13 Topical Minoxidil (Rogaine) Side Effects to Look Out For

Medical Disclaimer: Freebird provides general information, not medical advice. For any health or medical advice, consult a licensed healthcare professional

Are you looking for a solution to hair loss? Rogaine (minoxidil), seems like an obvious choice. It's FDA approved, it's been around for decades, and it's easily available on drugstore shelves.

But did you know that Rogaine only works for 30 to 40% of users? This means 60% of users see little to no results. Even if you're among the lucky ones you're signing up for a lifetime of twice daily applications.

When pattern baldness hit me, using minoxidil crossed my mind. I did my research and what I learned about the side effects, why it doesn't work for most people, and the alternatives helped me decide on what to do with my hair loss.

We'll be talking about topical minoxidil since oral minoxidil isn't FDA approved yet.

Read along to find out if a lifetime of treatment is worth it.

What is Rogaine?

Rogaine is a topical hair growth medication clinically proven to stimulate hair growth. Minoxidil is the active ingredient in Rogaine, and it's been available for over three decades. In 1987, a topical formulation was developed specifically for androgenetic alopecia, and the FDA approved it in 1988.

Whenever I encounter fellow baldies, they often say they have considered Minoxidil for treating androgenetic alopecia.

I heard about the serendipitous story of how Rogaine was initially meant to treat high blood pressure, but many patients noticed that it had an unexpected side effect: hair growth.

Imagine discovering a hair growth solution by accident.

At first, doctors dismissed hair growth in hypertensive patients as a harmless side effect, but this eventually led to Minoxidil being recommended to treat hair loss.

A friend of mine tried it but gave up after a few years of treatment. Most likely because the Minoxidil solution only works for 30 to 40% of users, and you need to continue the treatment indefinitely to maintain the results, if any. This means a lifetime of therapy, which is expensive. Plus, there's the risk of side effects that we'll discuss later.

The Science Behind Rogaine

It's not fully known how Minoxidil causes hair growth. The best theory is that Minoxidil is a vasodilator that increases the blood flow to the scalp. More oxygen and nutrients reaching your hair roots nourish hair follicles and aid in regrowth.

Here's what most people don't know. Minoxidil doesn't work until it's converted into its active form, "minoxidil sulfate," by an enzyme called sulfotransferase (SULT1A1) in your scalp.

About 40% of people have low sulfotransferase enzyme activity in their hair follicles. If you're in this group, topical minoxidil won't work for you, no matter how long you use it.

This explains why only 30-40% of users see results. It's not about consistency or patience; it's basic biochemistry. If you don't have enough SULT1A1 enzyme, topical minoxidil can't help your hair loss problem.

According to WebMD, Minoxidil works best in treating male pattern baldness, not for baldness in front or receding hairlines. It's available in 5% and 2% solutions or in foam form, such as minoxidil topical foam.

Common Side Effects of Rogaine & Minoxidil

While Rogaine has helped millions of people worldwide regain their hair, it is not without side effects. Here are the possible downsides of using Rogaine:

• Skin irritation

• Itching, redness, or burning

• Skin rash

These side effects are usually mild and temporary, often fading as your body adjusts to the medication.

Potential causes of skin irritation when using Rogaine may include worsening of seborrheic dermatitis, an allergic reaction to Minoxidil, or excessive application of topical Minoxidil. Do not hesitate to contact your healthcare provider if your condition worsens. 

Less Frequent Side Effects

Some users may experience less frequent side effects, such as:

• Temporary hair loss

• Unwanted hair growth

• Red bumps

• Acne breakouts

• Facial swelling

• Headaches

Although these symptoms are rare, you need to be aware of them while using Rogaine.

Temporary Hair Loss (Minoxidil Shedding)

Temporary hair loss? You read that correctly: a hair loss treatment that causes temporary hair loss. You may experience brief hair shedding during the first few weeks of using Rogaine.

As your hair follicles transition to the anagen phase, Rogaine helps hasten the shedding of thinning hair, making way for new and healthier hair growth.

Unwanted Hair Growth

Many call this the Tarzan effect, which isn't enjoyable, especially for women. Imagine waking up one day and seeing new hair on your forehead, chest, or cheeks. That's more shaving areas to cover.

Red Bumps

Some users may develop red bumps on their scalp due to irritation.

Acne Breakouts

The joys of being a teenager! Be prepared to relive your puberty skincare routine if you decide to use Rogaine.

Facial Swelling

If you wake up with puffy cheeks, don't panic. It's just Rogaine and one of its side effects.

Headaches

Dealing with hair loss can be a headache, so be prepared, as Rogaine may cause real headaches.

Serious Side Effects and When to Seek Medical Help

Now, let's talk about the serious stuff. Though rare, serious side effects may need immediate medical attention. These include:

• Dizziness

• Swelling

• Unexpected weight gain

• Breathing difficulties may occur, along with other side effects.

Dizziness

If you become dizzy after applying Minoxidil, it's time to visit your doctor. This may be caused by minoxidil's vasodilator effect, which lowers your blood pressure.

Swelling

Swelling occurs if you're allergic or may have something more serious. If your lips, face, tongue, or throat start swelling up like a balloon, ask a professional for help immediately.

Weight Gain

Thicker hair with a belly? I'm sure that's not what you signed up for when you bought Rogaine. If you unexpectedly gain weight, ask your healthcare provider for advice.

