Minoxidil is commonly used as an ingredient in hair loss treatment formulas. However, there are alternatives available which can provide with similar results.
In this article, I’ll introduce you to minoxidil, including how it works. Then, you’ll learn of common side effects and substitutes for this popular over-the-counter treatment.
In addition, I’ll share with you natural alternatives to minoxidil with promising results.
Minoxidil As a Treatment for Male Pattern Baldness
Minoxidil is the active ingredient in Rogaine, and it has been approved by the FDA for over twenty years as a hair loss treatment (even though there can be considerable side effects!)
To understand how it works, it’s first important to understand the causes of pattern baldness.
What Causes Thinning, Receding Hair?
There are various causes of hair fall, though the most popular one is Androgenetic Alopecia (AGA), also known as Male-Pattern Baldness (MPB).
The main cause of AGA is believed to be a sensitivity to DHT, an androgen hormone found naturally within the body.
DHT is produced when testosterone (the sex hormone) and 5-alpha-reductase (an enzyme) interact. This happens in the prostate, but also in places near the hair follicles.
How It Works
As a treatment for pattern baldness, minoxidil works by stimulating blood circulation to the scalp.
As mentioned, AGA is caused by a sensitivity to DHT. As DHT attaches to the hair follicle and remains, the follicle becomes irritated and inflamed. Over time, this leads to hair miniaturization.
As the follicle miniaturizes, the hair growth cycle shortens. This leads to shorter and shorter hairs being produced, eventually leading to no hair at all.
So, where does minoxidil come in?
As the process of miniaturization takes place, the link between the hair follicle and blood vessels becomes thinner. When this occurs, less nutrients and oxygen are delivered.
When minoxidil is used, blood circulation increases. This means more nutrients can be delivered, and the follicle can revive.
Minoxidil Side Effects and Considerations
While minoxidil has proven to be effective in the treatment for alopecia, it does have side effects associated with its use.
Common side effects include local irritation (itching, flaking, burning, rash),
In addition to side effects, there are a few things to consider before beginning treatment.
- Results only last as long as treatment continues.
- The treatment covers symptoms, but it doesn’t treat the root cause.
With these side effects and considerations in mind, it’s natural to want to reconsider your choice.
Are There Over-the-Counter Alternatives to Minoxidil?
As it currently stands, Rogaine (minoxidil) and Propecia (finasteride) are the only hair loss treatments approved by the FDA.
So, what happens if you don’t want to use Rogaine or Propecia?
Are There Natural Alternatives to Minoxidil?
If over-the-counter or prescription medications aren’t an option for you, or if you’ve tried both with poor results, you’ll be happy to know there are natural alternatives.
Many of these alternatives fall into one of two groups (or, sometimes both). Let’s take a look.
As sensitivity to DHT is believed to be a factor in AGA, it makes sense to use DHT blockers.
The problem with DHT blockers (and 5-alpha-reductase inhibitors, like finasteride) is their risk of side effects.
While DHT plays a role in AGA, it’s not necessarily the “cause.” And in fact, DHT plays a much larger role in the human body than many hair loss “experts” would have you believe.
Dihydrotestosterone (DHT) is an androgen sex steroid and hormone. It contributes to the development of secondary male sexual characteristics, like descent of the testes, voice deepening, facial hair growth, etc. That’s not the only biological activities it’s involved in, though.
In the prostate and elsewhere in the body (including the hair follicle), DHT is believed to modulate the inflammatory response. This is likely the reason that DHT levels are higher in men with pattern baldness.
All of that to say, while blocking (or minimizing) DHT has been shown to effectively treat hair loss, it can disrupt some key biological activities.
One way to minimize these effects is to use external DHT blockers as opposed to internal ones.
Finasteride, for example, is an internal drug. It’s taken orally, so it enters the bloodstream where it then travels to the organs and targets 5-alpha-reductase (and DHT) at the “source.” An external DHT blocker, however, would target DHT at the follicles only. This reduces its impact on systemic functions.
While I recommend a different method (which I’ll get into in more depth later), this can be a great way to get started on your hair growth journey.
Do keep in mind that the external DHT blockers below are not approved by the FDA. In many cases, they may not have even been tested on humans but only mice or extracted dermal papilla cells.
So, what are some natural DHT blockers for you to consider?
For example, pumpkin seed oil has been shown over the course of 24 weeks to increase hair count and hair thickness:
In another study, reishi mushroom (Ganoderma lucidum) was the most effective mushroom species at inhibiting 5-alpha-reductase, the enzyme that triggers the production of DHT.
But what about over-the-counter options?
There are topical finasteride formulations that have been developed. This includes a gel formulation and a cream or lotion.
The gel formulation, when used as a maintenance dosage after treatment with minoxidil and/or finasteride, was shown to maintain the hair growth in the majority of individuals.
As you can see, there is still much research to be done on both oral and topical DHT blockers and their overall effects on long-term hair regrowth and maintenance. This is why I recommend a more established method for treating hair loss, and that’s with circulation boosters.
