Minoxidil is one of two licensed medications for pattern baldness in the UK (the other is finasteride). Available as a topical foam or solution, or as an oral tablet, it works by increasing blood flow to the hair follicles, which stimulates hair growth. And it’s highly effective: it’s been shown in clinical trials to improve hair coverage in up to three in four men.
Side effects are a common concern for people looking into a treatment like minoxidil. However, the good news is that it's generally well tolerated. Most men don’t get any side effects. And if they do, they tend to be mild and manageable, provided the treatment is being used correctly.
Still, it helps to know what to expect before deciding if minoxidil is right for you.
Key Takeaways
- Minoxidil comes in topical form (a liquid or foam you apply externally) or oral tablets. The side effects are different for each, but topical side effects are usually milder.
- Dryness, itching, or temporary shedding are among the most common minoxidil side effects. But they don’t tend to be super noticeable, and they settle within a few weeks.
- Oral minoxidil does come with some cardiovascular warnings, but heart-related side effects are very rare, and typically linked to much higher doses.
- Since minoxidil doesn’t impact testosterone, there’s no clear clinical link with sexual side effects like low sex drive or erectile dysfunction.
- If you are experiencing persistent side effects on minoxidil, your clinician can explore different formulations or alternative treatments with you.
The more common minoxidil side effects
Minoxidil comes in two forms for hair loss: topical (a liquid or foam you apply directly to your scalp) and oral tablets.
Topical minoxidil side effects are usually milder and limited to the area where it’s applied, while minoxidil tablet side effects can sometimes affect the wider body.
Topical minoxidil side effects (foam or liquid)
- Redness, itching, or flaking where the product is applied.
- Temporary extra hair shedding—annoying, but it’s a sign that old hairs are making way for stronger new ones. And it usually only lasts a few weeks.
- Hair growth in places you don’t want, like the forehead or face—often from the product being spread accidentally. (While some men try using it intentionally for beard growth, this is considered off-label use.)
Be sure to apply topical minoxidil carefully to the scalp only. Applying a head covering afterwards can also limit unwanted spreading.
Most side effects settle down as your body adjusts. If irritation sticks around, switching between liquid and foam or applying less often can make a big difference.
Oral minoxidil side effects (low-dose tablets)
Commonly reported side effects from the Minoxidil can include:
- Mild ankle or foot swelling (fluid retention)
- Unwanted hair growth (i.e., again, not on your head)
- Lightheadedness
- Palpitations. This often improves after a few weeks and is not usually a concern unless you also have other symptoms.
- Changes in hair colour
Most people who experience side effects are able to continue treatment with an adjusted dosage.
Long-term side effects of minoxidil
Minoxidil was originally developed to treat high blood pressure. In smaller doses, it was later found to increase the blood flow to the hair roots, supporting hair growth. Still, due to its origins, oral minoxidil does come with a few cardiovascular warnings.
If too much gets into your system, heart or blood vessel problems can occur, like:
- Chest pain
- Fast or irregular heartbeat
- Swelling of your hands and feet
- Fainting
- Hypotension (low blood pressure)
If you notice any of these symptoms, you should stop using minoxidil and consult your doctor or clinician.
But remember: all of this is rare. It’s usually linked to improper use, or higher doses than you’d take for hair loss. And for the record, topical minoxidil comes with no clear increased risk of cardiovascular issues, because the amount you absorb through your skin is very low.
Minoxidil sexual side effects
Unlike finasteride (the only other licensed medication for male pattern baldness in the UK), minoxidil doesn’t significantly impact testosterone—a hormone linked to sexual function. This is likely why research doesn’t show a strong connection between minoxidil and erectile dysfunction or low sex drive.
There are some anecdotal accounts of sexual side effects on minoxidil. But without scientific evidence, these could be down to stress, anxiety, other health conditions, or taking e.g. finasteride at the same time.
If you notice changes in your sex drive or erections, it’s worth checking in with a clinician to look at the bigger picture.
Do minoxidil side effects go away?
Yes, most minoxidil side effects are temporary.
If you get dryness, itching, or flaking, it usually settles within a few weeks as your scalp adjusts. If these symptoms persist, check in with your clinician; they may advise stopping treatment. But skin reactions are largely down to the ingredient propylene glycol in liquid solutions—and if this is the case, switching to a topical foam (which doesn’t have propylene glycol) or oral tablets can make a big difference.
As for the extra shedding we spoke about, this usually lasts 2–12 weeks. Like we said, it can feel scary, but it’s actually a sign the drug is working, and making space for newer, stronger hairs.
Minoxidil side effects after stopping
Minoxidil is a medication that only works while you’re on it. If you stop, the hair you’ve gained will gradually shed over the next 3–6 months as things return to your natural pattern. For the record, that’s not “rebound loss” or damage—just the hair going back to its normal pattern.
Rarely, some mild irritation or extra shedding can continue briefly after stopping, but there are no long-term minoxidil side effects after stopping.
Who shouldn’t use minoxidil
Minoxidil is safe for most men, but it’s not the right fit for everyone.
You shouldn’t use minoxidil if you:
- Are under 18
- Have had an allergic reaction to minoxidil or the ingredients in it
- Have scalp issues such as active psoriasis on the scalp, infection, irritation, or open sores (if using topical formulation)
- Have sudden or patchy hair loss, or hair loss with no clear family history (this could be a different condition that needs proper diagnosis)
- Have uncontrolled low or high blood pressure
- Have certain heart conditions or abnormal heart rhythms
Minimising side effects
Here’s your checklist to ensure the smoothest ride with minoxidil.
Topical minoxidil
- Apply it only to a dry scalp and stick to the recommended amount.
- Wash your hands after each application, and consider a head covering until it dries.
- If irritation occurs, try a lower strength or switch formulations to oral tablets
Oral minoxidil
- Take it exactly as prescribed.
- Keep an eye on your blood pressure and report any swelling, palpitations, or unusual symptoms to your doctor.
Avoid mixing minoxidil with other hair treatments without professional guidance. If you’re using minoxidil through MANUAL, you’ll have access to our clinical team, who will monitor your plan and help manage your side effects safely.
Hair loss treatment that works
With science-backed, personalised treatments from MANUAL, you can start regrowing thicker, fuller hair in just a few months. Join over 500,000 men reclaiming their confidence today: Take our quick quiz for a treatment plan tailored to you.
¹
