This old-school drug is changing the future of hair loss treatment

A decades-old hair loss drug is making a comeback—but this time, in pill form. Originally developed as a blood pressure medication in the 1970s, minoxidil became widely known in the 1990s as Rogaine, a topical treatment for male and female pattern baldness. Now, dermatologists are increasingly prescribing low-dose minoxidil tablets, which may offer an easier and more effective way to maintain or regrow hair.

How Minoxidil works

Minoxidil’s ability to slow hair loss is linked to its effect on blood circulation. The drug increases blood flow to the scalp, encouraging hair follicles to remain in their growth phase for longer. “We’re trying to keep those hairs in that growth phase as long as possible,” explains Dr Adam Friedman, chair of dermatology at George Washington University.

While the topical version has been available for decades, recent studies suggest that taking the drug orally may work just as well—if not better—than applying it directly to the scalp.

Why patients prefer the pill

Many patients find the pill more convenient than the liquid or foam version, which must be applied once or twice daily with a dropper. “Although people often enthusiastically begin therapy—and even see results—after a while, many drop off,” says Dr Susan Taylor of the University of Pennsylvania. Taking a pill once a day is far simpler and eliminates the mess of topical applications.

Minoxidil tablets are typically prescribed at very low doses, reducing the likelihood of side effects such as dizziness, rapid heartbeat, or swelling. Men are often advised to take half of the lowest-dose pill, while women may need only a quarter. However, the drug is not recommended for pregnant or breastfeeding individuals or those with heart conditions.

The cost factor

Unlike newer hair loss treatments, minoxidil is highly affordable. Since its patent has expired, it is available as a low-cost generic medication, with some pharmacies offering a month’s supply for less than £5. “Not a single patient has complained to me about the cost of this medication, which is extremely rare,” says Dr Luiz Garza of Johns Hopkins University.

However, because the drug is already widely available, pharmaceutical companies have little financial incentive to fund new clinical trials that would secure FDA approval for hair loss treatment. Instead, dermatologists prescribe minoxidil pills off-label, meaning they are using a medication approved for one condition (blood pressure management) to treat another (hair loss).

Telehealth companies expand access

As interest in minoxidil pills grows, telehealth providers like Hims and Ro are making it easier to obtain prescriptions. These companies allow patients to complete a questionnaire about their medical history and hair loss concerns, which is then reviewed by a healthcare provider. If no red flags appear, a prescription can be issued and shipped directly to the patient.

While telehealth services improve accessibility, some dermatologists caution that in-person consultations remain the best approach. “I recommend seeing a board-certified dermatologist who knows the data, can evaluate your overall health, and discuss potential side effects,” says Taylor.

With minoxidil pills gaining popularity, the landscape of hair loss treatment is shifting. This repurposed medication offers a promising, cost-effective solution for those seeking to slow hair loss and promote regrowth, all while avoiding the inconvenience of daily topical applications.