How Rogaine (Minoxidil) Works for Hair Growth
Medically reviewed by Lindsay Cook, PharmD
Rogaine (minoxidil) is an over-the-counter (OTC) medication that treats certain kinds of hair loss. When applied directly to the scalp, Rogaine helps hair grow faster and thicker. Rogaine works by increasing blood flow to the hair follicles, which stimulates hair growth and helps prevent further hair loss.
Different formulations of Rogaine are available. Versions marketed for males include a liquid solution in two strengths (2% and 5%) as well as a 5% foam. Two formulations are marketed for females: a 2% liquid solution and a 5% foam. Despite some slight differences, all Rogaine formulations contain the same active ingredient: minoxidil.
Keep reading to learn more about how Rogaine works, what results to expect, and potential side effects.
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How Rogaine Works
To understand how Rogaine works, understanding the basics of hair growth helps.
Each strand of hair on your head and body grows out of a hair follicle in your skin. Hair grows in a cycle with phases of growth and rest.
Over time, hair follicles may shrink. The hair growth cycle changes due to age, genetics, and other factors.
As hair follicles shrink, the growth phase typically gets shorter, and the rest phase may get longer. Eventually, the strand of hair doesn’t grow long enough to reach the surface of the skin, leading to balding areas on the scalp.
Rogaine can help hair grow thicker and faster. Minoxidil, the active ingredient in Rogaine, belongs to a group of drugs known as vasodilators. Vasodilators make blood vessels relax, which increases blood flow to your hair follicles.
Minoxidil is also available by prescription as an oral tablet. Oral minoxidil is approved by the U.S. Food and Drug Administration (FDA) to treat high blood pressure. In some cases, healthcare providers prescribe oral minoxidil off-label for hair loss. Studies have found that low-dose minoxidil tablets are safe and effective for hair regrowth in adults with male- or female-pattern baldness.
Rogaine comes as a topical liquid or foam that you apply directly to your scalp. When applied to the skin, topical medications absorb into the skin and mainly work at the area of application.
Rogaine works by absorbing through the skin and relaxing blood vessels around the hair follicles. This increases blood flow to your hair follicles. With regular use, Rogaine works to promote hair growth by:
Increasing the size and thickness of each strand of hair
Extending the growth phase of the hair growth cycle in hair follicles
Promoting the production of proteins in your body that are essential for hair growth
A Note on Gender and Sex Terminology
Verywell Health acknowledges that sex and gender are related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “female,” “male,” “woman,” and “man” as our sources do.
Does Rogaine Grow Hair Back Fully?
The amount of hair growth with Rogaine varies, and you have to keep using it to maintain its effects. Some people see partial hair regrowth, while others may experience a return to a full head of hair. And some people may not see any improvement.
Results from clinical studies can help give you an idea of what to expect with Rogaine use. A yearlong study of over 900 men applying Rogaine 5% twice daily resulted in considerable hair regrowth. Nearly 85% of individuals saw some hair regrowth, with 62% experiencing significantly smaller bald patches.
In another study of 278 male participants, those using Rogaine 2% or 5% solution for 48 weeks had 70% more hair growth than participants not using the treatment. The higher-strength formulation resulted in about 45% more hair regrowth than the lower strength.
In a study of about 400 females using the Women’s Rogaine 5% foam formulation, the results revealed that 80% of participants had more hair (based on an increase in hair count) after six months of use.
Why Rogaine works better for some and not at all for others is unclear. Rogaine appears to work best in those 40 years of age and younger or when started early in the hair thinning process.
Though the exact reasons Rogaine may or may not work aren’t fully understood, there are steps you can take to optimize your results.
Make sure to apply Rogaine once or twice daily, according to the specific instructions on the product label. Skipping applications makes Rogaine less effective. The more applications you skip, the less likely it is to work.
Similarly, starting Rogaine as soon as possible after you first notice thinning or balding areas can improve your overall results with the medication. When hair thinning first starts, each hair growth cycle produces weaker and thinner hairs. So, starting as early as possible may reverse this trend.
How Long Will Rogaine Take to Work?
Rogaine starts working from the first application, but people may experience different timelines for results. Hair growth is a relatively slow process, and noticeable improvement may take two to four months of regular use. You can expect to see Rogaine’s maximum or peak results after 12 to 18 months of regular use.
If you do not see any improvement after six to 12 months of regular use, consider stopping it and talking to a healthcare provider about other treatment options.
After hair grows back with Rogaine use, you’ll need to keep using it regularly to maintain the results. If you stop using it, you’ll likely see a return to thinner hair or bald spots within four to six months.
What Rogaine Products Are Available?
Currently, five different formulations of Rogaine are available OTC, including:
Men’s Rogaine 5% Aerosol Foam
Men’s Rogaine 2% Solution
Men’s Rogaine Extra Strength 5% Solution
Women’s Rogaine 5% Aerosol Foam
Women’s Rogaine 2% Solution
All of these products are similar in that they contain minoxidil as their active ingredient and are designed to be applied directly to the affected area of hair loss.
