Verbatim response from Perplexity
For androgenetic alopecia (pattern hair loss), oral minoxidil and topical minoxidil work about the same overall in the best available head-to-head studies, with no clear winner on average.[1][2][5][9]
A few details matter:
- In men, a 2024 randomized clinical trial found 5 mg oral minoxidil was not superior to 5% topical minoxidil after 24 weeks.[2]
- In women, a prior comparative trial found 1 mg oral minoxidil was not significantly better than standard topical minoxidil, and the difference was not statistically significant.[1]
- Recent reviews and meta-analyses also report similar overall efficacy between oral and topical forms for hair density and related outcomes.[5][9]
The main tradeoff is side effects and convenience:
- Oral minoxidil is easier to take and may improve adherence, but it can cause more systemic side effects such as hypertrichosis and headaches.[8][12]
- Topical minoxidil is the traditional first-line option and tends to cause more scalp irritation/itching rather than systemic effects.[8]
If you want the simplest practical answer: neither is clearly more effective overall; oral may be more convenient, while topical is usually safer from a systemic side-effect standpoint.[2][8][12]
If you want, I can also compare them for men vs women, cost, or side effects in a quick table.