Side effects of minoxidil foam
Minoxidil 5% foam is a widely used treatment for hereditary hair loss (androgenetic alopecia). The product is applied directly to the scalp and can stimulate hair growth and inhibit hair loss in users. 2,3,4
As with any medicine , side effects can occur with minoxidil. In this article, we discuss which side effects may occur, how often they occur, and when it is advisable to consult a doctor. The information is based on the official package leaflet and clinical experience.
Briefly summarized
Minoxidil 5% foam is a proven treatment for hereditary hair loss. Most side effects are mild and temporary, such as itching, scalp irritation, or temporary additional hair loss in the first few weeks. If symptoms persist or if you have any doubts, it is advisable to consult a doctor or pharmacist.
What is minoxidil?
Minoxidil is a drug that was originally developed for the treatment of high blood pressure. During its use, it was discovered that patients developed more frequent hair growth. As a result, a form was later developed that can be applied directly to the scalp to treat hair loss. 3,4
When used topically, minoxidil can stimulate the activity of hair follicles. This allows hair follicles to re-enter the growth phase and can increase hair growth. The agent specifically influences the hair growth cycle by prolonging the hair's growth phase. 3,4
Unlike some other hair loss treatments, minoxidil does not work via hormonal mechanisms. For example, it has no effect on the hormone dihydrotestosterone (DHT), which plays an important role in hereditary hair loss. 3,4
Minoxidil 5% foam
Minoxidil is available in various forms, including solution and foam. The foam contains 5% minoxidil (50 mg per gram) and is applied to the scalp twice daily. 1
The foam is often well tolerated and is intended for use from the age of 18 for hereditary hair loss.
The effect of the treatment usually becomes visible after about 3 to 4 months of consistent use. It is important to know that the product only works as long as it is used; if treatment is stopped, the regrown hair may fall out again within a few months. 3
Temporary increase in hair loss (shedding)
In the first weeks of treatment, hair loss may temporarily increase. This usually occurs between 2 and 6 weeks after starting treatment. 1
This phenomenon occurs because old hairs fall out at an accelerated rate to make way for new hairs growing from the same hair follicles. Although this may seem alarming, it is usually a temporary effect and often a sign that the treatment is starting to work. The hair follicles shed old hairs to allow new, thicker, and stronger hairs to grow back. 3
Common side effects of minoxidil foam
Most side effects of minoxidil foam are mild and local to the scalp. 1
Common side effects
Common side effects (up to about 1 in 10 users) are:
- headache
- irritation of the scalp
- itching or skin rash
- eczema or dermatitis at the application site
- acne-like skin reactions
- shortness of breath
- increased hair growth on other parts of the body, for example on the face or arms
Unwanted hair growth occurs when the product comes into contact with skin areas other than the scalp. Always wash your hands after use.
Factors that influence the risk of side effects
The occurrence of side effects with minoxidil can be influenced by various factors. For instance, the risk of skin reactions increases with more frequent daily use. Additionally, personal sensitivity plays a role; some users experience irritation or itching more quickly than others. 2.6
Moreover, other medications used simultaneously can affect the risk of side effects. If in doubt, it is always wise to seek advice from a doctor or pharmacist first.
How can you limit side effects?
In practice, a number of simple measures can help limit side effects:
- Apply the minoxidil foam only to a dry and healthy scalp
- Do not use more or more often than necessary
- Avoid contact with eyes, face, and other skin areas.
- Always wash your hands after use.
- Use a mild shampoo to reduce scalp irritation
It is important to consistently follow the instructions in the package leaflet; applying it more often or in larger quantities than recommended does not improve the results, but does increase the risk of side effects.
Minoxidil tablets
Sometimes doctors prescribe minoxidil tablets for hair loss. This is usually done at a low dosage and only when a doctor deems it appropriate. This use is called off-label, because the pills are not officially intended for the treatment of hair loss. They are originally intended for the treatment of high blood pressure. 5
Minoxidil pills can cause more side effects than minoxidil applied to the scalp. Possible complaints include a drop in blood pressure, palpitations, or fluid retention (edema). Therefore, minoxidil tablets are only used under the supervision of a doctor and with the guidance of a pharmacist. 5
For most people, minoxidil applied to the scalp, for example as a foam or solution, is the first choice for hereditary hair loss. 3,4
Minoxidil alternatives
There are various products offered as alternatives to minoxidil, such as Spectral DNC, Neofollics Lotion, and Trioxidil. However, the scientific evidence for the effectiveness of these agents is limited. Therefore, dermatologists usually do not recommend these types of products as a treatment for hereditary hair loss. 3,4,8
Minoxidil foam or solution, on the other hand, has been extensively researched and proven effective in a portion of users. Products such as Spectral DNC, Neofollics Lotion, and Trioxidil are cosmetic products and not medicines. At most, they can play a supportive or nourishing role, but are not a treatment for hair loss like minoxidil.
Other treatments that are medically substantiated
- Finasteride: a prescription oral medication that inhibits the conversion of testosterone to dihydrotestosterone (DHT), a hormone that plays a major role in hereditary hair loss.
- Hair transplantation: a surgical procedure to repair hair loss by moving hairs from a donor area to bald spots.
