Minoxidil 2% Topical Treatment for female hair loss

Minoxidil was originally used in tablet form as a medicine to aid in the treatment of high blood pressure. Experts noticed that patients being treated with minoxidil exhibited the side effect of excessive hair growth. Researchers discovered that hair growth also resulted when minoxidil was applied, in a solution form, directly to the scalp. The makers of minoxidil suggest that women use the 2% concentration and not the 5% concentration (that men use). However, many dermatologists prescribe minoxidil 5% for women.   

Check with your doctor as immediately if you experience any of the following side effects while taking minoxidil topical:

  • increased hair loss or facial hair growth
  • inflammation or soreness at root of hair
  • acne at site of application
  • Itching or skin rash  
  • burning of scalp
  • reddened skin or swelling of the face

Sometimes you may absorb too much medicine into your body. In these cases the following side effects may occur: 

  • chest pain
  • blurred vision or other changes in your vision
  • dizziness or fainting
  • fast or irregular heartbeat
  • swelling of face, hands, feet, or lower legs
  • rapid weight gain
  • flushing
  • headache or lightheadedness
  • numbness or tingling of hands, feet, or face

Additional information

A study of 35 men using either topical minoxidil 2% twice a day or placebo for 6 months, found that minoxidil was associated with cardiac symptoms. This included symptoms such as, significant increases in; left ventricular end-diastolic volume, left ventricular mass, and cardiac output. [1]


Cimetidine (Tagamet) for women

Cimetidine is most often prescribed to treat GERD (gastroesophageal reflux disease or ulcers. It works by decreasing the acid in the patient’s stomach.

Cimetidine and hair growth

Cimetidine is effective in treating stomach ulcers as it slows down the stomach’s production of irritating acid. The drug also affects androgens, which are responsible for male and female pattern baldness. Cimetidine has some, although weak, androgen-blocking capabilities. It is thought that it may partly block the hormone dihydrotestosterone (DHT). Because of this a hand full of studies looked at cimetidine (most of them were conducted 20 years ago) as a possible hair loss treatment for women suffering from thinning hair. These studies were small in size and their results were mixed.

Cimetidine should only be taken as a hair loss treatment if you doctor recommends and supervises. Cimetidine has side effects and does pose health risks.

Minor side effects:

  • Diarrhea
  • Headache or dizziness
  • Sleepiness
  • Swelling of the breasts in men

Major side effects:

  • Confusion
  • Hallucinations
  • Feeling depressed or nervous

Cimetidine may also be unsafe for individuals who are:

  • Pregnant or are thinking of becoming pregnant
  • Allergic to any of the substances in cimetidine
  • Taking certain other medications (including antidepressants, ketoconazole, or antacids)

Aldactone as a hair loss treatment for women

Aldactone is traditionally used as a potassium-sparing diuretic. This means it gets rid of the body’s excess fluids, without causing you to lose potassium. It is generally used to treat high blood pressure, swelling, and potassium deficiency. However, Aldactone also acts as an anti-androgen. Because of this it has been used to help women who are experiencing hair loss.

Possible side effects of using Aldactone:

  • Frequent urination
  • Irregular menstrual cycles
  • Increase in potassium levels
  • Lower blood pressure causing dizziness and lightheadedness
  • Can interact with other medication (Such as blood pressure medications)

Hormone Replacement Therapy (HRT) (also known as Estrogen/Progesterone treatment)

Hormone replacement therapy (HRT) is normally prescribed during menopause. The most common form of treatment for women with hair loss in menopause is probably estrogen and progesterone pills and creams. These pills and creams are usually prescribed when a women’s estrogen and/or progesterone levels are lacking.
Some more serious side effects of HRT include:

  • Increased risk of breast cancer (when HRT is taken long-term)
  • Increased risk of dying if you do get breast cancer
  • For women with an intact uterus, increased risk of uterine cancer if you take estrogen replacement by itself (without progesterone therapy)
  • Increased risk of stroke and heart disease
  • Bigger risk of blood clots

Some less serious side effect include:

  • Irritability
  • Nausea and bloating
  • Abnormal vaginal bleeding (see your doctor if this occurs)
  • Headaches
  • Sore breasts
  • Mood changes

Oral contraceptive (birth control pill)

All birth control pills have the potential to influence the growth and look of your hair, on your scalp and body. Birth control pills may not affect scalp hair at all, but if you have a predisposition to hormonal hair loss they can have, either a negative or positive effect. The effect the pill has on your hair will depend on the pill’s hormone combination and on your body’s metabolism of the drug. Some pills are prescribed solely to address the issue of hair loss. One example of such as pill is Dianette, and it is prescribed in cases of hair loss associated with Polycystic Ovary Syndrome (PCOS). 

It is important to note that some pills like Levonorgestrel, Norethisterone and Gestidone contain androgens, and therefore may worsen hair loss. This depends on the sensitivity of your hair follicles and your genetic makeup. Also when you stop the birth control pill you may find that your hair temporarily sheds. It can cause a type of post-partum shedding.

Always consult your gynecologist before starting or stopping any contraceptive pill.

Main side effects of the oral contraceptive pill:

  • Breakthrough bleeding
  • Missed periods

Other side effects are specific to the relative excess of estrogen or progestogen in different formulations

Excess of estrogen can cause:

  • Nausea
  • Fluid retention
  • Increased noninfective vaginal discharge

Excess of progestogen can cause:

  • Vaginal dryness
  • Depression
  • Acne
  • Loss of libido

Nizoral/Ketoconazole treatment for women
Ketoconazole is primarily an antifungal drug that is used in the management dandruff. Ketoconazole has also been used as a hair loss treatment for hair loss in both men and women. Ketoconazole works by decreasing the production of DHT (dihydrotestosterone).

Ketoconazole comes in the form of shampoo, cream and a pill to treat fungal infection. For hair loss only the shampoo is used. The shampoo is called Nizoral and has 2 percent ketoconazole.
Some possible side effects include:

  • Irritated skin
  • Itchy skin
  • Dry skin
  • Blistering skin
  • Differences in the texture of the hair

If you are allergic to ketoconazole you should not use Nizoral.

Female hair transplant

Many women with the typical type of female patterned hair loss, where the hair becomes thin all around the scalp, are not good candidates for a hair transplant. This is because they do not have the adequate amount of hair needed for donor supply, on the back and sides of their scalp. In addition, as women are prone to hair loss throughout the scalp their transplanted hair may fall out at some point. Women should carefully consider if they are a good candidate for a hair transplant procedure. Before proceeding with a hair transplant the doctor needs to consider the extent of the areas with active balding and determine the number of permanent hairs that the woman has on her scalp.


Cosmetics can help to reduce the color contrast between the hair and the scalp. This can have a temporary effect of reducing the appearance of balding. Women may also chose to dye their hair to a color that closely matches their skin tone. This works by making the contrast between hair and scalp less severe.

Scalp Micro-pigmentation (SMP) for women

This is a surgical treatment that places pigment into the dermal layer of the scalp skin. This gives the appearance of a hair follicle. SMP works by darkening the thinning areas of the scalp, thus reducing the contrast between scalp and hair.