Minoxidil is a medication that was originally developed as an antihypertensive, but was later discovered to promote hair growth and prevent hair loss. It exists in two forms: topical (Gupta et al., 2022) and oral (Gupta et al., 2023), both of which can be used to increase body and/or facial hair. This review provides general information; an overview of the main studies evaluating efficacy; an update on the safety of oral minoxidil in light of the clinical evidence; practical information on sourcing and usage; and a comparison of the two forms. For further information on the use of minoxidil for hair loss, see the TFS article on hair loss.
This post is a translation of the article Le minoxidil pour la pilosité originally in French with some additional DIY and international related details.
Translation by Ari and uriel, with initial pass by alix using gemma 4 open-weight LLM, run on local hardware. Our em-dashes are certified organic.
Topical minoxidil comes as a spray or foam meant to be applied to the areas where hair growth is desired (typically the scalp or face).
It can be used by anyone: individuals with no facial hair who are not taking testosterone (for example, transmasculine people not taking T), individuals with some facial hair who want to develop it further (with or without T), individuals with otherwise well-developed facial hair who want to fill in patches in their beard, etc.
For individuals on T, the effect of minoxidil is thought to be permanent. For people not on T, it’s less clear: hair would not be expected to fall out upon stopping minoxidil, but it is suspected that it will revert to vellus hair rather than remain as terminal hair. Effects may appear in as little as a few weeks, but this depends on the individual and their hormonal context.
Some people show little to no response to topical minoxidil, likely because they lack an enzyme, sulfotransferase, which has been implicated in its mechanism of action. In such cases, the activity of this enzyme—and thus the efficacy of topical minoxidil—can be increased by using local tretinoin (prescription only) (Ferry et al., 1990; Sharma et al., 2019; Shin et al., 2007).
Topical minoxidil is very safe, and few side effects are reported. Irritation, itching, or redness may occur in the application area. In such cases, a single application per day and/or the use of the foam formulation may be preferred.
There are still relatively few studies on the use of topical minoxidil for hair growth, and they focus on facial rather than body hair. In addition to case studies (Pang et al., 2021; Shokravi & Zargham, 2024) and some articles on eyebrows, the following clinical trials have been published:
Wattanawinitchai et al. (2026), a double-blind randomized controlled trial; n=34, use of 3% minoxidil over 12 weeks in transmasculine people on testosterone.
This study showed a significant increase in hair density as well as diameter (i.e., individual hairs became thicker) with minoxidil, resulting in fuller facial hair according to various measurements. A significant difference from placebo was observable after 2 months of use.
Minoxidil was tolerated well, with similar side effects in both the treatment and placebo groups, and no systemic effects (such as increase in blood pressure).
Marinelli et al. (2024), a non-randomized, controlled trial; n=16, use of 2% minoxidil over 6 months in transmasculine people on testosterone.
This study showed an increase in facial hair on the chin and upper lip at 3 months and 6 months of treatment, and minoxidil was well-tolerated.
Ingprasert et al. (2016), a double-blind randomized controlled trial; n=23, use of 3% minoxidil over 16 weeks in cis men.
This study showed a significant increase in the amount of facial hair with use of minoxidil, but no change in the average hair diameter, compared to controls, and treatment was well-tolerated.
Topical minoxidil is available without a prescription from pharmacies in much of the world. The cost varies but it tends to be relatively cheap (approximately <10€ monthly for liquid in the EU for instance) - the foam formulation is typically more expensive.
For facial hair, 5% minoxidil (of any brand) is used applied once or twice daily. Sufficient coverage of the beard area typically requires ~1mL/6 pumps; refer to the dose indicated on the package leaflet.
To give the medication time to penetrate into the hair follicles, wait at least a few hours before rinsing the area. Do not attempt to dry the area after application. Do not mix the minoxidil solution with lotion, or apply lotion just before applying minoxidil, as this can limit absorption.
Minoxidil is very toxic to pets, so care must be taken to prevent any exposure to or ingestion of the medicaiton. For example, if you apply minoxidil to your face, do not allow your pet to rub against or lick the area of application. Keep any contaminated clothes, towels, or bedding away from pets.
Oral minoxidil comes in the form of tablets designed to be swallowed. It may increase the development of both facial and body hair; the effect is not localized. Efficacy also depends on the dose; while there will always be variation between invidivuals, in general a higher dose will have a greater effect on hair growth. For preventing hair loss, a lower dose is often sufficient. When choosing a dose of oral minoxidil, the goal is to find a balance between desired effects and side effects.
Oral minoxidil can be used by anyone, with or without testosterone. As with the topical version, it is likely the effect will be less pronounced and potentially less permanent without testosterone.
Oral minoxidil is very safe; data now show that the use of low-dose oral minoxidil has a very favorable risk profile, as confirmed by a recent meta-analysis of 27 studies with a total of nearly 3,000 people (Liu et al., 2025).
One of the studies in this meta-analysis, which alone included over a thousand people (Vañó-Galván et al., 2021), had only a ~1% discontinuation rate for oral minoxidil due to side effects (excluding hypertrichosis, i.e. increased hair growth, as this is desirable in the context of this article). Systemic side effects were reported in 5.5% of participants, all of which resolved upon discontinuation or dose reduction. There were no life-threatening side effects. Among the rare reported side effects were dizziness, water retention, and tachycardia.
Should any of these side effects occur, they can often be improved simply by reducing the dose of oral minoxidil. For dizziness in particular, taking minoxidil at bedtime may be preferable. A significant drop in blood pressure is not expected, at least with lower dosages (Desai et al., 2024; Ong et al., 2024b). There may be differences in side effects between cis men and women (Ong et al., 2024a) according to some studies, but it is unclear how these risks might differ in trans people on HRT.