Scalp Tension Reducers
I mentioned above that DHT plays a role in hair loss, but it’s not the cause. Instead, it seems to be that scalp tension is the underlying cause of male pattern baldness in the majority of hair loss sufferers.
Scalp tension is a somewhat ambiguous term, but all it refers to is the chronic tension which is found in the top-most layer of the scalp known as the galea. The galea is a fibrous tissue connected to the muscles on the perimeter of the scalp (frontal, occipital, temporal, and external auricular).
Contractions from these muscles can trigger an inflammatory response in androgen-sensitive regions of the scalp. And can you guess where these regions are? That’s right – in the same areas where male-pattern baldness tends to progress.
As scalp tension increases, so too does inflammation at the hair follicles. This can progress to hair follicle miniaturization, which ultimately means stunted hair growth and the development of pattern balding.
The solution seems simple, then. To stop the progression of pattern balding and to potentially even reverse it, the tension must be reduced.
What does tension really mean when referring to the muscles and their surrounding tissues? Your muscles contract and release on a regular basis. This helps you to perform basic functions and movements. But tension occurs when the muscles remain in a semi-contracted state for an extended period of time.
This is where scalp massage comes in.
Scalp massage is a gentle manipulation of the muscles and tissues (like the galea) with your hands or a specialized massaging tool. The massages will, over time, release the contractions and bring your muscles back to their natural resting state.
In terms of pattern baldness triggered by scalp tension, massage can reduce the inflammatory response and reverse miniaturization of the hair follicles.
There are many scalp massage techniques you can use to your benefit. To view in-depth tutorials on the different techniques I recommend, go here.
If you want to work more muscles for the potential of improved benefits, you can also incorporate scalp exercises into your daily routine.
Scalp exercises are, essentially, an extension of scalp massages. You’ll still manipulate the scalp, but you’ll do so in a less direct way than with scalp massages.
A popular scalp exercise, and one which highlights the indirect nature of the action, is the eyebrow exercise.
- Begin with your eyebrows in a neutral (relaxed) position. Slowly lift your eyebrows up towards your hairline. For best results, hold this position for 10 seconds and then release. You’ll then return your eyebrows to the neutral position. Repeat this exercise five to 10 times.
- Next you’ll furrow your eyebrows. Slowly furrow your eyebrows as deeply as possible, and hold for 10 seconds. Return to neutral position, and then repeat five to 10 times.
- Finally you’ll lift your eyebrows towards your hairline, hold for five seconds, and then immediately move to the furrowed eyebrows position. You’ll hold this position for five seconds, and then return your eyebrows to rest. Repeat this five to 10 times.
Just like with scalp massages, there are plenty of different techniques to try.
If you want to replicate the way in which minoxidil works, then circulation boosters are the way to go. But first, let’s discuss why circulation boosters may be a more viable option for hair loss.
I mentioned above that scalp tension is the true culprit of pattern baldness. What does this have to do with circulation?
As the scalp tension becomes chronic, the scalp and hair follicles will experience an inflammatory response. Anti-inflammatories, like DHT, will flood to the area.
As we know, however, this isn’t very helpful for those who are prone to DHT sensitivity. As a result, the hair follicles will miniaturize and this will stunt hair growth until the follicle eventually dies.
It’s not as simple as the follicle dying from inflammation, though. The true cause of follicle death is the lack of blood flow, oxygen, and nutrient delivery that occurs during the miniaturization process.
Without proper blood flow, there cannot be adequate delivery of oxygen and nutrients. This weakens the hair follicle.
While circulation boosters won’t solve the underlying cause of pattern baldness, they can help your follicles to survive in spite of it.
Circulation boosters are things which increase blood flow to the area. They can be medications (like minoxidil), oils and herbs, or even manual stimulation of the scalp.
Herbs and Oils
There are a few oils and herbs that can improve blood circulation. For example:
Note: If using essential oils to stimulate blood circulation, you must be sure to dilute them appropriately. Undiluted essential oils can damage the skin.
However, I recommend that you also practice manual stimulation of the scalp for added benefits.
There are two main routes you can take when it comes to stimulation of the scalp. First, scalp massage.
Scalp massage involves gentle stimulation of the scalp, either with your fingertips or a head messaging device. As you gently work the scalp, blood flow increases.
This leads to improved circulation overall and can stimulate new hair growth when practiced continually over a period of time.
A more intensive (and effective) route is microneedling.
As a practice commonly used to reduce scarring, microneedling involves the use of tiny needles. These needles are gently rolled over the scalp, and small puncture wounds are made.
As the wounds heal, a three-step process occurs:
- Maturation (Remodeling)
While minoxidil is popular in the hair loss community, not everyone wants to use minoxidil as part of their hair growth regimen. That’s where natural alternatives come in.
Not only can the results of many natural methods be more effective than minoxidil, but they can also come with less side effects.
*This article was reviewed by Dr. Debra Rose Wilson.