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When it comes to hair loss treatments, there’s a lot of smoke and mirrors. We know — it can feel really overwhelming. But there’s one treatment with numerous studies proving its efficacy for hair growth. Plus, it has FDA approval for the treatment of female pattern hair loss and is considered safe for women to use. And that would be — drumroll, please — minoxidil.
If you’re dealing with a wider part or hair thinning around the crown of your head, you’ve probably already heard of topical minoxidil (commonly sold under the brand name Rogaine®). Minoxidil is typically a dermatologist’s first line of defense in the treatment of hair loss.
The initial effects of minoxidil occur after about eight weeks of treatment, and better results can be seen after four months. If you can play the long game, a review of multiple studies showed peak improvements at the year mark.
If you’re looking to learn more about female hair loss, this article will walk you through the root causes and various treatments (including good ’ol minoxidil). We’ll dive into the different minoxidil formulations (typically available over the counter in 2% and 5% concentrations), along with the side effects and potential results.
It can seem like there’s a lot of shady stuff available for female hair loss. But as one of the most researched hair loss treatments on the market, numerous studies have shown minoxidil to work safely and effectively for both men and women as a hair loss treatment. Phew.
And as mentioned above, topical minoxidil is FDA-approved for usage by women. Both 2% and 5% formulations are available to purchase over the counter, no prescription necessary.
We dive deeper in our guide to minoxidil for female hair loss if you want to learn more.
Not to sound like a presidential campaign, but yes, we can. Many studies have focused on 5% minoxidil usage in women, demonstrating significant results in hair regrowth.
While 5% minoxidil foam has been approved for men since 2006, the FDA approved 5% minoxidil foam for female pattern hair loss (FPHL) in 2014.
In even better news, minoxidil foam allows for more effective delivery and easy penetration with less irritation.
When it comes to comparing 2% minoxidil solution to 5% topical foam, a couple of clinical trials have indicated that the higher-strength dosage may offer more promising results. However, results vary among individuals. We’ll get more into that below.
Now, let’s get into some of the clinical studies and their findings to help you make a decision on which option is best for you.
A 48-week placebo-controlled study looked at the effects of 5% topical minoxidil and 2% topical minoxidil in 381 women for the treatment of female pattern hair loss.
The women in the study applied minoxidil twice a day, and at the end of the 48 weeks, researchers found that hair regrowth and scalp coverage increased relative to prescription strength. The 5% group experienced the best results, and the 2% group experienced superior results to the placebo group.
In another six-month randomized clinical trial comparing 5% minoxidil foam to 2% topical solution, 113 women were given randomized treatment with either strength for the treatment of androgenetic alopecia.
The 5% users only applied the treatment once a day, while the 2% users applied it twice daily. At the end of the study, researchers concluded that there was no significant increase in hair count and target area hair width.
Another major thing to note? Women who applied 5% minoxidil topical foam experienced substantially lower rates of intolerance compared to those who used the 2% solution. It’s hard to gauge if that’s because of the formulations or due to the frequency of usage (once a day versus twice a day).
While side effects with either version are rare, it’s always best to check with your dermatologist or healthcare provider for the most appropriate medical advice (especially if you’re pregnant or breastfeeding). Learn more about minoxidil while breastfeeding if that’s a concern for you.
As noted in the study above, even though it seems counterintuitive, those who used 5% minoxidil foam had less itching or dandruff on the scalp compared to the 2% topical minoxidil solution users. This could be due to the twice-a-day application of the 2% solution, whereas the 5% foam was only applied once daily.
But in the 48-week study noted above, there was an increased occurrence of pruritus, local irritation and hypertrichosis observed with 5% topical minoxidil versus the 2% topical minoxidil and placebo.
So these two studies basically have opposite findings. But we think it goes to show that minoxidil effects are specific to the person using it.
