Nanoxidil vs. Minoxidil: What’s the difference?

If you struggle with hair loss, you’re not alone. Half of all men will experience some form of hair loss before they reach 50.1 The good news is that there are plenty of effective strategies to stop hair loss and even regrow hair.

Minoxidil is one such strategy, and it has an excellent track record of helping men with androgenetic alopecia (male pattern baldness) and other forms of hair loss. Minoxidil has been around as a hair loss treatment for nearly 40 years, but it’s certainly not perfect. There are those for whom it doesn’t work, as well as those who experience some mild but unpleasant side effects like scalp irritation. Nanoxidil, by comparison, is virtually brand new. It doesn’t have the same amount of research behind it, but early studies indicate a similar level of effectiveness and, potentially, a lower side effect profile.

In the interest of delivering you from the gut-wrenching suspense, we would advise more people looking into hair loss treatments for the first time to try minoxidil before reaching for nanoxidil. That recommendation might change as scientific studies produce more data and as nanoxidil’s price comes down closer to minoxidil’s. But, given that their similarities outweigh their differences, we think that any subtle increases in efficacy or slight decreases in side effect frequency are not compelling enough to justify the difference in cost or the potential risk of opting for a less thoroughly researched medication.

All that said, there are some people for whom nanoxidil would be a good fit. Specifically, if you’ve tried minoxidil in the past and have been frustrated with the results or experienced some side effects, nanoxidil might be a good alternative for you.

At Innerbody Research, we extensively test each health service or product we review, including nanoxidil and minoxidil. We’ve had several team members utilize various hair loss products through the years so that we can give you clear examples of what it’s like to use them and whether any of them are especially effective.

In addition to actually ordering these products for ourselves, our team pored over hundreds of scientific publications regarding hair loss and the various treatments that have been developed to reverse it. More than 1,000 hours of concerted research went into making this page as helpful as possible.

Additionally, like all health-related content on this website, this review was thoroughly vetted by one or more members of our Medical Review Board for accuracy. We’ll continue monitoring the landscape to keep this article current.

Over the past two decades, Innerbody Research has helped tens of millions of readers make more informed decisions involving staying healthy and living healthier lifestyles.

Winner: Minoxidil

Nanoxidil and minoxidil are two topical hair loss treatments you apply directly to your scalp twice each day. Molecularly, they are nearly identical, and they seem to be similar in terms of safety and effectiveness. Ultimately, nanoxidil has one less carbon atom and two fewer hydrogen atoms. That gives it a lower molecular weight and an extremely slight size advantage over minoxidil. In practice, this allows it to absorb into your skin slightly faster than minoxidil, giving it more penetration before evaporating.2

Whether such a subtle difference in structure can make such a significant impact in side effects is unclear at this point. Differences in side effects may have less to do with the two compounds and more to do with other ingredients in the carrier solutions. Most minoxidil solutions contain propylene glycol, which is a known irritant.3 Nanoxidil solutions do not contain this substance which is derived from petrochemicals. Instead, they use propanediol, an alternative that’s derived from corn and has a lower incidence of side effects.4

Some itching, dryness, and reddening were reported in an early nanoxidil study.22 Two of the four researchers conducting the study had direct links to DS Labs, the makers of nanoxidil. The researchers use some very strange language in addressing this itching side effect, as well, stating that “the number of patients reporting no itching was 25/49.” Why they chose to focus on reports of “no itching” rather than reports of itching is unknown to us, but this would indicate that just under half of the participants experienced itching.

Those study results are the only known example of clinical research performed on nanoxidil. They’re promising, but between the small sample size and the conflicts of interest among researchers, it’s not enough to earn any kind of endorsement. And DS Labs’ claim that there are no known side effects is, to be blunt, baffling.

By contrast, it’s important to note that minoxidil has been studied rigorously for decades. Nanoxidil is in its infancy, having only been part of the landscape of hair loss treatments for a decade.

