Minoxidil alternatives: What can I take instead of minoxidil?

Compare minoxidil alternatives | Oral minoxidil tablets | Finasteride | Spironolactone | Corticosteroids | Antifungals | Natural alternatives | How to switch meds

Minoxidil is primarily used to treat male pattern hair loss as a topical solution or foam. It also comes as an oral tablet that may be prescribed for high blood pressure, although it’s not a first choice for a blood pressure medication. As a vasodilator, minoxidil increases blood flow by making the blood vessels broader. Commonly known by the brand-name Rogaine, minoxidil is available over-the-counter. It’s typically used as a topical foam or solution twice daily for hair growth. However, the oral tablet form is taken once daily. 

While minoxidil is an effective hair loss treatment, it may not be right for everyone. For example, it may cause side effects that are intolerable for some people, or it might not be working well enough to produce the desired effects. In addition, the twice-daily topical dosing can be inconvenient or burdensome for many people who take multiple medications or have trouble remembering to stay on schedule. Other factors like cost may also be an issue for some people. Using a SingleCare prescription discount card can help with savings. Whatever the case may be, minoxidil alternatives are available. These alternatives can be just as effective as minoxidil, depending on your treatment goals. 

Continue reading to learn more about the alternatives to minoxidil, how they work, and how they compare to minoxidil. Here, we will focus on alternatives for hair loss, as minoxidil is mainly used to treat hair loss.

RELATED: Why is my hair falling out? Learn the causes of hair loss

What can I take in place of minoxidil?

There are various treatment options, prescription and over-the-counter, that can be used instead of minoxidil for hair problems, such as a receding hairline. These options may work in different ways to combat hair loss. For instance, they may target different aspects of hair loss to prevent hair loss or stimulate hair regrowth. Certain drugs, such as finasteride, can help reduce the conversion of testosterone to dihydrotestosterone (DHT), which, in high levels, can cause hair follicles to shrink and ultimately lead to hair loss. 

Some treatment options may have approved or off-label uses for hair loss. Drugs that are used off-label are approved by the FDA for other conditions but may be prescribed for a specific condition based on supporting studies and a healthcare provider’s clinical judgment. Other drugs may be prescribed to treat an underlying condition that is causing hair loss. The best treatment option will depend on your overall condition, potential side effects, and dosages.

Another important factor in determining the best treatment option is determining the cause of hair loss. Examples of hair loss conditions include androgenetic alopecia, also known as male pattern hair loss, and alopecia areata, an autoimmune condition that causes hair loss. Some cases of hair loss may be caused by other conditions, such as thyroid disease or ringworm of the scalp (tinea capitis). 

Other alternatives to minoxidil

• Kenalog (triamcinolone)
• Azulfidine (sulfasalazine)
• Dritho-Scalp (anthralin)
• Trexall (methotrexate)
• Sandimmune (cyclosporine)
• Xeljanz (tofacitinib)
• Jakafi (ruxolitinib)
• Elocon (mometasone furoate)
• Advantan (methylprednisolone aceponate)

Top 5 minoxidil alternatives

The following are some of the most common alternatives to minoxidil.

1. Oral minoxidil tablets

Oral minoxidil tablets may be an alternative to the topical version of the medication. Minoxidil tablets are not approved for hair loss but may be prescribed off-label in some cases. People with high blood pressure and hair loss who are not experiencing an improvement in blood pressure with other medications could benefit the most from oral minoxidil. For people who find the twice-daily dosing of topical minoxidil inconvenient, the once-daily dosing of oral minoxidil may be a better option. However, systemic side effects, such as nausea, vomiting, and salt and water retention, may be a problem with oral minoxidil. 

2. 5-alpha reductase inhibitors (such as finasteride and dutasteride)

Oral finasteride is one of the most popular alternatives to minoxidil for male pattern baldness. Known by the brand-name Propecia, finasteride has DHT blocker effects and is FDA-approved as an effective medication to stop hair loss in men. It is also approved for an enlarged prostate under the brand-name Proscar. As an oral tablet, finasteride may be more convenient to take than topical minoxidil. In many cases, a healthcare provider may recommend taking finasteride and minoxidil together since their effects can work in synergy. Dutasteride, known by the brand-name Avodart, is an FDA-approved drug similar to finasteride for treating an enlarged prostate. However, it may be prescribed off-label for hair loss.

