Long term effects of minoxidil on hair loss

Minoxidil is a popular product to combat hair loss, and the short term effects are understood fairly well. Both the advantages, but also possible detrimental side effects to the skin.

But what about the long term effects of minoxidil on hair loss?

Well, science has conducted multiple studies on that front too. Let’s take a look at what the scientific community has to say about the effects of long term use of minoxidil.




Long term effects of minoxidil

Picture of a man putting minoxidil foam on his hand.

So does minoxidil lose effectiveness over time or not?

The long term effects of minoxidil on hair loss are usually positive. And rest assured, the product minoxidil does not lose its efficiency over time.

People who start using minoxidil as soon as they notice hair loss frequently have the best results. Probably because hair loss is typically progressive, and because preventing hair loss is easier than regrowing lost hair.

The only disadvantage is that minoxidil usage must be continued indefinitely, or hair loss will start to occur again. That’s not to say that missing one dosage of minoxidil is the end of the world. But prolonged discontinuation of the product will result in your hair gains being lost over time, and progressive hair loss occurring again.

Does minoxidil lose effectiveness over time?

No, minoxidil does not lose effectiveness over time.

However, it might seem that way because the hair on your head and everywhere else goes through the 4 stages of hair growth. Thus, one will also experience hair shedding. Especially when you’ve just started using minoxidil.

Also, since hair loss is typically progressive, it might seem like minoxidil loses effectiveness over time. In reality, this is not the case. But it’s simply an individual’s hair loss that has been progressing.

Still though, minoxidil can help mitigate, or sometimes even completely halt hair loss. Whether minoxidil can regrow your hair completely depends on how much hair you’ve already lost before starting minoxidil, and how well you respond to the medication. The sooner you start applying after noticing you’re losing hair, the more favorable the results typically are.

Long-term side effects

Image of minoxidil tablets with the words 'side effects' written on a piece of paper underneath them.

Long term use of minoxidil is considered safe, but there are some possible, albeit mostly minor, side effects. Keep in mind that minoxidil will never worsen preexisting hair loss.

Side effects are normally mild since the product is typically well tolerated. Some irritation, redness, and flaking of the skin might occur. Usually, these side effects tend to subside long term because your body adapts to the new balance and creates homeostasis.

What you could also try to do is applying topical minoxidil one time daily instead of two times. This might reduce, or even totally eliminate, side effects. Another possible solution could be to use a lower strength product, as these typically bring along fewer negative side effects, at the cost of reduced effectiveness.

When side effects persist, you can decide to keep using the product if they’re not severe and not too unpleasant.

However, you should quit immediately when experiencing severe side effects such as heart palpitations, sweating, or becoming depressed. If you happen to undergo these rare complications, then contact a doctor immediately!

Side effects will go away after a while when you stop using minoxidil. This is because the product will eventually be flushed out of your system. But, if you quit using minoxidil, hair loss will start to occur again. And your hair gains will slowly be lost over time.


Long term effects of Rogaine

A bottle of Rogaine 2% for woman.

Long term effects of Rogaine are exactly the same as any other general minoxidil brand, which means that it typically works very well, and that side effects are usually rare and mild.

Rogaine works best when started early on in the hair loss process. It is mostly well tolerated and people don’t experience many, if any, side effects at all.

Side effects tend to subside because the body eventually reaches a new homeostasis. Still, one should quit Rogaine immediately when suffering from severe side effects.

Side effects will certainly go away quickly after stopping minoxidil usage. But minoxidil must be continued indefinitely, or the hair gains one made will be lost over time.

Does Rogaine lose effectiveness over time?

No, just the same as any general minoxidil brand, Rogaine does not lose effectiveness over time.

But once more, hair shedding will occur naturally, and can happen more intensely and frequently when you’ve just started using minoxidil. But this is offset by the increased amount of new, healthy hair that’s being produced due to the minoxidil.

Even more so, the amount of new, vigorous hairs being produced due to the minoxidil will be larger than the hairs being shed because of the minoxidil. So don’t worry.

Also, hair loss is usually progressive. This might make it seem like minoxidil does lose effectiveness over time. In reality, though, the minoxidil is still working exactly as good, but it’s simply the hair loss that’s progressing.

And don’t worry, Rogaine long term usage has been proven to be safe.


Long term effects of topical minoxidil: Studies

Image of people doing the “thumbs up” sign before a blackboard with their hands with the words “long-term” written above it.

The first minoxidil long term study performed a long-term follow-up of men with male pattern baldness treated with topical minoxidil.