Here’s a quick breakdown of the advantages and disadvantages of each:

As you can see, the absorption rate and the available botanical mixtures are the only two significant advantages nanoxidil offers. It’s possible that it also offers a lower side-effect profile, but more research is needed to confirm this.

Winner: Minoxidil

With the exception of restoration surgeries or concealment, most hair loss products are forever treatments, meaning that you have to keep using them for however long you want them to work. If you take finasteride for two years and a fair amount of your hair has long since grown back, but you decide to stop taking it, your hair loss will pick up right where it left off.

Considering that both minoxidil and nanoxidil are also forever treatments, cost becomes a critical factor in choosing one over the other. The patent on minoxidil solution expired in 1996, and the foam patent expired in 2019, which is why both formulations of the drug are widely available at a low cost. On the flip side, nanoxidil is patented and owned by DS Labs, making them the sole influence on its cost. If nanoxidil had hit the market before generic minoxidil became widely available, it might have sold even more than it does now, but the low cost of minoxidil forces DS Labs to reign in that price, at least a little bit.

Take a look at the cost of nanoxidil compared to the cost of minoxidil from our preferred minoxidil provider, Keeps. These are the best possible prices, including subscription savings from DS Labs and the first-order discount from Keeps. We also factored in Keeps’ $5 shipping charge:

As you can see, even the more expensive minoxidil foam is less than half the cost of nanoxidil over the course of a decade, all for a product that, as we’ll discuss in our next section, seems fairly close to identical.

Winner: Minoxidil (for now)

There are certain limitations to a direct comparison between the effectiveness of minoxidil and that of nanoxidil that arise from the small amount of research that’s been done on the latter. We wanted to build a chart that could illustrate specific differences between study results for minoxidil and nanoxidil, but there weren’t enough direct comparisons to warrant a side-by-side evaluation.

There are also significant discrepancies in treatment times, measurement methods, and the interpretation and specificity of results between minoxidil and nanoxidil studies. For example, the only published human nanoxidil study uses global photographic assessments to measure cessation of hair loss and the return of hair growth, but it conveys its findings in terms that are incomparable to any other research.22 Rather than providing numerical data interpreting these global photographic assessments, the researchers categorized the results into four groups to describe growth:

1. No change
2. Slightly increased
3. Moderately increased
4. Greatly increased

The paper in no way explains what these terms mean.

Perhaps the most striking direct comparison (and one of the few we can make with certainty) is in hair density. According to a 2019 review of minoxidil’s use in various hair loss disorders, the drug’s average increase in hair density for patients with androgenetic alopecia was 21.94 hairs/cm2.5 The sole nanoxidil study conducted on humans saw an increase in density of just 13.04 hairs/cm2.

Keep in mind that the minoxidil review contains well-designed, placebo-controlled studies, whereas the nanoxidil study was not placebo-controlled, so it fails to eliminate other variables that could influence its results. Also, the nanoxidil study involved prominent employees of DS Labs, which could introduce significant bias in procedures and interpretation of results.

Based on this information alone, it would appear that minoxidil is more effective than nanoxidil, which undercuts DS Lab’s marketing significantly. It’s possible that future studies will reveal superior efficacy for nanoxidil, but, for now, that does not appear to be the case.

Most minoxidil products contain minoxidil as a sole active ingredient, but DS Labs’ Spectral DNC-N (its main nanoxidil product) contains nanoxidil and seven other ingredients. These include retinol, caffeine, and copper tripeptides, each of which has a successful history of use in cosmetics.