One study observed comparable safety of oral minoxidil use in individuals with cardiovascular problems (hypertension and arrhythmias) as in healthy people (Jimenez-Cauhe et al., 2024). Safety has also been found to be acceptable in children and adolescents, at least for low doses (Williams et al., 2024).
It should be noted that the studies cited here primarily used relatively low doses of oral minoxidil (5mg or less, sometimes 2.5mg or less), and their conclusions are not necessarily applicable to more intermediate doses of 5-10mg, which may be more suitable for hair growth. That said, some reassuring data exist for these dosages as well (Moreno-Arrones et al., 2025; Sanabria et al., 2024). The doses of oral minoxidil used to treat hypertension, its usual clinical indication, are typically even higher (10-40mg, sometimes more).
There are still relatively few studies on the use of oral minoxidil for hair growth. However, some information can be gleaned from reports of side effects of oral minoxidil used for hair loss, where hypertrichosis is considered undesirable.
The following studies contain relevant information on the use of oral minoxidil for hair growth:
Zaminski et al. (2025), a retrospective study on the use of oral minoxidil in trans people.
It notes that two transmasculine patients used oral minoxidil for facial hair development in addition to treatment for androgenetic alopecia and were satisfied (average maintenance dose: 1.88mg).
Ramos Rodriguez et al. (2025), a retrospective study on the use of oral minoxidil for androgenetic alopecia in trans people.
It observed that the use of higher doses (7.5-10mg/day) in trans men (n=5) was well tolerated and associated with a significantly greater increase in facial and body hair.
Luengarun et al. (2025), a prospective study on the characteristics of hypertrichosis caused by oral minoxidil (5mg/day) for androgenetic alopecia in cis men (n=30) over 6 months. The study refers to increased body hair growth as hypertrichosis, an undesirable side effect.
The study found increased hair growth on the forearms in almost all participants (93%). More specifically, 100% of those under 41 and 73% of those over 41 had signs of hypertrichosis at 3 months (100% and 82% at 6 months). The percentage of hair growth classified as hypertrichosis increased slightly over time, indicating denser or more extensive body hair at 6 months than at 3 months.
Jimenez Cauhe et al. (2021), a prospective study investigating hypertrichosis caused by oral minoxidil (~1mg/day) in about a hundred cis women (as well as a few cis men taking ~3mg/day). As above, it considers hypertrichosis to be an undesirable side effect. Since this study primarily examined oral minoxidil use in cis women, it is likely more informative for transmasculine people who are not taking testosterone.
This study found a very high incidence of increased hair growth, starting after an average of 2 months of use. However, the hair growth remained generally minimal. The most affected areas were, in order of frequency, the sideburns, temples, arms, and the upper lip and chin. The increase in hair growth was more marked with higher doses.
Ramos Rodriguez et al. (2026), a literature review on androgenetic alopecia in trans people issues the following recommendation:
In trans men, we recommend an initial dose of 2.5-5mg. In young and healthy trans men, with good tolerance and seeking an increase in facial or body hair, a cautious gradual increase up to 7.5-10mg may be considered.
Oral minoxidil is typically available only with a prescription. It is also commonly available at grey market online pharmacies. Its cost varies but it tends to be cheap (approximately 10-20$ monthly).
The use of minoxidil for androgenetic alopecia is not very common outside of North America, and even less common for hair growth. It is possible that your doctor may not be familiar with this usage; do not hesitate to insist and show them this article if necessary!
There are several brands of oral minoxidil, formulated as 5 or 10mg tablets, as well as compounded options. The dosage must be adjusted according to the desired effects and, if necessary, side effects. Based on the studies and expert opinions cited previously, it is advisable to start with 2.5-5 mg/day with a possible increase up to 10mg per day if the medication is tolerated well.
As the half-life of oral minoxidil is not very long, it may be taken in two doses over the course of the day (once in the morning and once in the evening), but this is not strictly necessary and one dose per day is sufficient for hair growth.
Specific monitoring is not indicated by the literature, but routine blood pressure measurements seem reasonable, especially in case of pre-existing blood pressure problems or use of high doses of oral minoxidil (≥7.5mg). Because the effect on blood pressure is quick, you can measure it before and 2 hours after a dose (Olsen et al., 2025).
You probably shouldn’t use minoxidil without medical supervision if you have congestive heart failure, ischemic heart disease, pheochromocytoma or renal failure. In general, exercise caution when using oral minoxidil if you have any major cardiac condition or medical condition causing low blood pressure. In particular, titrate up slowly and discontinue use if you get tachycardia, dizziness, etc.
A more exhaustive list of relevant conditions and guidelines on safer use is available in Olsen et al. (2025 Table 2).
Be aware minoxidil may require caution when taken with other blood pressure-lowering medication. If it makes you dizzy, exercise caution when taking sedative medications. You can check a non-exhaustive list of medications oral minoxidil may interact with here.
While it’s typically fine not to mention HRT to doctors when going in for an unrelated health issue or surgery, it’s probably a good idea to mention you’re taking oral minoxidil if you’re seeing a doctor for anything cardiovascular, general anesthesia, etc. Make sure they understand you’re talking about oral minoxidil, and not over-the-counter topical minoxidil. This shouldn’t out you, because oral minoxidil is used by both cis men and cis women, mostly to treat hair loss.
| Topical | Oral |
|---|---|
| Over-the-counter | Prescription/DIY only |
| Localized effect | Whole-body effect |
| only affects the site of application | effective against androgenetic alopecia |
| must take precautions if interacting with pets | no risk for pets |
| possibility of local side effects (irritation, itching, redness, …) | low possibility of systemic side effects (dizziness, water retention, tachycardia, …) |