Can minoxidil regrow hair in bald spots? An in-depth look at its efficacy

October 7, 2025 •

4 min read

Over 50% of men over 50 and many women experience pattern hair loss, but FDA-approved treatments like minoxidil offer a way to address it. This article explores the scientific evidence behind how minoxidil can regrow hair in bald spots and what potential users should know.

Quick Summary

Minoxidil, an FDA-approved topical and oral treatment, can stimulate hair regrowth in bald spots caused by pattern hair loss. Its effectiveness is influenced by the extent and duration of hair loss, with consistent, long-term use being crucial for results. Expect a process that takes several months, and consult a dermatologist for personalized guidance.

Key Points

Stimulates Regrowth, Doesn't Cure Baldness: Minoxidil can regrow hair in bald spots by stimulating existing follicles, but it is not a permanent cure and new growth will cease if treatment is stopped.
Effectiveness Varies by Severity: The medication is most effective in the early stages of hair loss and on smaller, more recent bald spots, especially on the crown.
Requires Consistent, Long-Term Use: For any results to be maintained, minoxidil must be applied indefinitely as part of a daily routine.
Expect an Initial Shedding Phase: Increased hair shedding is common during the first few weeks of use and indicates that the medication is pushing old, resting hairs out to be replaced by new, healthier ones.
Results Take Time: It typically takes 4 to 6 months of consistent use to see noticeable improvement, with more significant results possible after a year.
Combines Well with Other Treatments: For men, combining minoxidil with finasteride often yields better results than using either medication alone.
Consult a Professional: Proper diagnosis from a dermatologist is recommended before starting minoxidil, particularly for oral forms or if you have pre-existing health conditions.

The Science Behind Minoxidil: How It Promotes Growth

Minoxidil, originally developed as an oral medication for high blood pressure, was serendipitously discovered to have the side effect of hypertrichosis (excessive hair growth). This led to its reformulation as a topical treatment for hair loss, specifically androgenetic alopecia, also known as male and female pattern baldness.

The precise mechanism by which minoxidil promotes hair growth is not fully understood, but several key actions are believed to be at play:

Vasodilation: Minoxidil acts as a vasodilator, widening the blood vessels and increasing blood flow to the hair follicles. This delivers more oxygen, nutrients, and hormones to the follicles, which supports hair growth.
Extends the Anagen Phase: It is thought to prolong the anagen, or active growth, phase of the hair cycle. This allows hair follicles to grow for a longer period, resulting in longer, thicker hair strands.
Shortens the Telogen Phase: Minoxidil may also shorten the telogen (resting) phase, which can cause an initial period of shedding. This shedding is actually a sign that the medication is working, making way for new, healthier hair to grow.
Follicle Stimulation: Minoxidil may directly stimulate the hair follicle, potentially increasing its size.

Can Minoxidil Target Bald Spots?

Yes, minoxidil can effectively stimulate hair regrowth in bald spots, particularly in the early stages of hair loss. Clinical studies have shown it to be effective for male and female pattern baldness. The FDA has approved minoxidil specifically for the vertex (crown) of the scalp, though research and anecdotal evidence also support its use for receding hairlines.

However, there are important factors that influence minoxidil's effectiveness on bald spots:

Severity of Hair Loss: Minoxidil works best on areas where hair follicles are still active, though miniaturized. It cannot create new hair follicles in areas that are completely bald and slick. For men, a smaller, more recent bald spot, particularly on the crown, is most likely to see results.
Consistency is Key: The medication only works for as long as it is used. If treatment is stopped, any new hair growth will be shed within a few months, and hair loss will resume. This makes long-term, consistent application essential.
Individual Response: Not everyone responds to minoxidil. In clinical trials, success rates vary, and factors like individual genetics and sulfotransferase activity can influence the outcome.

Forms of Minoxidil: Solution vs. Foam

Minoxidil is available in two primary topical formulations: a liquid solution and a foam. The choice between them often comes down to personal preference and skin sensitivity.

Liquid Solution

Applied with a dropper directly to the scalp.
Contains propylene glycol, which can cause scalp irritation, itching, or dryness for some users.
Good for targeting smaller, specific areas of hair loss.

Foam

Held upside down and dispensed onto fingertips, then massaged into the scalp.
Generally better tolerated and causes less irritation because it typically does not contain propylene glycol.
Dries faster and is easier to apply over larger areas.

