Efficacy and Safety of Oral Minoxidil in Comparison to Topical Form in Male Pattern Hair Loss

This randomized controlled trial compared low-dose oral minoxidil (2.5 mg daily) with 5% topical minoxidil in 42 men with androgenetic alopecia over six months. Patients receiving oral minoxidil demonstrated greater gains in hair density, thickness, and anagen/telogen ratios, while the topical group showed minimal changes. Compliance was superior in the oral group, and adverse effects were generally tolerable.

Positives:

1. Head-to-head randomized design directly addresses a clinically important question.
2. Objective trichoscopic and quantitative measures provide strong efficacy evidence.

Negatives:

1. Small sample size and short duration (42 patients, 6 months) limit power and long-term applicability.
2. Incomplete safety reporting—rare cardiovascular risks of oral minoxidil may not emerge in such a limited cohort.

Overall, the study suggests oral minoxidil may be more effective and user-friendly than topical formulations, but confirmation in larger, longer trials is essential.

https://link.springer.com/article/10.1007/s00403-025-04355-z