3. Antiandrogen treatments (such as spironolactone and estrogen) 

Spironolactone is the active ingredient of the brand-name drug Aldactone. It works as an aldosterone receptor antagonist that blocks the effects of aldosterone on the kidneys. Although it’s primarily used to treat heart failure and high blood pressure, it may also be used off-label to treat female pattern hair loss or female androgenic alopecia. Estrogen has been shown to extend the growth phase of the hair cycle. Birth control pills may be viable solutions for hair loss in women that is caused by altered estrogen levels. Side effects of these antiandrogen treatments include breast tenderness and changes in the menstrual cycle. 

4. Corticosteroids (such as triamcinolone and clobetasol)

For people with alopecia areata, hair loss is triggered by an abnormal immune response. Corticosteroids, simply known as steroids, can help reduce an overactive immune response that is damaging hair follicles. Steroids can be administered orally, topically, or by injection. Topical steroids are typically used in children, while injectable steroids are used in adults for hair loss. Because of the risk of side effects, such as acne and skin thinning, steroids are not usually recommended for long-term use. 

5. Antifungals (such as ketoconazole and itraconazole)

Antifungal agents may be prescribed to treat scalp ringworm, a common fungal infection that can cause hair loss. It can take at least six weeks of treatment for scalp ringworm to clear up with an antifungal agent. An antifungal, such as ketoconazole or itraconazole, is taken orally to treat scalp ringworm. The topical forms of antifungals are not effective for this type of infection. However, the topical formulation of ketoconazole can be used to treat seborrheic dermatitis, which can cause hair loss. 

Natural alternatives to minoxidil

There are numerous natural minoxidil alternatives to minoxidil that have been studied for hair loss. These alternatives include vitamins, creams, essential oils, herbals, and dietary supplements. While natural alternatives may be supported by scientific studies for their use, they are not approved or regulated by the FDA. In many cases, there may not be a standardized dosage or strength of a natural supplement. 

Herbal supplements like saw palmetto and rosemary oil may help promote hair growth, healthy hair, and stimulate blood flow. Clinical trials have found that saw palmetto can improve overall hair quality, total hair count, and hair density in people using topical or oral saw palmetto supplementation. 

Zinc is known to be involved with hair growth. People with zinc deficiency can experience hair thinning and a brittle hair appearance. Therefore, supplementation with zinc may be an option to support hair health. Other vitamins and nutritional supplements that may help hair loss include biotin, vitamin D, and vitamin C. 

In severe cases, hair transplantation surgery can be an option for hair loss. It involves relocating hair follicles from one part of the body to the area of hair loss. Studies have shown another non-drug treatment called low-level laser therapy can be a good option for stimulating hair growth in men and women. 

Cometic remedies, such as shaving the head and using a wig, may be a convenient option for people who prefer not to use other methods. Scalp micro pigmentation is a cosmetic procedure that involves placing ink pigment on the scalp to create the appearance of a shaved head. 

How to switch to a minoxidil alternative

When switching treatments, it’s always best to consult a healthcare professional, such as a dermatologist, who specializes in hair care. They can help guide you on the best treatment option, as treatments can vary depending on what is causing hair fall. In addition, one treatment formulation may be better than another, based on your overall medical condition and dosage preferences. 

In some cases, you may be recommended to try a combination of treatments, such as finasteride and minoxidil, to help regrow hair and maintain new hair growth. However, these medications are not a cure for hair loss, and if treatment is stopped, hair loss could reoccur. 

Tell your doctor or healthcare provider about other medical conditions or medications you have before switching to a new medication. You’ll also want to consider the risks and benefits of the particular alternative you switch to. In addition to prescription and over-the-counter medications, natural treatments may be helpful for supporting hair health.