Verbatim response from Perplexity
Neither is clearly better for everyone. The best evidence in men shows oral minoxidil 5 mg once daily is not superior overall to 5% topical minoxidil, though oral minoxidil may do better at the vertex/crown in some analyses.[5] In women and mixed-population studies, results are generally similar, with some studies finding topical slightly better on hair density and others finding no significant difference.[4][3]
What this means in practice:
- Topical minoxidil is the better-established first choice because it is FDA-approved for hair loss and usually has fewer systemic side effects.[7][8]
- Oral minoxidil is often chosen when people want easier daily use, have scalp irritation from topical treatment, or have not responded well to topical minoxidil.[1][3]
- Oral minoxidil may cause more body/facial hair growth and other systemic side effects, so it is typically used more cautiously.[7][3]
If you want the shortest bottom line: topical is the standard first-line option; oral is a reasonable alternative, but not clearly more effective overall.[5][4][7]
If you want, I can also compare them by effectiveness, side effects, cost, and who each is best for.