The site of application varies slightly between the different forms. The FDA has approved each of the three Men’s Rogaine products for application to the vertex of the head. The vertex is the upper-most point in the center of the scalp and represents a common location for hair loss among men.
Men’s Rogaine was approved for hair loss based on its application only to the vertex of the head. The product isn’t FDA-approved for use on the face, hairline, or anywhere else to promote hair growth.
The two Women’s Rogaine products are FDA-approved for a broader application site. The instructions indicate that these medications can be applied anywhere on the scalp to promote hair growth.
Though FDA approval of Rogaine products only includes these specified areas for hair growth, some healthcare providers may recommend applying the medication to other areas as an off-label treatment. However, the evidence supporting non-scalp use is mixed.
Some studies and case reports suggest Rogaine’s potential benefit to hair growth of the eyebrows, beard, and facial hair. However, other studies have found little or no improvement. The medication's effectiveness is also unclear for certain kinds of alopecia, such as scarring alopecia.
Ultimately, you should only apply Rogaine to the approved areas of the scalp unless instructed otherwise by a healthcare provider who determines another plan is safe for you.
Both the foam and solution work pretty much the same way, but you apply them slightly differently. With the solution, you apply the liquid to the balding area with a dropper. With the foam, you massage it into your scalp where you want it to work. This helps the medication reach the hair follicles to optimize effectiveness.
The foam is generally easier to apply, dries faster, and doesn't contain propylene glycol, a potential irritant found in the liquid solution.
Most Rogaine products require a twice-daily application for the best results. The exception to this is the Women’s Rogaine aerosol foam, which requires once-daily application. Twice-daily application of the higher strength (5%) is generally more effective than the 2% strength.
Who Can Use Rogaine?
Rogaine is FDA-approved for hair loss in adults. Specific products are designed for males versus females based on the studies conducted to establish the medication’s safety and effectiveness.
Specifically, Rogaine is approved to treat androgenetic alopecia, commonly known as male-pattern baldness or female-pattern baldness. This type of hair loss is very common and occurs gradually over time, affecting up to 80% of males and 50% of females by age 70.
Who Should Not Use Rogaine?
Rogaine can be a safe and effective treatment for hair loss, but it isn’t right for everyone. According to the product labeling, you should not use Rogaine if:
You have no family history of hair loss.
You have sudden, unexplained, or patchy hair loss.
You are under the age of 18.
You have hair loss that occurs in association with giving birth.
You have skin problems at the intended application site, such as scalp irritation, infection, or pain.
You apply other medications to your scalp.
Side Effects of Rogaine
Most people do not have bothersome side effects from Rogaine. Mild side effects may occur, such as itching, redness, or flakiness on the scalp.
Also, when you start using minoxidil, you might notice more hair growth initially, followed by some shedding of old hair after two to eight weeks. This shedding is generally a sign that the treatment is working.
Another mild side effect of topical minoxidil is hypertrichosis, which appears as fine hairs growing on areas like the face and hands.
Mild allergic reactions are also possible. Consider testing the product on a small area first.
Rogaine mainly works in the hair follicles, with very little of the medication affecting the rest of your body. Rarely, however, some report Rogaine can cause severe side effects that require medical attention. These include:
Sudden, unexplained weight gain
Side effects occur more frequently with 5% Rogaine products than with 2% Rogaine products because the 5% forms provide more of its active ingredient, minoxidil. However, if irritation occurs with the liquid solution of Rogaine, switching to a foam formulation may help.
How Does Rogaine Compare With Other Hair Loss Medications?
In addition to Rogaine, other medications are available that might help regrow hair. One is Propecia (finasteride), an oral tablet the FDA has approved for male-pattern baldness. Some healthcare providers prescribe a similar medication called Avodart (dutasteride) off-label for hair loss, but the FDA hasn't approved it for this use.
Propecia is expected to work better than Rogaine, but these medications have not been directly compared in clinical trials. Keep in mind you need a prescription for Propecia, while Rogaine is available OTC.
Rogaine is the only medication the FDA has approved for female-pattern baldness.
Alternative Remedies for Hair Growth
Various dietary supplements offer an additional option for managing hair loss, most notably those containing biotin. Other ingredients in these products often include marine collagen complexes, plant oils, vitamin C, and amino acids.
Few studies investigate supplemental or herbal remedies for hair loss; however, some individuals may experience beneficial results. Talk to a healthcare provider before starting any herbal or dietary supplement because they may pose a safety risk or interact with other medications.
Summary
Rogaine (minoxidil) is an over-the-counter medication that you apply to the scalp for hair loss. Rogaine works by improving blood flow to the hair follicles, which increases the size and strength of hair strands and stimulates hair growth. With regular use, Rogaine typically provides noticeable hair growth within three to four months.
However, Rogaine may not work for everyone. If you’re not seeing results after four months, reach out to a healthcare professional to discuss other options.
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