Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2025 Mar;64(3):479-484.
doi: 10.1111/ijd.17524. Epub 2024 Oct 19.

Efficacy and safety of oral minoxidil versus topical solution in androgenetic alopecia: a meta-analysis of randomized clinical trials

Milene Vitória Sampaio Sobral #  1 , João Lucas de Magalhães Leal Moreira #  2 , Livia Kneipp Rodrigues  3 , Paula Rocha  4 , Rafaela da Cunha Pirolla  1 , Victor Gonçalves Soares  5 , Davi Santos Lima  6 , Isac Ribeiro Moulaz  7 , Beatrhiz Costa da Silva  2 , Caroline Baima de Melo  8
Affiliations
Meta-Analysis

Efficacy and safety of oral minoxidil versus topical solution in androgenetic alopecia: a meta-analysis of randomized clinical trials

Milene Vitória Sampaio Sobral et al. Int J Dermatol. 2025 Mar.

Abstract

The benefits and potential risks of oral minoxidil therapy versus topical minoxidil therapy in patients with androgenetic alopecia (AGA) are controversial. We systematically searched PubMed, Embase, and Cochrane for randomized clinical trials (RCTs) comparing the use of oral minoxidil and minoxidil topical solution in patients with AGA. Statistical analyses were performed using R Studio 4.3.2. Standard mean difference (SMD) and risk ratio (RR) with 95% confidence intervals (CI) were pooled across trials. This meta-analysis included four RCTs reporting data on 279 patients. Follow-up ranged from 24 to 39 weeks. There were no differences in hair density (SMD 0.02; 95% CI -0.25 to 0.29; P = 0.88; I2 = 0%) or hair diameter (SMD -0.25; 95% CI -0.75 to 0.26; P = 0.34; I2 = 36%). The incidence of hypertrichosis was statistically significantly higher in the oral minoxidil group when compared to the topical minoxidil group (RR 2.01; 95% CI 1.18-3.41; P = 0.01; I2 = 0%). There was no statistically significant difference between groups for the incidence of hypotension (RR 2.42; 95% CI 0.26-22.46; P = 0.44; I2 = 0%). In patients with AGA, oral minoxidil and minoxidil topical solution have similar efficacy and safety, with equivalent improvements in hair density, hair diameter, and incidence of adverse events, such as hypotension.

Keywords: androgenetic alopecia; meta‐analysis; oral minoxidil; topical minoxidil.

PubMed Disclaimer

References

    1. Wolff H, Fischer TW, Blume‐Peytavi U. The diagnosis and treatment of hair and scalp diseases. Dtsch Ärztebl Int. 2016;113:377–386. https://doi.org/10.3238/arztebl.2016.0377
    1. Sinclair RD. Female pattern hair loss: a pilot study investigating combination therapy with low‐dose oral minoxidil and spironolactone. Int J Dermatol. 2018;57:104–109.
    1. Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editor(s). Cochrane Handbook for Systematic Reviews of Interventions. 2nd Edition. Chichester: John Wiley; 2019. https://doi.org/10.1002/9781119536604
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred reporting items for systematic reviews and meta‐analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097.
    1. Higgins JPT, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, et al. The Cochrane collaboration's tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.

MeSH terms

LinkOut - more resources