Minoxidil for Men side effects: What to know about Rogaine

In this article:

• Minoxidil for Men: Available forms
• Common side effects
• Sexual side effects
• Rare but serious side effects
• How soon do Minoxidil for Men side effects start?
• How long do Minoxidil for Men side effects last?
• Long-term side effects
• Interactions
• Safety measures while using Minoxidil for Men
• How to prevent side effects
• How to treat side effects
• Minoxidil alternatives for men
• When to see a doctor for minoxidil side effects

In this article

• Minoxidil for Men: Available forms
• Common side effects
• Sexual side effects
• Rare but serious side effects
• How soon do Minoxidil for Men side effects start?
• How long do Minoxidil for Men side effects last?
• Long-term side effects
• Interactions
• Safety measures while using Minoxidil for Men
• How to prevent side effects
• How to treat side effects
• Minoxidil alternatives for men
• When to see a doctor for minoxidil side effects

The thinning hair and receding hairlines that come with androgenetic alopecia (male and female pattern hair loss) can be distressing, pushing many men to try products like minoxidil. By increasing blood flow to the scalp, Minoxidil for Men (generic Rogaine) can help deliver more nutrients to hair follicles and decrease their telogen (shedding) phase. But it can also cause certain side effects, and it’s important to understand them before diving into treatment.

Minoxidil for Men: Available forms

There are a few different ways to take minoxidil, and it has both over-the-counter (OTC) and prescription formulations. The OTC options come in either 2% or 5% concentrations and include topical liquid solutions, foams, and sprays. While dermatologists might recommend either formulation for women, packaging and other marketing materials often recommend the 5% concentrations for men only.

For anyone who would rather take a pill, oral minoxidil tablets are available but require a prescription. The typical dosage for these tablets is 0.5 mg–5 mg daily. It should be noted that the oral tablet form of minoxidil is only FDA approved for hypertension, and so using it for hair regrowth is off-label.

The brand name for topical minoxidil is Rogaine. However, some pharmacies may sell it over the counter as their own generic brands, like Kirkland at Costco or Equate at Walmart. For oral minoxidil, common brand names include Loniten and Minodyl, which have been discontinued in the U.S.

Common side effects of Minoxidil for Men

The most common side effects of minoxidil depend on which formulation you’re taking, since they can be different for topical and oral versions. 

Topical minoxidil side effects in men

The most prevalent adverse effect of topical minoxidil is scalp irritation, which may present as dryness, itching, stinging, scaling, flaking, or redness. A study from 2023 found that 13.8% of patients reported irritation, 12.3% reported facial hair growth, 9.8% experienced increased hair shedding, and 9.5% had an exacerbation of seborrhea (oily skin).

Increased hair shedding might seem like an odd one, since Rogaine is meant for hair regrowth, and some people might find it startling for Rogaine to do the opposite. However, this side effect is usually temporary and a natural part of the hair life cycle. The drug shortens the telogen (resting) phase, causing older hairs to shed, making way for new hair during the anagen (growth) phase.

Other side effects of topical minoxidil may include:

• Changes in hair texture
• Skin rash
• Residue on the scalp
• Scalp dryness
• Nausea
• Vomiting
• Headaches

Oral Minoxidil side effects in men

For minoxidil tablets, one of the most common side effects is hypertrichosis, also known as unwanted body hair. Clinical trials showed that 28.9% of patients taking 0.25–0.75 mg/day, 30.4% of patients taking 1–1.25 mg/day, and 86.8% of patients taking 2.5–5 mg/day experienced unwanted body hair. However, while it was reported by both men and women, it’s much more common in women than in men.

A separate study with a solely male cohort found that 20.6% of patients reported headaches, 2.9% experienced vertigo, and 2.9% had fluid retention (edema).

Other side effects of oral minoxidil in men may include:

• Nausea
• Vomiting
• Breast tenderness
• Skin rash
• Irregular heartbeat
• Low blood pressure
• Lightheadedness
• Dizziness

Minoxidil side effects sexually

The chance of sexual side effects while taking minoxidil is pretty small. In a comparison study between minoxidil and finasteride, only 4.35% of male participants who took minoxidil reported erectile dysfunction, compared to 50.39% of finasteride patients. Additionally, only around 1% of those minoxidil patients reported loss of libido, ejaculation disorder, and decreased semen volume, while none of them reported erectile dysfunction.

