Minoxidil – more popularly known as Rogaine – is a hair loss product used by thousands worldwide. Due to its rate of absorption, however, its use is limited to liquid and foam formulations. This can make it difficult to use on a daily basis.
This article will discuss the mechanism behind minoxidil’s effectiveness. This will include a look at how the product absorbs into the scalp.
Since minoxidil cannot effectively be used in shampoo formulations, the article will then outline THREE ways to use it more effectively.
What is Minoxidil?
Minoxidil started off with a very different purpose. Researchers originally developed it in the late 1950s as a treatment for ulcers (1). While it performed poorly against ulcers, they found it to be an effective vasodilator. Upjohn, the makers of minoxidil, was eventually released in 1979 as a drug to treat hypertension (high blood pressure).
After patients started using it, it soon became obvious the drug was also effective in growing new hair. For a while, doctors prescribed it off-label to their balding patients. Eventually, however, the FDA approved it as a male pattern hair loss treatment.
The brand name was Rogaine, and it appeared in pharmacies in 1988. The patent has now expired, and it is available in countless generic versions.
How Does it Work?
Minoxidil’s hair growth properties are directly related to it being a vasodilator.
Your hair follicles are miniature organs. As such, they are part of a larger system. One component of this system is capillaries: the tiny blood vessels that deliver nutrients and oxygen to the follicle, while also removing buildup and waste.
When you suffer from Male-Pattern Baldness (MPB), your follicles undergo a process called miniaturization. This happens when the hormone DHT attacks sensitive hair follicles. Scientists don’t understand exactly how DHT causes the follicles to miniaturize (2).
Whatever the mechanism, the result is that the follicles gradually shrink in size. With each hair growth cycle, the follicle becomes smaller. It also spends less of its time in the growth phase, and more in the resting phase. The result is shorter and finer hairs. Without treatment, this can lead to permanent baldness.
Where minoxidil comes in is in its capillary-widening abilities. As a vasodilator, minoxidil works by relaxing the smooth muscle cells on the walls of the capillaries. This allows proper delivery of vital nutrients and oxygen, kickstarting the hair follicles to produce new hair.
The result is a halt in the miniaturization process, and more hairs in the anagen growth phase: thicker, longer hair.
This process takes place in spite of DHT’s damaging action. You can think of DHT as pushing on the brake of hair growth, and minoxidil pushing even harder on the accelerator.
How Fast Does It Absorb?
It is important to understand how your scalp absorbs minoxidil. This will allow you to use it most effectively and see faster results.
In 1990 a study looked at the length of time the scalp needs to absorb minoxidil (3).
Twice daily for six days, 22 healthy male volunteers applied one mL of minoxidil to their scalps. They applied this over 150 cm2 of bald scalp.
The minoxidil was wiped from the scalp after 1, 2, 4, or 11.5 hours. The researchers then took urine samples and measured the amount of minoxidil and its metabolites.
They found that by hour 1, only about 50% of minoxidil was absorbed. By hour 4, however, this was more than 75%.
As a user of minoxidil, this means it is important to leave the product on your scalp – undisturbed – for at least four hours.
You should not shower, apply other hair products, or in any way interrupt the absorption process. This is why a minoxidil cream can work quite well since it has the time to absorb into the scalp.
Common Minoxidil Formulas
There are two forms of minoxidil for hair loss: liquid or foam.
The liquid formula was the first to enter the market in 1988.
As the use of minoxidil spread, it became obvious that the liquid formulation was causing some unpleasant side effects. These were mostly confined to the application area. They included itching, rash, flaking, and irritation.
The problem, however, was not with minoxidil itself. Instead, it was an inactive ingredient: propylene glycol.
Propylene glycol is short-chain alcohol and, as such, it can cause a number of issues. These include the aforementioned dryness, flaking, and irritation. For many users, these side effects can be a minoxidil deal breaker.
In response, the makers of Rogaine created a propylene glycol-free product: Rogaine foam.
Without the troublesome ingredient, complaints of side effects dropped significantly.
Minoxidil Cream: A New Option?
With liquid and foam formulations currently on the market, you may have thought that manufacturers were out of ideas. But that is where minoxidil cream comes in.