The most common topical minoxidil side effects can include:
Scalp irritation, dermatitis or rash at the application site
Scalp itchiness or flaking
A slight burning sensation
Tend to be a Nervous Nellie? Check out our guide to the side effects of minoxidil for women for a full list.
No matter which percentage you choose, minoxidil gives you a solid game plan to help promote new hair growth and increase hair density. The key takeaways?
Both dosages have been shown to be effective at regrowing hair.
Side effects tend to be mild.
Both are safe options for women to use and are FDA-approved.
You can also consider other hair loss treatments to add to your regimen, including:
Oral minoxidil. Don’t want to add another step to your hair styling routine? We get ya. Thankfully, studies have shown that low-dose oral minoxidil (OM) can be an effective treatment of numerous hair disorders, including female pattern hair loss.
Spironolactone. Another oral medication, spironolactone commonly prescribed off-label for its antiandrogenic effects — especially for hair loss. It’s been shown to decrease testosterone levels in the blood and lessens its effect in certain areas of the body. Research indicates it may be helpful for women with signs of hyperandrogenism.
Speak with your healthcare provider to figure out which treatment (or combination of treatments) may be right for you. And you can get started with an easy online quiz. The best part? No waiting room to deal with.
Sara Harcharik Perkins, MD, FAAD is a board-certified dermatologist and Assistant Professor in the Department of Dermatology at the Yale School of Medicine. She is the director of the Teledermatology Program, as well as the Associate Program Director of the Yale Dermatology Residency Training Program. Her research focuses on telemedicine and medical education. Her practice includes general medical dermatology, high-risk skin cancer, and procedural dermatology.
Dr. Perkins completed her undergraduate education at the University of Pennsylvania and obtained her medical degree at the Icahn School of Medicine at Mount Sinai. She completed her medical internship at the Massachusetts General Hospital, followed by residency training in dermatology at Yale University, after which she joined the faculty.
Ahmad, M., Christensen, S. R., & Perkins, S. H. (2023). The impact of COVID-19 on the dermatologic care of nonmelanoma skin cancers among solid organ transplant recipients. JAAD international, 13, 98–99. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10518328/
Ahmad, M., & Perkins, S. H. (2023). Learning dermatology in medical school: analysis of dermatology topics tested in popular question banks. Clinical and experimental dermatology, 48(4), 361–363. https://academic.oup.com/ced/article-abstract/48/4/361/6869515?redirectedFrom=fulltext&login=false
Belzer, A., Leasure, A. C., Cohen, J. M., & Perkins, S. H. (2023). The association of cutaneous squamous cell carcinoma and basal cell carcinoma with solid organ transplantation: a cross-sectional study of the All Of Us Research Program. International journal of dermatology, 62(10), e564–e566. https://onlinelibrary.wiley.com/doi/10.1111/ijd.16700
Ahmad, M., Marson, J. W., Litchman, G. H., Perkins, S. H., & Rigel, D. S. (2022). Usage and perceptions of teledermatology in 2021: a survey of dermatologists. International journal of dermatology, 61(7), e235–e237. https://onlinelibrary.wiley.com/doi/10.1111/ijd.16209
Asabor, E. N., Bunick, C. G., Cohen, J. M., & Perkins, S. H. (2021). Patient and physician perspectives on teledermatology at an academic dermatology department amid the COVID-19 pandemic. Journal of the American Academy of Dermatology, 84(1), 158–161. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491373/
Belzer, A., Olamiju, B., Antaya, R. J., Odell, I. D., Bia, M., Perkins, S. H., & Cohen, J. M. (2021). A novel medical student initiative to enhance provision of teledermatology in a resident continuity clinic during the COVID-19 pandemic: a pilot study. International journal of dermatology, 60(1), 128–129. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753449/
Cohen, J. M., Bunick, C. G., & Perkins, S. H. (2020). The new normal: An approach to optimizing and combining in-person and telemedicine visits to maximize patient care. Journal of the American Academy of Dermatology, 83(5), e361–e362. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316470/
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