Can women use Minoxidil 5% for Hair Loss Treatment?

Q:

Dr. Mohebi,

I was recently in a store trying to buy minoxidil 5% from a pharmacy. I was not successful as the pharmacist told me that 5% minoxidil foam is only for men.  Instead, he told me that I should only use the 2% solution on a regular basis.

I am pretty sure you recommended 5% for me, is that correct? Does it matter which solution I use? Thanks for your help with this question!

A:

Minoxidil, which is also known by the brand name Rogaine, is one of the FDA-approved medications that is currently used for the treatment of many hair loss conditions in both men and women. Minoxidil has been available for purchase by hair loss patients over the counter for many years now.  It is available in both 2% and 5% over the counter solutions or foams but the use of higher doses should only be prescribed by hair restoration specialists.

A study, published in the Journal of the American Academy of Dermatology in April of 2004, compared the result of hair loss treatments with 2% vs. 5% minoxidil in women with female pattern hair loss after 48 weeks of treatment. The results of the study showed that 5% minoxidil was more effective in regard to an increased number of hairs as well as overall hair growth in patients.

When you are trying to purchase the product over the counter, it is written on the box of the 5% version that it is intended for male patients only. The reason for that is the 2% concentration was the initial licensed amount for female patients. It is not a hard and fast rule that women cannot use minoxidil 5% but it does means that a higher than 2% concentration requires a physician prescription.  This is mostly a safety measure for manufacturers since the medication is sold over the counter.

The over-the-counter manufacturer labeling instruction is superseded by your attending physician’s prescription and continued monitoring of your treatment. It is important to reiterate my point here: Minoxidil treatments should always be started after you are examined by a hair restoration specialist.  As medical doctors, we monitor the patient’s response to the treatment through follow-up evaluations and a comparison of miniaturization numbers and pictures.