Minoxidil cream is a formulation you apply to the scalp, similar to a lotion. The FDA has not approved the cream formulations, but this does not prevent companies from selling them.
On the face of it, a cream formulation may seem “longer-lasting” than a liquid or foam. After all, the other formulations evaporate pretty quickly.
The cream formulation would stay on for much longer. Theoretically, this leads to greater absorption. But that is not necessarily the case. The other ingredients in the cream product may make it more difficult for the actual medication (minoxidil) to penetrate the skin.
The good news is that the liquid and foam formulations are manufactured with absorption in mind. While the bulk of the product will evaporate over time, the minoxidil absorbs effectively into the scalp.
And while the cream formulations have a higher concentration of minoxidil (15% to 20%, typically), this does not mean they will be more effective.
Safety Considerations
You also have to consider safety.
As mentioned, the cream formulations tend to have higher levels of minoxidil. This can increase the risks and potential for side effects.
While minoxidil side effects are often minor, the dosage increase can make them worse or more likely to occur. These include headaches, flushing, and dizziness.
The most important thing to remember, though, is that the FDA has not approved the cream formulation. This means there was no formal testing carried out on the product. There is no guarantee of its efficacy, side effects, and potential contraindications.
Ease of Use
Another important consideration is the ease of use.
On bare skin, creams are practical. Hairy surfaces like the scalp, however, are a completely different story. There, a cream formulation can be difficult to apply. This is especially true if you have medium-length to long hair.
A liquid or foam formulation will be much easier to apply and less likely to interfere with your day-to-day activities.
Which Concentration is Best?
Aside from deciding between liquid and foam, you also have to choose the suitable concentration for you.
The two concentrations the FDA has currently approved are 2% and 5%. There are more powerful concentrations (10% and 15%), but neither is recommended unless under the supervision of a medical professional. Even then, the side effects may be too intense, and the extra benefit marginal or non-existent.
Men can use either the 2% or 5% concentration. Clinical studies have found the 5% concentration to give slightly better results, so many men begin with this. Women, however, are advised to use the 2% concentration.
(Learn more about Women’s Rogaine, including tips for use and possible side effects.)
This is because the 5% solution has been shown to increase the risk of hypertrichosis – excessive hair growth – on the face.
In addition, women were shown to be more susceptible to other side effects as the concentration increased. These included dizziness and allergic dermatitis.
Is Minoxidil Available as a Shampoo?
Due to the time it takes to fully absorb into the scalp, minoxidil is not available as a shampoo.
There may be shampoo products on the market that contain minoxidil, but their use would be futile. This is because there is no way to hasten the absorption of minoxidil into the scalp, and only time can lead to proper absorption rates.
This is unfortunate, as a minoxidil shampoo would be very convenient. However, it is a reality of the ingredients that can not be changed.
How to Boost Minoxidil’s Effectiveness (3 Ways)
If minoxidil-containing shampoo is ineffective, what can you do to improve the effectiveness of the product?
1. Combine With a DHT-Blocking Shampoo
As you learned above, DHT is believed to be the main culprit in MPB. As such, it is important to remove DHT from your scalp and use a DHT-blocking shampoo regularly to keep your scalp as free from DHT buildup as possible.
Such shampoos work either by 1) inhibiting 5AR (the enzyme responsible for DHT’s conversion from testosterone), or 2) inhibiting DHT.
Ingredients:
- Warm water (1 cup)
- Baking soda (1 tablespoon)
- Apple cider vinegar (1 tablespoon)
- Citrus essential oil (5 drops)
- Saw palmetto gel (1 capsule)
- Olive oil (1-2 teaspoons)
Directions:
Combine the water, baking soda, vinegar, and olive oil in the container of your choice. As the baking soda and vinegar react, it is best to use a non-airtight container to avoid gas buildup.
Next, use a needle or knife tip to pierce the saw palmetto capsule. Squeeze the gel into the combination above, and mix by stirring. At this point, you can also add in the citrus essential oil drops.
Hair Benefits:
The baking soda and vinegar work together to create a gentle, but fully-cleansing shampoo base.
This combination gently removes the buildup of oil, dead skin, and chemicals, but it leaves the necessary oils behind to protect your hair and scalp from overdrying.
(Check out this post to learn more about the health and hair benefits of apple cider vinegar.)