- PRP (Platelet Rich Plasma) treatments: in this procedure, the patient's own platelets are injected into the scalp to stimulate hair follicles and reduce hair loss. PRP can be effective, but the evidence is not strong and it does not offer lasting results. 7
When is it wise to consult a doctor?
Contact a doctor or pharmacist when:
- side effects are severe or persistent
- you experience symptoms such as palpitations, dizziness, or swelling
- the hair loss continues to worsen after six weeks of treatment
- no effect is observed after 6 months of consistent use 8
Conclusion
Minoxidil 5% foam is a widely used treatment for hereditary hair loss. For some people, it can help reduce hair loss and stimulate hair growth. 2,3
Most side effects are mild and temporary. For example, some people experience some itching or irritation on the scalp. There may also be some temporary increased hair loss during the first few weeks. 1
Use the product according to the instructions and pay close attention to how your scalp reacts. For many people, minoxidil is a safe treatment. If you have any doubts or if symptoms persist, contact a doctor or pharmacist.
FAQ – Frequently asked questions about minoxidil foam
Is minoxidil foam better than minoxidil solution?
Minoxidil foam and minoxidil solution contain the same active ingredient and are both effective for hereditary hair loss. The foam usually does not contain propylene glycol, which means some people experience less scalp irritation. The effectiveness is comparable when the product is used correctly.
Does minoxidil foam have many side effects?
Most side effects of minoxidil foam are mild and temporary. Some people experience mild irritation of the scalp, such as itching, redness, or a burning sensation. Serious side effects are rare when the product is used according to the package leaflet. 1
Can minoxidil temporarily cause more hair loss?
Yes. In the first few weeks, more hair may temporarily fall out. This is often called shedding. Old hairs fall out faster so that new hairs can grow. This is usually a temporary effect and often stops after a few weeks. 1,3
How long does it take for minoxidil foam to work?
It usually takes 3 to 4 months before the first effect becomes visible. It is important to continue using the product daily. Stopping minoxidil can cause the regrown hair to fall out again. 2,3
What should you do about itching caused by minoxidil?
Itching can be caused by irritation of the scalp. Sometimes using a mild shampoo or taking good care of the scalp helps. If the symptoms persist, consult a doctor or pharmacist. 1
Are there alternatives to minoxidil?
Besides minoxidil, there is one other medicine in the Netherlands that is registered and scientifically proven effective for the treatment of hereditary hair loss (alopecia androgenetica). This is finasteride, and it is intended only for men with hereditary hair loss.
Some online shops or hairdressers promote cosmetic products such as Spectral DNC, Neofollics Lotion, and Trioxidil. These are brand names of cosmetic products, not medicines. There is little to no scientific evidence available for these products. Dermatologists recommend treatments that have been well researched, such as minoxidil or, in some cases, finasteride. 3,4
Can minoxidil also be taken as tablets?
Doctors sometimes prescribe minoxidil tablets for hair loss. This is usually done in low doses and only under the supervision of a doctor. Tablets can cause more side effects than minoxidil applied to the scalp. 5
When should you stop taking minoxidil?
Stop taking minoxidil and contact a doctor if you experience severe side effects, such as palpitations, dizziness, or swelling. It may also be wise to seek medical advice if no effect is visible after about 6 months. 8
References
- SmPC Minoxidil 5% foam – official product information
https://www.geneesmiddeleninformatiebank.nl/bijsluiters/h128704.pdf - Olsen EA, Dunlap FE, Funicella T, et al.
A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in androgenetic alopecia in men.
Journal of the American Academy of Dermatology. 2002.
https://doi.org/10.1067/mjd.2002.120909 - Suchonwanit P, Thammarucha S, Leerunyakul K.
Minoxidil and its use in hair disorders: a review.
Drug Design, Development and Therapy. 2019.
https://doi.org/10.2147/DDDT.S214907 - Gupta AK, Talukder M, Venkataraman M, Bamimore MA.
Minoxidil: a comprehensive review.
Journal of Dermatological Treatment. 2022.
https://doi.org/10.1080/09546634.2020.1770163 - Randolph M, Tosti A.
Oral minoxidil treatment for hair disorders.
Journal of the American Academy of Dermatology. 2021.
https://doi.org/10.1016/j.jaad.2020.12.071 - Lucky AW, Piacquadio DJ, Ditre CM, et al.
A randomized, placebo-controlled trial of 5% and 2% topical minoxidil solutions in the treatment of female pattern hair loss.
Journal of the American Academy of Dermatology. 2004. - Gentile P, Garcovich S.
Systematic review of platelet-rich plasma use in androgenetic alopecia compared with minoxidil, finasteride, and adult stem cell-based therapy.
International Journal of Molecular Sciences. 2020. - Van Dongen T, et al.
Guidance on androgenetic alopecia and female pattern hair loss.
Dutch Journal of Dermatology and Venereology. 2021. - Blume-Peytavi U, Hillmann K, Dietz E, et al.
A randomized controlled trial of 5% minoxidil foam for the treatment of androgenetic alopecia.
Journal of the American Academy of Dermatology. 2011.