So while they’re possible, sexual side effects are very rare. That said, anyone who has existing sexual dysfunction or concerns about sexual side effects should speak with a healthcare provider about it prior to starting minoxidil.

Rare but serious side effects of Minoxidil for Men

Serious side effects while taking minoxidil, particularly topical minoxidil, are fairly rare. But it’s still important to know what they are, since they often require medical attention. Here are some of minoxidil’s potentially serious adverse reactions for men:

• Dizziness
• Flushing 
• Irregular heartbeat
• Fainting
• Fatigue
• Difficulty breathing when lying down
• Swelling in hands or feet
• Unusual (rapid) weight gain

If you notice any of these side effects, it’s important to see a healthcare professional.

How soon do Minoxidil for Men side effects start?

“The onset of side effects can vary,” according to Jerome Burke, MD, Ph.D, a medical contributor at Drugwatch.com. “Local skin irritation from the topical solution can begin within days of starting minoxidil treatment. The systemic effects can appear within the first few weeks to months as the drug accumulates in the body,” Dr. Burke says.

For oral minoxidil, studies have suggested that dizziness, lightheadedness, hypotension, and tachycardia may occur within the first week, while headaches might appear after 15–20 days. Other side effects, specifically hypertrichosis (excessive hair growth), fluid retention, and weight gain, might not appear for the first three months.

Just keep in mind that side effects depend on the person. There are several variables in play, so not everyone will have the same experience.

How long do Minoxidil for Men side effects last?

The persistence of minoxidil side effects also depends on the person, as well as the dosage and the type of side effect. “Most side effects are temporary and manageable with proper medical supervision and follow-up care,” says Alan Bauman, MD, hair restoration specialist and founder of Bauman Medical. “It’s important to understand that the ‘shedding’ side effect when starting minoxidil is actually a positive sign that the medication is working as expected.”

Dr. Burke says that skin irritation often becomes asymptomatic as the scalp adjusts to the dose or foam formulation. “Systemic side effects are usually reversible and will typically resolve within a few days to a week after stopping medication administration. If there are any heart-related symptoms that require medical attention, it may take longer for the body to fully readjust after discontinuing the drug,” Dr. Burke says.

What are the long-term side effects of Minoxidil for Men?

Dr. Bauman says long-term side effects of Minoxidil for Men are rare if you use it at the correct dosage under medical guidance. However, if treatment is stopped, hair that was previously supported by minoxidil can shed, and overall thinning will continue. “That’s why consistent use, periodic monitoring, and measuring of hair density are key.”

Minoxidil for Men interactions

Minoxidil doesn’t have a ton of drug interactions, but it does have some. These include:

• Blood pressure medications: Minoxidil and drugs like metoprolol both lower blood pressure. When combined, they may lower it too much, causing hypotension.
• Some corticosteroids and immunosuppressants: Sometimes minoxidil and corticosteroids are prescribed simultaneously, but corticosteroids and other immunosuppressants can also increase the risk of fluid retention.
• Some antidepressants: These might also lower your blood pressure, potentially leading to hypotension.
• Erectile dysfunction drugs: Medications like Viagra (sildenafil) might lower your blood pressure as well.
• Alcohol: Drinking while using minoxidil might worsen side effects like dizziness, headaches, and lightheadedness. There’s also evidence that oral minoxidil can worsen hangover symptoms.

Safety measures while using Minoxidil for Men

Not everyone who starts losing hair should take minoxidil. For example, if you’re allergic to any of its ingredients, you should avoid it. Additionally, it’s contraindicated for pregnant and breastfeeding women, as well as anyone under age 18. According to the label for the 5% topical solution, you shouldn’t use it if you don’t know the reason for your hair loss, or if your hair loss is sudden, since it might not help in those situations, and your hair may come back without any medication.

Additionally, anyone who has existing heart disease should speak with a healthcare professional before using minoxidil, because it may cause fluid buildup around the heart and worsening angina pectoris (chest pain) for some people. 

Minoxidil is not a habit-forming drug, but it can cause overdose, primarily if you ingest the topical solution or foam. Symptoms of overdose can include hypotension, trouble breathing, fluid retention, weight gain, facial flushing, dizziness, blurred vision, and fatigue. The maximum dose is typically 5 mg per day, and if you believe you may have overdosed, seek medical attention.