Saw palmetto is the main DHT-blocker ingredient in this recipe.
It works similarly to Propecia – another FDA-approved hair loss drug – and studies have shown that saw palmetto shampoos may improve your hair’s growth.
Last, olive oil is the hydrating carrier oil used in this recipe to deliver the free radical-scavenging citrus essential oil throughout the scalp. This ensures even distribution of the citrus oil.
2. Use a Dermaroller
To further open the pores and improve the absorption of minoxidil, you should consider a dermaroller.
A dermaroller is a small device with tiny needles attached to a rolling pin. It is used to create small punctures in the skin, where the skin then repairs itself and generates new hair follicles.
Are you a bit wary? Check out this 12-week study that shows just how effective the dermaroller can be (4):
One hundred men with varying degrees of male-pattern baldness were split into two groups. The first group received a weekly microneedling procedure and twice daily application of minoxidil 5% lotion.
The second group received only the twice-daily application of minoxidil 5% lotion.
During the day of microneedling, the participants did not apply minoxidil; instead, they were to resume application 24 hours after the procedure.
There were three efficacy measures:
- Change from baseline hair count at 12 weeks;
- Patient assessment of hair growth at 12 weeks; and
- Investigator assessment of hair growth at 12 weeks.
In the graph below you can see the results. The red line is the before and after average hair count of the men who used minoxidil only. The green line shows the men in the combination treatment:
It is clear that the microneedling + minoxidil group performed significantly better than the minoxidil-only group. The researchers hypothesized that there were a few reasons for this difference.
First, microneedling can induce the release of platelet-derived growth factor. This leads to wound regeneration and, as a result, the growth of healthy hair follicles.
Second, it is believed that activation of stem cells in the hair bulge area occurs. This further perpetuates the growth of healthy follicles.
Fortunately, you do not need to work with a professional to get these same results. You can do this at home.
3. Change Your Diet
One of the best things you can do for hair loss – minoxidil or not – is to bring your diet back into alignment with your body’s natural state.
Your body requires a variety of vitamins and minerals to thrive. These include iron, vitamins A, C, and D, niacin, biotin, and more.
When you are on a poor diet, your body often lacks these vitamins and minerals. Whatever nutrients are available will then go to vital organs and tissues first. This will leave the non-essential organs, like the hair follicle, to suffer.
Will a balanced diet help minoxidil to absorb more quickly? Not likely. But it can work alongside minoxidil to provide you with enhanced results.
You do not just want your body to survive, but to thrive. That is why a healthy, balanced diet is crucial to your overall health, but also to hair growth.
The term balanced diet refers to the balance of healthy food groups, including:
- unsaturated fats
- whole grains
- protein
- fruits and vegetables.
That is not to say you cannot indulge every now and again. You should, however, limit your consumption of trans and saturated fats, highly refined grains, and sugary beverages.
While you are unlikely to see benefits overnight, a change in your diet for the better can result in many positives.
With more available nutrients, your body will be able to support secondary functions like hair growth. A varied diet will also likely make you feel better, both mentally and physically.
Starting off
It is best to make small changes so that they stick.
You should first begin by adding healthier food options to your diet. Perhaps you can have a green salad with your dinners, or replace half of the carbs on your plate with an extra serving of vegetables.
Once you are comfortable with these changes and they’ve become part of your routine, you can begin to remove less healthy options. This may happen naturally as you fill up on the healthier foods you have introduced. You could also deliberately cut out or reduce fast food and takeout, soda, and other sugary drinks, as well as carb-loaded snacks like chips.
Remember this is about balance. As such, you do not need to remove these foods entirely from your lifestyle. Aim to eat healthy at least 80% of the time and you will be off to a great start.
Conclusion
In theory, minoxidil shampoo sounds like a great idea: a shampoo that stimulates hair growth while taking no extra time from your schedule.
Unfortunately, the idea is not feasible. Minoxidil has a very slow absorption rate. This means that any minoxidil-containing shampoo will not stay on your scalp long enough to allow sufficient absorption.
Fortunately, there are a few things you can do to increase minoxidil’s effectiveness. Some of the easiest ones are adding a DHT-blocking shampoo or combining it with microneedling. Lifestyle, and particularly dietary changes, are also very helpful.