Breathing Difficulties

When breathing becomes a struggle after using Rogaine, this is an emergency. Seek help immediately.

Is Rogaine Safe to Use?

With all these potential side effects, you may ask, Is Rogaine safe?

The good news is that Rogaine is generally considered safe and effective for hair regrowth, with millions of users worldwide and no evidence of systemic side effects when used topically as directed. Studies have established the efficacy and safety of Minoxidil in treating androgenetic alopecia, making it a trusted option for individuals seeking to combat hair loss.

Despite Rogaine being considered safe for most users, you should seek advice from your healthcare provider before starting the medication if you're pregnant, breastfeeding, or dealing with pre-existing medical conditions.

How to Use Rogaine Correctly

For maximum benefits from Rogaine, you have to use it correctly:

1. Ensure that your hair and scalp are dry before applying the medication. A little prep can go a long way.

2. Apply the recommended amount of Rogaine solution or foam to the affected areas of the scalp twice daily, in the morning and at night. Avoid drowning your scalp with the solution. More doesn't mean faster results.

3. Remember that it may take up to 4 months or longer before any new hair is observed, so patience is critical. It took years before you lost your hair, so you need patience to grow it back.

After applying Rogaine, follow these steps:

1. Wash your hands thoroughly to avoid accidental contact with other body areas. Be careful with your eyes and other parts of the body. Remember the Tarzan effect?

2. Be cautious when using other topical products on your scalp, as they may cause drug interactions or other adverse effects. If you are taking medications for hypertension, they can interact with Rogaine. Consult your doctor for any possible conflicts.

3. If you miss a dose, apply it as soon as you remember.

4. If it is close to the time for your next dose, skip the missed dose and do not use additional medicine to make up for it.

Interactions with Other Medications

Rogaine isn't known to cause substantial drug interactions. However, you should still disclose all medications you're currently on, including prescription and over-the-counter medicines, vitamins, and herbal products.

Important note: Daily aspirin use may reduce topical minoxidil effectiveness. Studies show that aspirin inhibits sulfotransferase enzyme activity in hair follicles, reducing minoxidil conversion to its active form. In one study, 50% of subjects were predicted to be responders before aspirin use, but only 27% after 14 days of daily aspirin.

This will help your doctor determine if Rogaine is the best option for your hair loss treatment and ensure that other medications will not interfere with its effectiveness.

Personal Insights

I was always wary about drugs and chemicals being absorbed into my body. I always choose natural treatments for my baldness and never thought about Rogaine as a solution for my hair loss. I believe my case was due to androgenetic alopecia in men since baldness runs in the family.

I tried natural hair loss solutions, but they only made the McDonald's logo on my head smaller. I wasn't satisfied with this since my goal was complete hair restoration, which is impossible for baldies, except for a miracle.

I was thinking about minoxidil but then I learned about the sulfotransferase enzyme factor. I realized that even if I used Rogaine religiously, there was a 60% chance it simply wouldn't work for me because of genetics I can't control.

I got tired of thinking about my hair loss problems and chose an opposite route: Head Shaving.

I was now free!

I made the best decision a bald man can make: confidently accept baldness and shave my head.

If you decide to join the bald lifestyle like the rest of us, the Freebird FlexSeries is the go-to head shaver for bald guys.

The Bottom Line

Rogaine is a widely trusted and effective solution for individuals experiencing hair loss, either male-pattern baldness or female-pattern hair loss, but only if you're among the 30 to 40% who respond to it. 

While there are some common and less frequent side effects associated with the use of Rogaine, most users find them to be mild and temporary.

But here's what you need to consider: Rogaine requires lifetime use. Stop using it, and you lose your gains within 6-12 months.

Remember to tell your doctor before using the minoxidil solution. Follow the instructions for proper application, and be patient, as it may take several months to see results. If you don't see improvement after 6-12 months, you're likely a non-responder and should consider alternatives, like head shaving.

If you are still on the fence about accepting your baldness, our article on how to confidently accept baldness may help you decide.

FAQs

Are There Adverse Effects When Using Rogaine?

Rogaine (Minoxidil Topical) can cause side effects like scalp discomfort, unexpected hair growth, temporary hair shedding, and, in rare cases, contribute to a rapid heartbeat. Severe allergic reactions are also possible. 

Why Do So Many People Stop Using Topical Rogaine?

People stop using topical Rogaine because of the time-consuming twice-daily application, greasy hair appearance, scalp irritation, lack of results after months of use, and the cost of indefinite treatment. A study backs this up and shows that 86.3% of people discontinue topical minoxidil.

Does Rogaine Regrow Hair?

Based on observational research, 47.8% of participants found Rogaine effective for hair regrowth, and an additional 15.9% found it very effective. Thus, Rogaine can be an effective tool for regrowing hair.

Is it Safe to Use Rogaine Forever?

Minoxidil is safe to use for long-term results, and to maintain hair regrowth, continued use of ROGAINE® products is necessary. All treatments for Androgenetic Alopecia require lifelong use if results are to be maintained.

Can I Use Rogaine if I am Pregnant or Breastfeeding?

Consult your healthcare provider before using Rogaine if you are pregnant or breastfeeding. The safety of the medication during pregnancy and lactation has not been well established.

How Long Does it Take for Rogaine to Show Results?

It may take up to 4 months or longer to use Rogaine before any new hair growth is observed, so patience and consistency are needed to achieve the desired results.