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Keeping Your Hair Might Have Just Gotten Easier

The latest thing in preventing hair loss? It’s pretty old. But it just might work.

man washing hair discovers hair loss
Getty Images

Over the last decade, you’ve probably read numerous predictions in men’s magazines that a cure for baldness was just around the corner. Sometime soon, they promised, an advancement in stem cell treatments would be able to reactivate dead follicles on your dome and sprout it with luscious locks.

We’re still waiting on that miracle cure.

But there is new hope for guys with thinning hair. And it’s coming from a familiar name. As reported recently in The New York Times, a growing number of dermatologists are prescribing low-dose minoxidil pills — intended for treating high blood pressure — for the off-label use of regrowing hair. And for many users, this one-pill-a-day regimen is working to produce thicker hair in a matter of months. As a bonus, the pills are also incredibly cheap.

Minoxidil is the effective drug in Rogaine, and minoxidil foams are at least somewhat effective in stimulating hair regrowth for most users. The problem is that most users loathe using it.

Why? “Because it’s a mess,” explains Antonella Tosti, M.D., a professor of clinical dermatology at the University of Miami and a dermatologist in Miami Beach. Applying a small amount to the scalp twice a day can be a messy chore. 

Tosti has been prescribing low-dose minoxidil pills to patients over the past four years, and she says it’s both “effective and safe.”

Oral minoxidil is available in 2.5-milligran, 5-milligram and 10-milligram tablets, but generally prescribed for off-label hair growth in dosages of 0.25 to 5 milligrams, taken once daily. (This is a much lower dosage than what’s used for hypertension — from 10 to 40 milligrams per day.) 

In several studies, a majority of patients have noted either a reduction in shedding, improved hair growth, or both. 

And how does it work? It’s thought that minoxidil increases blood flow (and oxygen) to the hair follicle, among other possible benefits. But, as noted in a recent story from the American Academy of Dermatology, the drug is still something of a mystery: “Even after decades of use, we still do not completely understand how minoxidil improves [hair loss].”  

And while it has very few side effects when taken in low doses, there are a few that might give you pause. Propecia or finasteride — Propecia is the brand-name drug, while finasteride is the cheaper generic version — is the only oral medication approved by the FDA for the treatment of hair loss. But its main side effect is a possible diminished sex drive, as well as mood changes like depression. 

“Propecia isn’t dangerous, in my experience, and the side effects are rare,” Tosti says. “But people are very afraid of medications that may interfere with their sex drive or their mental state.”

Users have also reported excess hair growth in places other than their scalp, which can be managed in most cases by a little manscaping. And although rare when prescribed at a low dosage, it may lower blood pressure for some patients. 

“I wouldn’t give it to someone who’s under cardiac care, but other than that, there’s really not much risk,” says Michele Green, M.D., a dermatologist in Manhattan. “It works a lot of the time and has so little downside that if someone doesn’t think it’s working for them, they can just stop taking it.”

But before you go racing to an online service that promises a decision on a prescription within minutes, no office visit needed, think twice. 

Hair loss isn’t always about aging — it can be caused by problems in your endocrine system, for example, a diagnosis that likely wouldn’t be caught via a text exchange with a doctor at an online service in which blood work is rarely required. 

Sorry to sound like the end of a prescription drug commercial, but … ask your doctor or dermatologist if a low dose of oral minoxidil is right for you. 

You might not grow tresses worthy of a romance novel. But you could hang on to what you’ve got. “If you stay where you are, and you don’t lose more hair, that’s a success,” Green says. 

“Lots of times, people come in [with huge bald patches], and it’s too late,” she adds. “They don’t understand that it’s like a plant — if the bulb’s dead, it’s not going to grow back. It’s much smarter to start earlier and try to protect what you have.”