Oral vs. Topical Minoxidil: What’s Best for Hair Growth?

Minoxidil is one of the most commonly used hair loss treatments — and for good reason. Simply put, it works. But if you’ve decided on minoxidil for hair growth, you’ll need to make yet another choice: oral versus topical minoxidil.

Ahead, we’ll cover how minoxidil works, plus the efficacy, tolerability, and practical considerations of using oral or topical minoxidil so you can decide which form of this popular hair loss treatment is right for you.

Minoxidil is the active ingredient and generic version of Rogaine®. This medication is used to treat male pattern baldness (androgenetic alopecia) and other types of hair loss, including telogen effluvium and traction alopecia.

How Minoxidil Affects the Hair Growth Cycle

Its exact mechanism of action isn’t fully understood. But we know minoxidil is a vasodilator, meaning it widens blood vessels, including those in the scalp. That brings blood flow, oxygen, and nutrients to hair follicles to promote healthy hair growth.

Research shows that minoxidil also shortens the telogen (resting) phase of the hair growth cycle, thereby extending the anagen (growth) phase.

History of Minoxidil

Minoxidil has a storied history. Originally created to treat ulcers (it didn’t work for that), scientists realized the drug dilated blood vessels. In 1979, minoxidil tablets were FDA-approved as a treatment for high blood pressure (hypertension). When used for high blood pressure, it’s sold under the brand name Loniten®.

There was another surprise: People taking minoxidil for high blood pressure started noticing unexpected hair growth. That brings us to today, when minoxidil is a widely used hair loss medication.

Many people Google “Rogaine pill vs. topical Rogaine.” But there’s actually no such thing, strictly speaking, as a Rogaine pill.

Instead, what they’re really wondering about is the difference between topical and oral minoxidil. We’ll go over this in detail below.

The most obvious difference between oral and topical minoxidil is how each is used. But there are some other important distinctions between the two.

Here’s what to know about oral versus topical minoxidil.

Topical Minoxidil

Topical minoxidil is applied directly to the scalp in areas where you see hair thinning, a receding hairline, or baldness. It’s designed to be used twice daily — once in the morning and once at night.

The topical form of minoxidil works locally, so you’ll only see hair growth where you apply it (which is why it’s important not to let it drip onto your face).

Topical minoxidil is FDA-approved for hair loss and is over-the-counter, meaning you can buy it without a prescription.

It’s available in different forms, too — the choices keep on coming. You can get topical minoxidil as a liquid solution or a foam.

Oral Minoxidil

On the other hand, oral minoxidil is a once-daily pill. It’s swallowed and then absorbed into the bloodstream.

Since it’s not applied locally, oral minoxidil causes general hair growth all over. So in addition to more hair density on your head, you may also see changes in your body and facial hair or your eyebrows.

At this time, only topical minoxidil is FDA-approved for hair loss. However, oral minoxidil is often prescribed off-label for hair loss.

Generally, low-dose oral minoxidil — which is fewer milligrams than what’s needed for hypertension — is prescribed for hair loss.

For example, our minoxidil chews contain 3 milligrams of minoxidil. Meanwhile, a dose of Loniten for high blood pressure may contain as much as 40 milligrams — far more than what’s needed to address male pattern baldness.

Oral minoxidil is used off-label for both male and female pattern hair loss. (Off-label use is when a medication is prescribed for something it’s not FDA-approved for.)

Like its topical counterpart, studies show that oral minoxidil results in the stabilization of hair loss (meaning it stops shedding) and even improvement in hair count.

A 2021 review found that oral minoxidil is a “successful and well-tolerated alternative for patients with hair loss.”

In a 2020 study, participants saw a “significant increase” in baseline hair counts after 12 and 24 weeks of daily oral minoxidil use in a 5-milligram dose.

Progress was tracked by photographs of the patients’ vertex (the crown of the head), and an expert panel found 100 percent improvement. This means all participants showed some improvement in hair.

Who Should Use Oral Minoxidil?

Oral minoxidil can be a good option for folks who’ve had a skin reaction to topical minoxidil. It might also appeal to those who have trouble using the topical version every day, twice a day.

People may want to use oral minoxidil because:

• It’s convenient. Convenience is one of the main draws of oral minoxidil over topical. For example, if you’re someone who travels regularly, you may find it easier to pack a few pills than a dropper bottle or aerosol can.

• It’s easy. Or if you’re just forgetful and it seems easier to pop an additional pill along with your vitamins, that may be a good enough reason to try oral minoxidil.

• There’s no risk of scalp irritation. If you’ve ever gotten a rash or had discomfort at the application site when using topical minoxidil (which is rare but possible), you may also be a good candidate for the oral form.

One of the cool things about our oral minoxidil chewables is that they combine minoxidil with other ingredients that support hair health, like biotin, vitamin B5, and vitamin B6.

