Expanding the Therapeutic Landscape of Minoxidil for Androgenetic Alopecia: Topical, Oral and Sublingual Formulations

This review discusses the use of minoxidil in treating androgenetic alopecia (AGA), highlighting topical, oral, and sublingual formulations. Topical minoxidil is the only FDA-approved treatment for both men and women, effectively increasing hair counts, though results can vary. Low-dose oral minoxidil (0.25–5 mg) is a viable option for those unresponsive to topical treatment, with hypertrichosis as a common side effect and rare cardiovascular events. Sublingual minoxidil, a new method bypassing first-pass metabolism, shows promise with similar efficacy to oral use and potentially fewer cardiovascular risks. While topical minoxidil remains the first-line treatment, oral and sublingual options offer personalized management. Further research is needed to optimize dosing and confirm the safety and benefits of sublingual administration.