recession (frontal baldness responds less well than crown thinning)
• Hair loss caused by anything other than androgenic alopecia (alopecia areata, telogen effluvium, etc.)

What Results Can You Realistically Expect?

Don’t expect the before/after photos in ads. Here’s what the clinical evidence actually shows:

Regrowth: In trials, around 40% of men using 5% minoxidil topically saw “moderate to dense regrowth.” The majority see slowing or stopping of loss, with partial regrowth.

Timeline: Don’t expect anything for the first 3-4 months. Visible results typically emerge at 4-6 months, with maximum effect around 12-16 months of consistent use.

The shedding phase: Around weeks 2-8, many men experience increased shedding. This is normal — telogen hairs are being pushed out to make way for new anagen hairs. It’s temporary and a sign the treatment is working.

Maintenance: Minoxidil is not a cure. If you stop, you’ll lose whatever you gained within 3-6 months and return to where you’d have been without treatment.

5% vs 2% Minoxidil

The clinical evidence consistently shows 5% is more effective than 2% for men. The 2% concentration was originally developed for women (to reduce systemic absorption and associated side effects). Use 5% unless a doctor advises otherwise.

Oral Minoxidil: The New Option

Low-dose oral minoxidil (0.625mg–2.5mg daily) has emerged as an alternative to topical application, particularly for men who find twice-daily topical application inconvenient.

Early evidence is promising — some studies suggest oral minoxidil may even outperform topical. It’s currently prescribed off-label in the UK. Talk to a dermatologist if you’re interested.

Side Effects

Topical minoxidil is generally well-tolerated. Known side effects include:

• Scalp irritation — more common with the liquid formulation due to propylene glycol; switching to foam often resolves this
• Unwanted facial/body hair — occurs in some users due to systemic absorption
• Initial shedding — common and temporary (see above)
• Dizziness/fluid retention — rare with topical use, more relevant to oral minoxidil

Minoxidil is not for everyone. Men with heart conditions should consult a doctor before use.

How to Use It Properly

1. Apply twice daily — morning and evening, to a dry scalp
2. Use 1ml per application for liquid; half a capful for foam
3. Massage in gently — don’t vigorously rub, which can cause breakage
4. Wash hands thoroughly after applying liquid formulation
5. Let it dry before bed — ideally 2-4 hours before lying down
6. Commit to 12 months before evaluating results — don’t quit during the shedding phase

Minoxidil vs. Finasteride

These are frequently compared, but they work differently and aren’t mutually exclusive.

	Minoxidil	Finasteride
Mechanism	Increases blood flow	Blocks DHT production
Effectiveness	High for crown, lower for hairline	Strong across the scalp
Side effects	Scalp irritation, body hair	Sexual side effects (in minority)
Application	Topical (or oral)	Oral pill
Best for	Early to mid crown thinning	All-over thinning and recession

Many dermatologists recommend both for men with moderate-to-significant loss.

Bottom Line

Minoxidil is a legitimate treatment backed by decades of clinical evidence. It’s not magic — you won’t regrow a full head of hair in three months — but for men in the early to mid stages of androgenic alopecia, consistent use can meaningfully slow loss and deliver real regrowth, particularly at the crown.

The generic 5% foam or liquid is as effective as branded versions at a fraction of the cost. Start there, commit to a year, and manage your expectations.