ORAL MINOXIDIL EFFICACY AND SAFETY IN MALE ANDROGENETIC ALOPECIA - A LITERATURE REVIEW
DOI:
https://doi.org/10.31435/ijitss.2(50).2026.5303Keywords:
Oral Minoxidil, Androgenetic Alopecia, Male Pattern Baldness, Efficacy, Safety Of Oral MinoxidilAbstract
Background: Low-dose oral minoxidil (LDOM) has emerged as a promising treatment for male androgenetic alopecia (AGA), offering potential advantages over topical formulations. This review evaluates the efficacy and safety of oral minoxidil for male AGA.
Methods: A comprehensive literature search of PubMed, EMBASE, Cochrane Library, and Web of Science identified randomized controlled trials, observational studies, systematic reviews, meta-analyses, and consensus statements evaluating oral minoxidil (0.25-5 mg daily) for male AGA.
Results: Across multiple studies, oral minoxidil demonstrated consistent efficacy for male AGA. Prospective studies reported increases in terminal hair density of 21.6-23.6% on the vertex with 5 mg daily dosing. Systematic reviews reported clinical response rates of 61-100%, with meta-analysis confirming that doses exceeding 1 mg were associated with greater efficacy. Approximately 35% of patients experienced significant symptom improvement and 47% showed improvement overall. Hypertrichosis was the most common adverse effect (15-49%), but rarely led to discontinuation (0.5%). Serious systemic adverse effects were infrequent: lightheadedness (1.7%), fluid retention (1.3%), and tachycardia (0.9%). No life-threatening events were reported, and only 1.7% discontinued treatment due to adverse effects. Meta-analysis confirmed that LDOM does not significantly affect blood pressure.
Conclusions: LDOM is an effective and well-tolerated treatment for male AGA and represents a valuable option for patients preferring oral therapy or intolerant to topical treatment.
References
Akiska, Y. M., Mirmirani, P., Roseborough, I., Mathes, E., Bhutani, T., Ambrosy, A., Aguh, C., Bergfeld, W., Callender, V. D., Castelo-Soccio, L., Cotsarelis, G., Craiglow, B. G., Desai, N. S., Doche, I., Duque-Estrada, B., Elston, D. M., Goh, C., Goldberg, L. J., Grimalt, R., … Fu, J. M. (2025). Low-dose oral minoxidil initiation for patients with hair loss: An international modified Delphi consensus statement. JAMA Dermatology, 161(1), 87–95. https://doi.org/10.1001/jamadermatol.2024.4593
Chen, M., Weichert, M., Guo, W., Ruzic, R., & Briley, J. (2025). Low-dose oral minoxidil does not significantly affect blood pressure: A systematic review and meta-analysis. Journal of the American Academy of Dermatology, 92(3), 554–555. https://doi.org/10.1016/j.jaad.2024.10.057
Dias, F. R., Yong, S. S., FitzGerald, H., Sinclair, R. D., & Bhoyrul, B. (2025). Expanding the therapeutic landscape of minoxidil for androgenetic alopecia: Topical, oral and sublingual formulations. Frontiers in Pharmacology, 16, Article 1718208. https://doi.org/10.3389/fphar.2025.1718208
Feaster, B., Onamusi, T., Cooley, J. E., & McMichael, A. J. (2023). Oral minoxidil use in androgenetic alopecia and telogen effluvium. Archives of Dermatological Research, 315(2), 201–205. https://doi.org/10.1007/s00403-022-02331-5
Gupta, A. K., Venkataraman, M., Talukder, M., & Bamimore, M. A. (2022). Relative efficacy of minoxidil and the 5-α reductase inhibitors in androgenetic alopecia treatment of male patients: A network meta-analysis. JAMA Dermatology, 158(3), 266–274. https://doi.org/10.1001/jamadermatol.2021.5743
Jimenez-Cauhe, J., Lo Sicco, K. I., Shapiro, J., Hermosa-Gelbard, A., Burgos-Blasco, P., Melian-Olivera, A., Ortega-Quijano, D., Pindado-Ortega, C., Buendia-Castaño, D., Asz-Sigall, D., & Vaño-Galvan, S. (2025). Characterization and management of adverse events of low-dose oral minoxidil treatment for alopecia: A narrative review. Journal of Clinical Medicine, 14(6), Article 1805. https://doi.org/10.3390/jcm14061805