Retinol is more closely associated with anti-aging and wrinkle-fighting effects, which may make it beneficial for scalp health.14 Caffeine is a common ingredient in topical hair loss supplements like shampoos and conditioners.6 And copper tripeptides (likely Cu-GHK) have been shown to have anti-inflammatory and antioxidant benefits.7

Winner: Minoxidil

Side effects with minoxidil are both rare and mild, but they aren’t non-existent. The most common side effect is irritant contact dermatitis, which results in itching and sometimes scaling around the application sites. This irritation is often associated with propylene glycol, a petrochemical-based component of a typical minoxidil carrier solution and a known irritant. Minoxidil foam formulations lack propylene glycol and often serve as a great alternative for men and women who experience irritation with minoxidil solutions.3

Some users have reported a burning sensation on the scalp along with other forms of discomfort, most of which could be traced back to that contact dermatitis reaction. In some cases, users have experienced hypertrichosis — the unwanted growth of hair in other areas of the body — but this is relatively rare given the targeted nature of topical treatment and may more likely result from mishandling of the product.

In the abstract of the sole published human study of nanoxidil, the authors state that “tolerability was good and patient satisfaction was high.” DS Labs has parlayed that statement into marketing that claims no known side effects are associated with nanoxidil. This is patently false, as the study itself refers to itching reported by nearly 50% of participants.22

In the researchers’ defense, there is no way to identify other potential causes without a placebo control group. For all we know, the study took place from late fall to early spring in a cold, dry climate that may have increased scalp dryness. Ultimately, much more rigorous research is needed to validate DS Labs’ marketing claims.

It’s also worth noting that DS Labs’ Spectral DNC-N (its primary nanoxidil serum) does not contain propylene glycol, which makes it a viable alternative for people sensitive to that common minoxidil ingredient. However, DS Labs includes a handful of additional active ingredients in its formula, and it does not provide doses for any of these ingredients. We think it’s worth considering some potential side effects associated with them:

• Azelaic Acid: may cause dryness, oiliness, pruritus, or a burning sensation8
• Caffeine: adversely affects wound healing, which may complicate other side effects9
• Adenosine: likely safe10
• Tricopper peptides: likely safe11
• Myristoyl Pentapeptide-17: very small potential for mild stinging12
• Lysophosphatidic Acid: likely safe13
• Retinol: potential for burning, scaling, and dermatitis14

Winner: Minoxidil foam

Applying either minoxidil or nanoxidil is a straightforward process (though the application of minoxidil does depend on whether it’s in a liquid or foam form). The two treatments are similar enough that the instructions for one apply identically to the other. Follow these simple steps, and you should see positive results:

1. Ensure that your hair and scalp are completely dry. You don’t have to bathe or shower before application, but if you do, make sure to dry thoroughly.
2. Apply the prescribed amount of solution directly from the container to the scalp. Nanoxidil uses a spray applicator, whereas most minoxidil solutions come with droppers. If using minoxidil foam, apply the foam to your fingers first.
3. Gently rub the solution or foam into your scalp. It won’t completely absorb during this step. Absorption and drying take up to four hours.
4. Wash your hands thoroughly.
5. Wait at least four hours before washing your hair, wearing a hat or helmet, or going to sleep.

We consider minoxidil the winner here because you can get it in two forms depending on your preference and budget. DS Labs only gives you its nanoxidil in a liquid form with a spray applicator, which can lead to misapplication as you get used to its range.

Before becoming part of Pfizer, the Upjohn Company developed minoxidil in the late 1950s to treat ulcers. The company found that it failed to produce the desired effect on ulcers in its initial trials but noticed its proficiency as a vasodilator. After several more years of development, they landed on what we know as minoxidil. It took until 1979 for them to gain approval from the FDA for minoxidil as a blood pressure medication marketed under the name Loniten.15

In later studies to test Loniten’s potential to treat hypertension, study administrators found unexpected hair growth to be a common and baffling side effect.16 That caused a significant shift in minoxidil trials, which would subsequently focus almost exclusively on treating hair loss. After nearly a decade of doctors prescribing Loniten off-label for hair loss, the FDA approved minoxidil specifically for hair loss, and it was marketed under the brand name Rogaine.

