Thinning hair is an issue that affects millions of women, with about 40% of us showing visible signs of female pattern hair loss by the age of 50. No wonder ‘how can I treat thinning hair?’ is the question that Philip Kingsley trichologist Anabel Kingsley is asked most often by women.
Her first answer is twofold: act quickly and go in hard. ‘For age-related hair-diameter changes, minoxidil tends to be the most effective treatment,’ confirms Anabel, who has just released her own hair bible, Haircare: The Ultimate Guide.
‘It’s the most well studied ingredient for female and male pattern hair loss and has the most robust evidence behind it.’
However, minoxidil is also a treatment that many women are confused about, so we’ve asked Anabel to break it down for us: what it is, how it works, how to get the best results and how to use it safely.
Does minoxidil really work for female hair thinning?
Yes, absolutely – and the women’s results often far exceed expectations, says Anabel. ‘Minoxidil helps to keep hairs in their anagen (growth) phase, can thicken the diameter of hairs and may awaken dormant hair follicles in some individuals,’ she says. ‘Women in particular often see an improvement to hair density, length and scalp coverage, rather than a simple maintenance of the hair they have.’
Annabel Kingsley Haircare: The Ultimate Guide
Annabel Kingsley Haircare: The Ultimate Guide
Is minoxidil a cure for thinning female hair?
Sadly not – and Anabel is always careful to emphasise this to her clients. ‘Like all hair loss treatments, minoxidil is not a miracle drug, nor is it a cure for hair thinning. As of yet, there is no cure for female (or male) pattern hair loss.’
‘It’s an ongoing and progressive condition and the mechanisms that cause it cannot be switched off – the hair follicle gradually shrinks, hairs become finer and shorter and follicles can remain empty for extended periods of time. This is why treatment needs to be ongoing to work.’
It’s also important to know it’s not for all types of hair loss. ‘It’s not indicated for use as treatment for acute telogen effluvium (excessive hair shedding),’ says Anabel.
How do I take minoxidil for best results?
Minoxidil can either be applied topically or taken orally in pill or gummy form, says Anabel. It comes in varying strengths – from 2% to 10% topically, and from 0.25mg orally – but more doesn’t equal better, she says.
‘Topically, it isn’t recommended to use over 5% as there isn’t evidence a higher percentage is more effective, and you also run a higher risk of scalp irritation and facial hair growth. From 3-5% topically tends to be the sweet spot for women.’
How long does it take to see results?
Minoxidil, on average, takes three to six months to work – as long as you take it properly, says Anabel. ‘It must be ingested or applied daily, and works only for as long as you use it. However, this is the same with all medications that help to manage ongoing progressive conditions.’
She likens this to skincare: ‘If you stop using retinol, you will lose the benefits. As minoxidil offers superior results than most other treatments, you have more to lose when you stop using it’.
Which form is better: topical or oral?
‘Whether you opt for topical or oral depends on your preference and the condition of your scalp,’ advises Anabel. ‘The most important thing when using minoxidil is consistency, so choose whatever you are most likely to stick to and what you are comfortable with.
‘Personally, I prefer the topical version as there is less of a risk of side effects, like facial hair growth and water retention,’ she adds. ‘When used topically, minoxidil can also be compounded with other growth supportive ingredients, such as hormones, melatonin and caffeine.’
Will topical minoxidil affect the texture or feel of my hair?
Topical minoxidil comes in a foam or liquid, and the best one for you might depend on your hair type, says Anabel. ‘If you have short hair, you may prefer the foam as it adds texture,’ she says. ‘If you have longer hair, bleached hair or coils, the liquid version may be easier to apply, and you may also prefer how it leaves your hair feeling.
‘The drops adhere to the scalp, while foam gets more into your roots. If you have a sensitive scalp, you may want to try formulations without propylene glycol. It’s best absorbed when applied to a clean, dry scalp, so shampoo as often as you can.’
Is minoxidil safe to use?
Anabel stresses that minoxidil is a medication and you should always consult a doctor or pharmacist before using it. ‘While it’s generally very well tolerated, it should be used under the guidance of a doctor, and certainly when taken orally,’ she says. 'If you have problems with blood pressure, it may not be suitable for you.’ A history of heart conditions can be a contraindication, and it should not be taken when pregnant or breastfeeding.
Minoxidil is toxic to pets. ‘If you have a pet and want to use topical minoxidil, you should wash your hands thoroughly after use (although this should be done regardless),’ she says.
‘If you apply minoxidil before bed, you should allow it to dry before lying down and swap out your pillowcase for a clean one each morning if your pet sleeps on your bed. Some of my clients have a ‘minoxidil pillow’. If your pet likes to preen your hair, you should opt for oral minoxidil.’
Are there any other mistakes to avoid?
Some specialists suggest rubbing in minoxidil foam with a toothbrush, ‘but I do not recommend this,' says Anabel. 'It can be abrasive on the scalp and the brush can get coated in germs if not cleaned properly after each use (which is annoying). Use your fingertips. Drops do not have to be rubbed in.’
I don’t want to take minoxidil. Is there anything else I can use to stop my hair thinning?
‘I totally get that having to take something “forever” is daunting,' says Anabel. 'But we do many things on an ongoing basis to see benefits – teeth brushing, sunblock application, supplement ingestion and skincare to name a few. When you think about it this way, applying a topical to your scalp every day, or taking a pill, seems less of an ask.
‘I also understand that many people don’t want to take a “medication”. However, by law, if a product claims to regrow hair, it must be classed as a medication. This rule applies to whether a product contains ingredients that are naturally derived or synthetic. The hair follicle is a complex mini organ, and changing its size, function and internal mechanisms is not a simple feat.'
‘If you don’t want to use minoxidil, you can try PRP, light therapy, microneedling and topical serums containing peptides, anti-oxidants, caffeine, melatonin and/or patented blends. Often, a combined approach gives the best results.' Always see a qualified practitioner for treatments.
Non-medicated, over-the-counter scalp serums can have certain benefits, adds Anabel. '"Anti hair fall” ranges etc can be helpful in anchoring hairs in the follicle, creating a healthy scalp environment, maintaining a normal growth-to-shedding ratio and helping ensure hair does not shed before it is meant to.'
‘However, they are incredibly unlikely to regrow hair density changes that are related to female pattern hair loss.’
Anabel Kingsley is the author of Haircare: The Ultimate Guide
