Minoxidil side effects and how to fix them

Minoxidil has been the go-to hair loss treatment for men and women since it was first FDA approved in the 1980s. However, not everyone can tolerate topical minoxidil. 

We have teamed up with our pharmacist and formulator to answer all the commonly asked questions when it comes to using topical minoxidil, the side effects from topical minoxidil and how to fix them.

Why does it itch after I apply minoxidil to my hair?

According to a study published by Shardi in 2023, approx. 20% of men and women will stop using topical minoxidil due to scalp itching. Scalp itching is a common side effect with topical minoxidil for a few reasons: 

1) The user has an allergy to propylene glycol, causing the intense itch.

2) Minoxidil is causing the itch (although this is more common with higher doses of minoxidil).

3) The alcohol is causing the skin to become drier over time, causing the scalp to itch.

It is important to identify which ingredient is the allergen to determine if topical minoxidil still remains a suitable option for managing your hair loss. 

Should I stop using minoxidil if my scalp is itchy?

Scalp itching occurs due to an allergy to one or more ingredients in the solution. It is recommended to stop using topical minoxidil if scalp itching occurs. Alternate minoxidil solutions made without propylene glycol and/or alcohol is recommended if you have scalp itching or flaking.

If scalp itching remains after switching to alcohol-free and propylene glycol-free solution, it is likely the user is allergic to minoxidil itself. From our experience, users can expect to see an improvement in symptoms within three to four weeks of not being in contact with the allergen. 

How to tell if minoxidil is working?

The best way to know if minoxidil is working is to stick with the treatment for at least 3-6 months (unless you are experiencing side effects). 

In the first 3 months, you will go through a shedding phase. After the initial 3 months, the shedding will stop and stabilise, and you will see less hair loss around the house and in the shower. 

The results from minoxidil does not peak for at least 12 months with continuous daily use.

What will happen once I stop using topical minoxidil?

When you stop using topical minoxidil, hair shedding will likely resume in as little as 30 days. Studies have shown that hair loss can return to baseline as if the user has never used the treatment if you stop for long enough. 

How often should I wash my hair while using minoxidil?

Hair washing is recommended at least twice a week to keep the scalp clean. This will help the topical solution absorb better. 

How do I know if I am applying minoxidil correctly?

It is recommended to concentrate on the areas that are balding or thinning and massage the solution into the scalp so that the solution can be absorbed into the hair follicles. Never apply the solution directly to the hair shaft and wait for it to dry.

Does tingling mean minoxidil is working?

Tingling is a sign of skin sensitivity. If the tingling sensation is severe, it is recommended that you stop using topical minoxidil and identify the causing allergen. 

Tingling can also signal the strength of minoxidil you are using is too high. From our experience, tingling is more likely to be reported when using 7.5% minoxidil and 10% minoxidil.

What happens when a woman uses 5% minoxidil?

Minoxidil has the potential to lower blood pressure and is not recommended if you are a woman with low blood pressure. Studies show both men and women experience greater results with 5% minoxidil compared to 2% minoxidil. Therefore, women will see better results with 5% minoxidil unless they have extremely low blood pressure.

Minoxidil is not recommended in pregnant women.

Can I use topical minoxidil while breastfeeding for postpartum hair loss?

There is minimal information on the use of topical minoxidil during breastfeeding. The information we have suggests there is minimal absorption in the breast milk, however, the use of topical minoxidil should be avoided while breastfeeding a preterm or neonatal infants.

References:

1. Drugs and Lactation. National Library of Medicine. Updated November 2024
2. Olsen, E et al (2002). "A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men". J Am Acad Dermatology. 2002 Sep;47(3):377-85. doi: 10.1067/mjd.2002.124088. 
3. Lucky, A et al (2004). "A randomized, placebo-controlled trial of 5% and 2% topical minoxidil solutions in the treatment of female pattern hair loss". J Am Acad Dermatology. 2004 Apr;50(4):541-553.