Jimenez-Cauhe, J., Saceda-Corralo, D., Rodrigues-Barata, R., Moreno-Arrones, O. M., Ortega-Quijano, D., Fernandez-Nieto, D., Jaen-Olasolo, P., & Vaño-Galvan, S. (2020). Safety of low-dose oral minoxidil treatment for hair loss: A systematic review and pooled-analysis of individual patient data. Dermatologic Therapy, 33(6), Article e14106. https://doi.org/10.1111/dth.14106
Liu, C., Liu, X., Shi, T., Wang, Y., Sui, C., Zhang, W., & Wang, B. (2025). Efficacy and safety of oral minoxidil in the treatment of alopecia: A single-arm rate meta-analysis and systematic review. Frontiers in Pharmacology, 16, Article 1556705. https://doi.org/10.3389/fphar.2025.1556705
Olsen, E. A. (2025). Hair loss in women. New England Journal of Medicine, 393(15), 1509–1520. https://doi.org/10.1056/NEJMcp2412146
Ong, M. M., Li, Y., & Lipner, S. R. (2026). Oral minoxidil for alopecia treatment: Risks, benefits, and recommendations. American Journal of Clinical Dermatology, 27(1), 101–119. https://doi.org/10.1007/s40257-025-00990-4
Panchaprateep, R., & Lueangarun, S. (2020). Efficacy and safety of oral minoxidil 5 mg once daily in the treatment of male patients with androgenetic alopecia: An open-label and global photographic assessment. Dermatology and Therapy, 10(6), 1345–1357. https://doi.org/10.1007/s13555-020-00448-x
Penha, M. A., Miot, H. A., Kasprzak, M., & Müller Ramos, P. (2024). Oral minoxidil vs topical minoxidil for male androgenetic alopecia: A randomized clinical trial. JAMA Dermatology, 160(6), 600–605. https://doi.org/10.1001/jamadermatol.2024.0284
Pirmez, R., & Salas-Callo, C.-I. (2020). Very-low-dose oral minoxidil in male androgenetic alopecia: A study with quantitative trichoscopic documentation. Journal of the American Academy of Dermatology, 82(1), e21–e22. https://doi.org/10.1016/j.jaad.2019.08.084
Price, V. H. (1999). Treatment of hair loss. The New England Journal of Medicine, 341(13), 964–973. https://doi.org/10.1056/NEJM199909233411307
Randolph, M., & Tosti, A. (2021). Oral minoxidil treatment for hair loss: A review of efficacy and safety. Journal of the American Academy of Dermatology, 84(3), 737–746. https://doi.org/10.1016/j.jaad.2020.06.1009
Sharma, A. N., Michelle, L., Juhasz, M., Muller Ramos, P., & Atanaskova Mesinkovska, N. (2020). Low-dose oral minoxidil as treatment for non-scarring alopecia: A systematic review. International Journal of Dermatology, 59(8), 1013–1019. https://doi.org/10.1111/ijd.14933
Shen, Y., Zhu, Y., Zhang, L., Sun, J., Xie, B., Zhang, H., & Song, X. (2023). New target for minoxidil in the treatment of androgenetic alopecia. Drug Design, Development and Therapy, 17, 2537–2547. https://doi.org/10.2147/DDDT.S427612
Vañó-Galván, S., Pirmez, R., Hermosa-Gelbard, A., Moreno-Arrones, Ó. M., Saceda-Corralo, D., Rodrigues-Barata, R., Jimenez-Cauhe, J., Koh, W. L., Poa, J. E., Jerjen, R., Trindade de Carvalho, L., John, J. M., Salas-Callo, C. I., Vincenzi, C., Yin, L., Lo-Sicco, K., Waskiel-Burnat, A., Starace, M., Zamorano, J. L., … Bhoyrul, B. (2021). Safety of low-dose oral minoxidil for hair loss: A multicenter study of 1404 patients. Journal of the American Academy of Dermatology, 84(6), 1644–1651. https://doi.org/10.1016/j.jaad.2021.02.054
Villani, A., Fabbrocini, G., Ocampo-Candiani, J., Ruggiero, A., & Ocampo-Garza, S. S. (2021). Review of oral minoxidil as treatment of hair disorders: In search of the perfect dose. Journal of the European Academy of Dermatology and Venereology, 35(7), 1485–1492. https://doi.org/10.1111/jdv.17216
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Maciej Makarewicz, Grzegorz Jałoszyński , Oliwia Marciniak , Sebastian Konecki , Natalia Bylak , Bruno Makowski , Dawid Szczepański , Anna Gwizdek, Maria Kurt, Norbert Gromadzki, Marcin Patryk Barbachowski
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.
How to Cite