Doctors often recommend minoxidil for balding at the crown or vertex; receding hairlines often fail to respond to it as effectively. Some users report success in treating frontal baldness with minoxidil, but we consider these anecdotal reports insufficient to recommend minoxidil for frontal hair loss. That said, numerous studies verify its efficacy and safety for its intended target at the crown and vertex.5 (If you’re looking for a well-studied treatment for frontal baldness that isn’t prescription finasteride, we can recommend laser light therapy.)

What about oral minoxidil?

For the purposes of this comparison, we’re going to focus on topical minoxidil, but prescription oral minoxidil has recently become a viable alternative to finasteride for many men and women seeking a pill to fight hair loss.16 In its earliest iterations, minoxidil was an oral medication, but its potential to treat hair loss led researchers to develop a topical solution, which hit the market in the late 1980s under the brand name Rogaine.

Oral minoxidil isn’t currently FDA-approved for use in fighting hair loss, but higher doses than those used to fight hair loss are approved for certain cardiovascular conditions, and dermatologists will often prescribe it off-label. Some telehealth providers offer prescriptions for oral minoxidil, including Roman and Happy Head. Between the two, Roman is the better deal.

Minoxidil’s oral form remains in use for hypertension and other cardiovascular issues, but there was little financial incentive for pharmaceutical companies to pursue it as a hair loss treatment, given the fact that its patent had expired. And while oral minoxidil doesn’t suffer from the same sexual side effects you might encounter when taking finasteride, it has some specific side effects of its own. One of those is hypertrichosis, or the growth of unwanted hair on unpredictable parts of the body.23 This is why a topical solution may be preferable to some; direct application to the scalp minimizes the chances that you’ll sprout new hair growth on your nose, for instance.

There are also some potential cardiovascular side effects from oral minoxidil that may make it more dangerous than its topical cousin. However, the worst of these effects are associated with doses ranging from 5mg to 40mg of minoxidil prescribed for cardiovascular issues — not for hair loss.15 Typical hair loss prescriptions are between 1.25mg and 5mg.

How to use minoxidil

You should apply minoxidil twice daily. We recommend finding a routine that you can keep to with ease, such as one application before heading to work and another before dinner. You should not sleep less than four hours after applying minoxidil, as the solution can migrate to your pillow and then to other unintended areas of the body.

If you’re using a minoxidil solution, it most likely comes with a dropper you can use to apply it to your scalp in areas of hair loss, after which you’d rub it in gently. Foam minoxidil is typically applied to your fingertips first, and then you’d rub it into your scalp.

Minoxidil’s chemistry and mechanism of action

Chemically, minoxidil acts as an adenosine 5'-triphosphate-sensitive potassium channel opener, though its exact mechanism of action is the subject of some debate in the scientific community.17 18 The prevailing theory is that it allows more oxygen, nutrients, and blood to reach your follicles than would otherwise be the case.

There’s also reason to believe that minoxidil may act as a nitric oxide agonist, causing your weak follicles in the telogen phase to fall out (a process we call shedding).19 As your follicles enter a new anagen phase, they come in much more robustly, thanks to the increased delivery of blood, oxygen, and nutrients. The process results in the revival of dormant follicles and a thickening and strengthening of existing hair.

More recent research points to genetic factors in minoxidil’s efficacy, including mediation of certain signaling pathways associated with inflammation and stem cell development.20

Where to get minoxidil

There are a lot of outstanding online providers from whom you can get minoxidil. Some are telehealth providers with a laser focus on hair loss, while others are full-service companies offering solutions for everything from hair loss and sexual dysfunction to obesity and acne.

The three companies we most often refer to in this space are Keeps, Hims, and Roman. All three are smart choices for anyone interested in minoxidil, but, in our opinion, Keeps is currently the best place for most people to start. It provides minoxidil as either a foam or a solution, and its prices are slightly lower than its competitors. This is especially true when you consider that Keeps offers new customers their first shipment at 50% off.

