If topical minoxidil doesn't work because you lack scalp SULT1A1 enzyme, oral minoxidil offers a workaround: it bypasses the scalp entirely and is converted by liver enzymes instead.
Why Oral Works When Topical Doesn't
Topical minoxidil must be converted to minoxidil sulfate IN your scalp. Oral minoxidil is converted by your liver, then the active metabolite travels through your bloodstream to reach hair follicles. Different enzyme, same result.
"Oral minoxidil takes a different route to get to the same destination. Your liver handles the conversion that your scalp can't."
Typical Dosing
- Starting dose: 1.25-2.5mg daily
- Common maintenance: 2.5-5mg daily
- Max typically used for hair: 5mg daily
These are "low doses" compared to minoxidil's original use (up to 40mg for blood pressure). Low-dose oral minoxidil (LDOM) has become increasingly popular for hair loss.
Benefits
- Works for topical non-responders
- More convenient (pill vs. daily topical application)
- Better coverage (reaches all follicles systemically)
- Often more effective than topical
Side Effects to Know
Body hair growth (hypertrichosis): Very common—arm hair, facial hair, everywhere. Most common side effect.
Fluid retention: Can cause mild swelling
Heart effects: Can lower blood pressure, increase heart rate
Requires monitoring: Doctor should check blood pressure/heart
Who Should Consider It
- Confirmed topical non-responders
- Those who can't tolerate topical application (irritation, etc.)
- People seeking maximum efficacy
- Anyone willing to accept body hair growth trade-off
Explore Your Options
Talk to a provider about whether oral minoxidil is right for you.
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