They reached the following conclusion:

at 2 years 9 months with maintenance topical minoxidil. There were subjects on both maintenance schedules of topical minoxidil who lost some of the nonvellus hair they had initially gained with topical minoxidil

However, there was a greater mean loss in those patients following the once-daily versus twice-daily topical minoxidil regimen (p = 0.05).

No subject lost nonvellus target hair as compared with baseline. Subject and investigator assessments of hair growth as compared with baseline diminished during the maintenance course of treatment with topical minoxidil; this was not related to the frequency of topical minoxidil application.

However, by the completion of the 2-year 9-month period, the investigator felt that 82.9% of subjects still had minimal regrowth and 4.9% had moderate regrowth over baseline. Subjects consistently graded their hair growth as greater than did the investigator.

Side effects were minimal and well tolerated.

These results indicate that continued use of topical minoxidil sustains the majority of vertex nonvellus hair growth initiated during the first 12-month period of topical minoxidil use and that twice-daily application of topical minoxidil is preferable to once-daily application for maintenance therapy.[1]https://www.sciencedirect.com/science/article/abs/pii/S0190962287700899

The next minoxidil long term study examined the long-term efficacy of topical minoxidil in male pattern baldness.

This is what they found to be true:

At 12 months, there were statistically significant increases in terminal hair growth within a 1-inch target area in those treated with 2% or 3% minoxidil solution, in comparison with baseline counts. However, there were few patients who had appreciable cosmetic restoration.

At 12- and 24-month intervals, progressive regression or stabilization of the size of the bald area was noted in the majority of patients. This therapeutic or preventive effect was statistically significant.

The data on actual target area hair counts suggested that the 2% minoxidil solution was equal to or more efficacious than the 3% minoxidil solution.

Baseline vital signs and laboratory parameters remained essentially unchanged.

Topical minoxidil was well tolerated, with no serious drug-related adverse reactions noted during the study.[2]https://pubmed.ncbi.nlm.nih.gov/3549806/

The following 30-month minoxidil long term review researched the effects of topical minoxidil therapy for androgenetic alopecia.

This is what they found out:

Hair regrowth (as measured by hair counts and bald-area diameters) was noted in all treatment groups at four months, and appeared to peak at approximately 12 months.

At 30 months, mean hair counts had decreased from the 12-months level, but remained elevated over baseline counts, while mean bald-area diameters returned to baseline.

However, 70% of the patients who did continue to use the drug for 30 months had 50% or more hairs than when they originally started the drug therapy. A subset of patients appeared to sustain a continued increase in hair counts after 12 months.

No systemic side effects were noted.[3]https://pubmed.ncbi.nlm.nih.gov/3314717/

And lastly, this minoxidil long term review researched the long-term clinical effects, bioavailability, and kinetics of oral minoxidil in relation to renal function.

These were their results:

Minoxidil, 27 to 30 mg per day, decreased systolic and diastolic blood pressure during the first three months of therapy.

Between the third and 24th months (30 months in one patient) there was no further change.

Propranolol or clonidine was needed to control heart rate, and furosemide or dialysis was needed to control edema induced by minoxidil.

Renal function improved in some of the mildy azotemic patients.

Minoxidil kinetics after the customary dose did not differ whether the drug was taken as tablet or solution.

Kinetic parameters during chronic administration of minoxidil did not differ from those after acute administration.

The kinetics in chronic renal insufficiency do not differ from these in subjects with normal renal function.[4]https://pubmed.ncbi.nlm.nih.gov/361764/


Final note

The long term effects of minoxidil on hair loss are very positive seeing as minoxidil increases the number of hair, as well as the thickness of the hair shafts leading to denser hair.

Minoxidil long term use is regarded as a safe treatment option to combat hair loss.

Minoxidil and Rogaine do not lose effectiveness over time. But since hair loss is typically progressive, advanced hair loss will probably still happen over time.

Nevertheless, minoxidil can help to mitigate, or sometimes even completely halt hair loss, and should be started as soon as one notices they’re losing hairs.

Side effects are usually uncommon, mild, and are mostly easily treatable. Especially if one uses topical foam over the topical solution, since using oral minoxidil long term will often cause more side effects than topical minoxidil does.





1 https://www.sciencedirect.com/science/article/abs/pii/S0190962287700899
2 https://pubmed.ncbi.nlm.nih.gov/3549806/
3 https://pubmed.ncbi.nlm.nih.gov/3314717/
4 https://pubmed.ncbi.nlm.nih.gov/361764/