Minoxidil

Minoxidil is one of the two best-known hair-loss treatments, and the story of how it got there is the best accident in the field. It was developed as a powerful vasodilator — a drug that relaxes blood vessels — and approved as an oral medicine (brand name Loniten) for severe, treatment-resistant high blood pressure.¹

The happy side effect

Patients taking it for their blood pressure began growing hair — and not only on their heads. The effect, called hypertrichosis, showed up on foreheads, cheeks, arms, and backs. Dermatologists started dissolving the pills and dabbing the solution on balding scalps, and after formal studies, a topical 2% minoxidil (brand name Rogaine) was approved for male-pattern hair loss in 1988.¹ A drug aimed at the heart had been rerouted to the hairline.

How it works (sort of)

Honesty compels a confession: the exact mechanism on hair is still not fully understood. The leading idea is that minoxidil prolongs anagen, the growing phase of the follicle, and thickens the resulting shaft, possibly by widening local blood vessels and nudging growth signals.¹ It treats androgenetic alopecia without touching the underlying hormones at all — unlike finasteride, which goes after the cause.

Like all pattern-baldness drugs, it works only while you keep using it. Stop, and the borrowed hairs leave.¹

See also

• Finasteride, the other main drug
• Androgenetic alopecia
• Alopecia

References

1. “Minoxidil.” In: StatPearls [Internet]. StatPearls Publishing (NCBI Bookshelf NBK482378). ↩ ↩² ↩³ ↩⁴