Comparing Minoxidil to Other Hair Loss Treatments

Minoxidil and finasteride are two of the most well-researched treatments for hair loss. While minoxidil is a growth stimulant, finasteride addresses the hormonal cause of male pattern baldness.

Minoxidil vs. Finasteride: A Quick Comparison


Feature	Topical Minoxidil	Oral Finasteride
Mechanism	Stimulates blood flow, prolongs anagen phase	Blocks 5-alpha-reductase, reducing DHT production
Target	Primarily local scalp level	Systemic (body-wide)
Availability	Over-the-counter for both men and women	Prescription-only for men (oral)
Side Effects	Scalp irritation, unwanted hair growth, potential systemic effects	Diminished sex drive, erectile dysfunction, rare cases of mood changes
Effectiveness	Stimulates regrowth, but doesn't halt the underlying hormonal cause	Prevents further hair loss by targeting the root cause; also promotes regrowth
Combination	Often used together with finasteride for enhanced results	Highly effective when combined with minoxidil

Potential Side Effects of Minoxidil

While generally well-tolerated, especially the topical form, minoxidil can cause side effects. It's crucial to be aware of these potential reactions:

Initial Shedding: During the first few weeks of treatment, some users experience increased hair shedding. This temporary effect is normal and indicates that the medication is prompting old, resting hairs to fall out to make way for new growth.
Scalp Irritation: The liquid solution's propylene glycol can cause an itchy, dry, or flaky scalp. Switching to a foam formulation may help reduce this side effect.
Unwanted Hair Growth: If minoxidil drips onto other areas of the body, such as the face or forehead, it can cause unwanted hair growth. This is more common in women and can be reversed by stopping the treatment.
Systemic Side Effects (Rare): Though uncommon with topical application, systemic side effects can occur if too much is absorbed. These include dizziness, rapid heartbeat, swelling, and chest pain. Oral minoxidil carries a higher risk of systemic effects.

Conclusion: Setting Realistic Expectations

Minoxidil is a proven and effective medication for stimulating hair regrowth in bald spots caused by male and female pattern baldness. By widening blood vessels and extending the growth phase of hair follicles, it can lead to thicker, healthier hair over time. For those seeking maximum efficacy, especially in men, combining minoxidil with finasteride is often recommended and can produce superior results.

However, it is critical to set realistic expectations. Minoxidil is not a cure and will not work for everyone, especially those with extensive, long-term baldness where follicles are no longer active. The treatment requires indefinite, consistent application to maintain benefits; stopping will reverse any progress. Patients should also be prepared for an initial period of shedding and potential scalp irritation.

Before starting any hair loss treatment, it is always recommended to consult with a dermatologist. They can properly diagnose the cause of your hair loss and help you develop a personalized, realistic treatment plan based on your specific needs and potential for response.

For more information on the mechanism of action, refer to resources from the National Institutes of Health.

Frequently Asked Questions

Minoxidil requires active hair follicles, even if miniaturized, to stimulate growth. It cannot grow hair on a scalp that has been completely bald for an extended period, as the follicles in that area are no longer functioning.

Patience is key, as it can take 4 to 6 months of consistent, twice-daily application for men and once-daily for women to see noticeable hair regrowth. The full effect may not be apparent for up to a year.

If you stop using minoxidil, any hair regrowth you experienced will gradually disappear, and the hair loss process will resume within a few months.

Yes, an initial increase in hair shedding is a common and expected side effect during the first several weeks of treatment. This is a sign that the medication is working to reset the hair growth cycle.

The foam formulation of minoxidil is often better for those with a sensitive scalp. It typically does not contain propylene glycol, an ingredient in the liquid solution that can cause irritation.

While the FDA-approved use is for the vertex (crown), clinical evidence and user reports suggest minoxidil can be effective for stimulating hair growth on the frontal hairline as well, though results can vary.

In addition to possible scalp irritation, other side effects can include unwanted hair growth if the product spreads, headaches, and rare systemic effects like a rapid heartbeat or swelling if over-absorbed. Oral minoxidil carries a higher risk of systemic issues.

You can continue your normal hair care and styling routine, but you should apply minoxidil first and allow it to dry completely (about 2-4 hours) before applying other products or styling.

Yes, minoxidil is approved and effective for treating female pattern baldness. The recommended dosage for women may differ from that for men.