Here’s a quick look at how the top companies compare when providing minoxidil as either a solution or a foam:

While Keeps charges $5 for shipping, that fee only applies quarterly, as the company sends you three bottles with each shipment. You can opt for larger shipments in bi-annual or annual plans if you want to spend a little extra up-front, and this will save you even more money by reducing your shipping costs to $5/year. Remember that minoxidil, nanoxidil, and almost every other hair loss treatment stops working if you ever decide to stop using it. So, those yearly savings will add up over time.

Keeps also provides its patients with free access to their prescribing physician through a simple messaging interface. That way, if you have any questions or concerns before or after you begin treatment, you can get the information you need quickly.

In 2011, Divine Skin Inc. developed nanoxidil specifically to fight hair loss. This was more than 30 years after the FDA first approved minoxidil for blood pressure. Divine Skin intended to create a topical product with greater efficacy and tolerability, so even patients with sensitive scalps could use it.

Divine Skin’s subsidiary, DS Laboratories, is the only company offering nanoxidil products to consumers. The company also provides minoxidil treatments and a host of additional products geared toward fighting hair loss.

Early studies indicate success, with an efficacy profile similar to minoxidil. Of the two human studies we found for nanoxidil, one was delivered at a conference in 2016 and is as yet unpublished, and both count Dr. Brijeshkumar Patel among their authors.21 Dr. Patel was the senior vice president of research and development for DS Labs at when both studies were conducted.

DS Laboratories claims nanoxidil will work for hair loss at the crown or vertex and at the front of the scalp. This makes it a potential replacement for finasteride, which studies show works well on receding hairlines but also comes with unpleasant risks. But area-specific information is lacking from either human nanoxidil study.

You can currently get nanoxidil in six DS Labs products:

• Spectral.DNC-N: The company’s original nanoxidil formula
• Spectral.CBD: A density serum combining nanoxidil with cannabidiol
• Spectral.CSF: A nanoxidil serum targeted at women
• Spectral.DNC-S: A nanoxidil serum with additional ingredients to fight graying
• Spectral.BRD: A facial nanoxidil serum for beard growth
• Spectral.BROW: A nanoxidil serum for eyebrow growth

How to use nanoxidil

Like minoxidil, nanoxidil operates on a twice-daily regimen. You’ll apply your nanoxidil solution once in the morning and again in the evening. You also don’t want to go to bed before your application has a chance to dry completely, which takes about four hours. A nanoxidil regimen may be slightly different for products targeting beard or eyebrow growth, but the fundamental principles remain.

Nanoxidil’s chemistry and mechanism of action

Divine Skin based nanoxidil on the molecular structure of minoxidil, so it should act in much the same manner when you apply it. It will likely serve as an adenosine 5'-triphosphate-sensitive potassium channel opener with noteworthy effects in circulation and oxygen and nutrient delivery.17

To date, the studies indicate that nanoxidil produces similar results in a similar timeframe as minoxidil.22 Given the similarities in performance and molecular structure, we feel it’s safe to assume that the mechanisms of action are also similar, but further study is needed to make any such declaration.

Where to get nanoxidil

Since there is only one reputable provider for nanoxidil at the time of this writing, we recommend them: DS Laboratories. It’s an expensive proposition for a product so similar to minoxidil, but DS Labs also sells minoxidil, so you could stick with one company to try both if you prefer. However, DS Labs’ minoxidil is also more expensive than minoxidil formulations from Keeps, Hims, or Roman.

After comparing nanoxidil and minoxidil side-by-side and evaluating all of the research we could get our hands on, it’s clear that minoxidil is currently the safer, more reliable choice. In a few years, more research might verify or completely undercut DS Labs’ marketing claims around nanoxidil, but for now, it remains a niche product we would only recommend to people who’ve had difficulty with both minoxidil solution and minoxidil foam.