Minoxidil 5% topical regrows hair
About 60% partial regrowth, 80% slowed progression at 12 months. OTC, well-tolerated. Lifetime commitment — stop and the gain reverts.
What the evidence says
The studies, decoded
Decades of RCT data establish minoxidil 5% topical as first-line OTC treatment for androgenetic alopecia. Olsen 2002 and Suchonwanit 2019 review: about 60% of users see partial regrowth, 80% see arrested progression. Most effective on the crown, less so on the temples. Foam vs solution: similar efficacy, foam tolerated better.
How it actually works
Mechanism
Originally a vasodilator (oral antihypertensive). Topically, it prolongs the anagen (growth) phase of the hair cycle and stimulates follicle perfusion. Exact downstream mechanism is still incomplete — but the clinical effect is robust.
What to actually expect
Realistic outcome
1mL 5% solution or half a cap of foam twice daily on dry scalp. 4-6 months for visible effect. Lifetime commitment — gains reverse within 3-6 months of stopping. Initial 'shedding phase' at weeks 4-8 is normal and predictive of response.
If this is overhyped — what is not
Better alternatives
Oral minoxidil 1-5mg (Sinclair 2017, off-label) — more convenient, slightly more efficacy, lower local side effects. Stack with finasteride for the most evidence-backed protocol.
Sources
Citations
- Topical minoxidil 5% for male pattern hair loss: a randomized placebo-controlled trialOlsen et al., 2002, J Am Acad Dermatol
- Minoxidil and its use in hair disorders — reviewSuchonwanit et al., 2019, Drug Des Devel Ther
Finasteride (Propecia) stops and partially reverses hair loss
The most-studied AGA drug. Reduces DHT by ~70%. Stable or improved density in 80-90% of users over years. Sexual side effects 1-4%, mostly reversible.
MaybeRosemary oil regrows hair like minoxidil
One real RCT showed comparable density gain to minoxidil 2% at six months. Smaller effect than minoxidil 5%, but a real signal — and topical, cheap, no Rx.
MaybeDerma roller (microneedling) regrows hair
Real adjunct effect — adding microneedling to minoxidil roughly doubles density gain in trials. Standalone effect is modest. 1.5mm roller, once a week, not daily.