Benefits of oral minoxidil:

• Only needs to be taken once daily

• Does not leave residue on hair

• Potential cost savings

Potential side effects of oral minoxidil:

• Hypertrichosis (excessive hair growth on the body)

• Postural hypotension (a drop in blood pressure when going from sitting to standing)

• Rapid heartbeat or elevated heart rate

• Unexplained weight gain

• Low blood pressure (hypotension)

• Dizziness

• Headache

• Nausea

• Acne

• Fluid retention

• Pedal edema (swelling of feet and ankles)

These side effects are rare, though, especially when taking a low dose for hair loss.

We have both a topical minoxidil foam and a liquid solution, each at 5% strength. While they’re equally effective, people with longer hair might find the liquid’s dropper bottle easier to apply.

The foam is mess-free because it doesn’t drip, and a little goes a long way. You’ll hear us say this a lot (because it’s true), but when it comes to foam or liquid solutions (or pills, for that matter), it’s just a matter of personal preference.

For a deeper comparison, see our guide to minoxidil foam versus liquid.

If you’re considering minoxidil foam versus pills, there are some things to know about topical minoxidil (in foam and liquid form).

Benefits of topical minoxidil:

• Goes exactly (and only) where you want to see hair growth

• Avoids internal side effects of oral minoxidil

• Can be used with other topical hair-loss medications

• May be an enjoyable part of a haircare routine

Potential side effects of topical minoxidil:

• Skin or scalp irritation at the application site

• Scalp itchiness (sometimes called pruritus)

• Slight burning sensation

• Skin rash

• Redness at the application site (erythema)

• Headache

• Facial hypertrichosis (excessive hair growth on the face)

Any redness or irritation where minoxidil is applied is more likely due to propylene glycol, an alcohol found in some formulations, than minoxidil itself.

Our minoxidil foam is free of propylene glycol. So it’s a good option if you have sensitive skin or have previously had adverse reactions to minoxidil.

Imagine this: You’re about to drift off to sleep, and you realize you forgot your minoxidil. Would you rather pop a pill or get up and apply something to your scalp?

If you’re thinking this situation doesn’t apply to you because you’d never forget to apply your minoxidil, then the topical version is probably great for you. In fact, some people may actually enjoy applying it as part of their routine.

For others, the scenario we just described conjures relatable dread. Those people may find it easier to stay consistent when all that’s required is swallowing a pill. Topical minoxidil also needs to be applied to dry hair twice a day, whereas oral minoxidil is taken just once a day.

So, is oral or topical minoxidil better? There’s really no right answer — it all depends on what works best for you. The two seem to work about the same.

Research on Oral vs. Topical Minoxidil Effectiveness

If you’re looking for a solid answer about whether topical or oral minoxidil is better, then, fine — twist our arm. A 2023 study comparing the efficacy and safety of 1-milligram daily oral minoxidil and 5% topical minoxidil found that topical minoxidil had a better therapeutic effect (meaning it worked a little better).

But the results weren’t statistically significant, meaning a slight difference in trial data would be expected even if the medications were equally effective.

So, truly, it’s a matter of personal preference.

One thing we love about minoxidil is that it can be paired with another hair-loss hero, finasteride. Finasteride (the active ingredient in Propecia®) is the only other FDA-approved hair loss medication besides topical minoxidil.

Not only can they be paired, but they work even better as a duo. A 2019 meta-analysis found that the combo of oral finasteride and minoxidil topical solution worked better than either one used alone (and was similarly safe).

One small study found that, although both oral finasteride and topical minoxidil were effective treatments for male androgenetic alopecia, finasteride worked a little better. Side effects were mild in both groups. The same findings were true in a separate study comparing finasteride and minoxidil lotions.

If you’re looking for an additional hair loss treatment to use in tandem with (or instead of) topical minoxidil, we offer finasteride tablets and a two-in-one topical finasteride & minoxidil spray.

Just when you’ve finally decided on minoxidil for the treatment of androgenetic alopecia — bam, more choices. At some point, you’ll need to choose between topical and oral minoxidil because taking the two together isn’t recommended.

Here are a few things to remember about oral versus topical minoxidil:

• Only one is FDA-approved for hair loss. Topical minoxidil is FDA-approved specifically for the treatment of pattern baldness. Oral minoxidil is FDA-approved for high blood pressure but is sometimes used off-label for hair loss.

• They produce similar results. Clinical trials show the two forms of minoxidil work comparably.

• The side effects are different. Side effects associated with the topical treatment include redness, itchiness, or irritation on the scalp. Side effects of oral minoxidil include things like dizziness or hair growth in areas other than the scalp.

If you’re interested in learning more about minoxidil, check out our guides on minoxidil dosages for hair loss and how long it takes minoxidil to work.

You can also peruse our hair loss treatments for men. And if you’re ready, do an online hair loss consultation to figure out what form of minoxidil (or other treatment plan) is right for you.