Is low dose Minoxidil a good idea for hair loss?

Is low dose Minoxidil a good idea for hair loss?

Hi Dr. Irwin. I’ve been reading a lot about low-dose oral Minoxidil for female hair loss. What are your thoughts? Does the oral Minoxidil work well enough on its own or should it be paired with another treatment, such as PRP, for optimal results?

I was at the American Academy of Dermatology annual meeting in March. It was fun partly due to all the research that had been done and published during Covid. Research on this topic was presented several times.


On the topic of oral, low dose Minoxidil, here are my thoughts:

  1. Important Causes of Hair Loss.  Can we agree that starting Minoxidil by requesting it from your primary care, if you were missing an important internal problem, would not be good? Some primary care doctors do a hair loss set of labs and history, but many don’t. At the minimum, please see a dermatologist or your primary care doctor. Things to think about are thyroid health, possible malabsorption syndromes like celiac disease, autoimmune diseases, and hormone imbalances, etc.
  2. Minoxidil Drug Reactions. Make sure you don’t have super low blood pressure and check all medications, including the occasional ones, for potential interactions.
  3. Combining Oral Minoxidil with Other Hair Loss Treatments.  While there’s a fair amount of data on each of these strategies individually, there isn’t much on combinations of these. We all want to be cost effective too. Would you want to use five different medications or injections for this, when you might do well on one or two? Since it takes 6 months to start to see a difference, consider starting the two treatments you think might work best for you. And then adding another one every 6 months.
  4. Other Hair Loss Strategies.  So for example, maybe start with the labs and scalp exam you need, then start lo-dose oral Minoxidil and topical Rogaine (topical Minoxidil). Perhaps with a little scalp massage once a week to stimulate circulation. Other treatments to consider in 6 months with your dermatologist or primary care might be oral spironolactone, hair support basic supplements, a tiny dose of estrogen (0.25mg), if you’re post menopausal (and no contraindications), laser light combs, and injectable PRPFM (Platelet Rich Plasma Fibrin Matrix). These are the main ones.
  5. How Much Is This Bothering You?  This is important. Some people are bothered very little, while others a lot. If it’s really bothering you, and money is no object, maybe you start 3-4 of these at the outset. Our sense of confidence, and love for our bodies, is important. I believe it’s important not to discount this factor.


Hope this helps!
Dr. Brandith Irwin, MD
Founder of SkinTour & MadisonMD Skincare
Follow my skin tips and travels on Instagram!