Topical minoxidil or tablets - Expert review Fellos

‍What exactly is minoxidil?

Minoxidil is a drug that was originally developed to treat high blood pressure. During clinical trials, physicians found that patients taking minoxidil experienced increased hair growth as a side effect. This led to the development of topical minoxidil, which is applied directly to the scalp to hair loss to slow down and stimulate hair growth.

It works by stimulating hair follicles and improving scalp blood flow. This allows hair to grow back thicker and stronger. Together with finasteride, Minoxidil is now one of the most researched drugs against hereditary baldness; androgenic alopecia.

The tablet form contains the same active ingredient, but works through the bloodstream throughout the body. This makes use less local and therefore less controllable.

Minoxidil side effects: lotion vs. tablets

The biggest difference between lotion and tablets is the risk profile.

• Minoxidil tablets can cause systemic side effects because they circulate throughout the body. Think of low blood pressure, fluid retention (edema), heart palpitations or dizziness. These side effects occur because the medicine was originally a blood pressure reducer. However, the risk of these side effects is very small and only occurs in rare cases. A relatively common side effect is headache.
• Topical minoxidil on the other hand, works locally on the scalp. The amount of active substance that enters the bloodstream is minimal. As a result, the side effects are usually limited to skin irritation, itching or scaling of the scalp. These side effects are also relatively rare and disappear when treatment with minoxidil is stopped.

Precisely because the lotion works locally and is easier to dose, it is considered by doctors to be safer and more reliable for use in case of hair loss. One reason that people still choose a tablet is its convenience; a tablet can easily be taken once a day. Where the topical variant should be applied twice a day for best results.

Is minoxidil available with a prescription?

Whether minoxidil is available by prescription depends on the variant.

• The tablets are only available by prescription but are not registered in the Netherlands as hair growth products and are therefore not available everywhere.
• The lotion or foam is freely available without a prescription. This form is approved for the treatment of male hair loss and is considered a standard treatment worldwide.

At Fellos, you can safely get advice about this from a BIG-registered doctor. This way, you can be sure that the treatment suits your situation and health.

Are there more effective treatment options?

While minoxidil (in both lotion and tablet form) has been proven to help stimulate hair growth, it is not always sufficient to completely stop baldness. Hormonal factors play a major role, especially in hereditary hair loss.

That is why agents are often prescribed that address the cause directly, such as finasteride country dutasteride.

• Finasteride blocks the enzyme 5-alpha reductase, which converts testosterone into DHT (dihydrotestosterone). DHT is the hormone responsible for shrinking hair follicles in case of hereditary baldness.
• Dutasteride works in a similar way, but is more powerful and inhibits the enzyme at two levels. As a result, it is sometimes used for persistent or advanced baldness.

These medicines are only available with a prescription and should be used under the supervision of a physician. At Fellos, our BIG-registered doctors will assess whether finasteride or dutasteride is suitable for your situation during an online consultation. The medication was then delivered discreetly and safely to your home via an authorized Dutch pharmacy.

When do you notice results?

Anyone who starts a hair loss treatment often has one urgent question: “When do I see a difference?”

With topical minoxidil, it takes an average three to six months before the first results become visible. At first, it may even seem like you're losing more hair — it's a normal process where old hair falls out to make way for new growth.

The combination of minoxidil lotion and finasteride tablets provides the best results for many men. This approach is safe, scientifically based and is considered the most effective treatment for male pattern baldness worldwide.

Fellos' role

At Fellos, we make care for men accessible, discreet and reliable. We understand that discussing hair loss is not easy. That's why we offer a 100% online process, where you can start an intake from home. Within 48 hours, you will receive personal treatment advice from a Dutch doctor. During your treatment, you can always ask questions to one of our doctors via chat and check in regularly to discuss your progress.

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