Monitoring is important too. “Always use minoxidil under the guidance of a board-certified hair restoration physician who can determine the proper dosage and formulation for your unique needs and always get a baseline measurement (e.g., HairCheck, HairMetrix, TrichoLAB, etc.),” Dr. Bauman says. He also recommends being patient, since results take time. 

How to prevent Minoxidil for Men side effects

Sometimes, side effects are unavoidable. But there are steps you can take to lower the risk. For minoxidil, these can include:

• Using the correct dosage: “For the topical solution, use only the recommended amount and apply only to a completely dry, healthy scalp,” Dr. Burke says. “It is strongly recommended for patients to start with the 5% foam, as it causes less irritation than the liquid.” For oral minoxidil, use it as your healthcare provider directs.
• Using it at night: This can help reduce the risk of side effects like lightheadedness, according to Dr. Bauman, particularly for oral minoxidil.
• Informing your healthcare provider of other medications: Since some drugs may interact with minoxidil, or make side effects more likely, it’s important to discuss other medicines you’re taking before starting minoxidil.
• Avoiding cuts or irritated skin: “Any open cuts or inflammation can be a route to increase how much enters your bloodstream,” Dr. Burke says. This may increase the likelihood of side effects.
• Performing a patch test: If you’re worried about scalp irritation, apply minoxidil to a small patch of scalp to see what happens before using it on your entire head.
• Don’t double up: If you miss a dose, just apply or take the next dose when you remember. Don’t take or apply double the amount, since this will increase the drug’s concentration in your body and increase the risk of side effects.

How to treat side effects of Minoxidil for Men

Anyone experiencing minoxidil side effects will likely want to know how to get rid of them. How to do this depends, however, on which side effects you’re experiencing.

For example, someone who gets scalp irritation after using topical minoxidil might want to switch the formulation. Foam versions without propylene glycol have a lower risk of irritation. Unwanted hair growth, on the other hand, typically requires some type of removal, like shaving, laser treatments, or waxing.

Fluid retention might seem more concerning, but sometimes reducing your salt intake can help, since sodium contributes to water retention. Some healthcare providers may also prescribe a diuretic to help. Other systemic side effects, like headaches and nausea, usually subside as your body grows accustomed to minoxidil treatment. But if not, the prescribing healthcare provider may recommend an alternate formulation, lower dosage, or different medication for hair loss.

Serious side effects like heart issues, fatigue, fainting, rapid weight gain, and allergic reactions typically require immediate medical attention and stopping minoxidil altogether.

Alternatives to Minoxidil for Men

There’s only one other drug that’s FDA approved to treat androgenetic alopecia, and it’s called finasteride (brand name: Propecia). However, other minoxidil alternatives, like dutasteride, are sometimes prescribed off-label for hair loss. In fact, one study found that, while finasteride is effective for treating hair loss, dutasteride might be even better. Another study found that spironolactone (a diuretic sometimes used off-label as a hair loss drug) is also effective.

Some natural treatments may help as well, either as a solo treatment or alongside minoxidil. For example, research has suggested that rosemary oil might have similar results to 2% minoxidil treatment. Other natural remedies that have shown promise include tea tree oil, peppermint oil, green tea, pumpkin seed oil, saw palmetto, and lavender oil.

Low-level laser therapy uses devices that stimulate the scalp to improve hair density and thickness, although the research on its effectiveness is limited. Alternatively, microneedling is a procedure that uses tiny needles to trigger the healing process in the scalp, increasing blood flow, and studies have found that it’s effective when paired with minoxidil. 

Finally, hair transplantation and its most common techniques, known as follicular unit transplantation (FUT) and follicular unit extraction (FUE), are more permanent hair restoration procedures.

When to see a doctor for minoxidil side effects 

Not every side effect requires a trip to your healthcare provider. Many minoxidil side effects simply go away on their own. However, anyone who experiences serious systemic side effects, like irregular heartbeat, trouble breathing, extreme fatigue, dizziness, serious swelling, or fainting, should see a healthcare professional right away. Allergic reactions require immediate medical care, too, and scalp irritation that doesn’t go away may also warrant a trip to your healthcare provider.

Bottom line: Is Minoxidil for Men safe?

Yes, Minoxidil for Men is a safe way to manage the common issue of male hair loss. Like any other drug, there are possible side effects, but many of them are mild and will subside as your body adjusts. The most important thing is to communicate with your healthcare provider and use minoxidil only as they prescribe it.