Once a Day vs. Twice a Day Topical Minoxidil

by Dr. Alan J. Bauman, MD, ABHRS

For patients using compounded minoxidil formulas like 82M, 82F, or 82D for hair loss, it’s important to know that these topical treatments work best when applied TWICE a day to the scalp.

These formulas all contain 5% minoxidil as a key active ingredient, which helps widen blood vessels and promote hair growth by keeping hair follicles in their active growing phase longer. Formula 82M adds tretinoin to help the minoxidil absorb better, a mild steroid to reduce irritation, and other soothing ingredients. Formula 82F combines minoxidil with topical finasteride to block DHT (a hormone that causes hair thinning), plus enhancers like tretinoin and antioxidants, with far less absorption of finasteride into the body than an oral version. Formula 82D includes minoxidil with dutasteride (the most powerful DHT inhibitor available), tretinoin, and a steroid for better results in advanced hair loss. While minoxidil from these formulas gets into the skin slowly (only about 1-2% enters the bloodstream), it can linger in the scalp for up to 22 hours, but its effects on blood flow and hair growth may last up to 72 hours in some cases.

NOTE: The only reason to temporarily decrease the use of compounded topical medications would be to combat side effects like scalp inflammation or irritation. (Notify your prescriber immediately if you have any scalp health issues, as this can impair hair growth.) Scalp symptoms such as irritation, itching, flaking, etc. can be easily addressed by Bauman Medical’s in-house Certified Trichologist, Kimberly Jenkings, WTS, CHC and her team.

Using these formulas once a day might still help a bit because of how long minoxidil stays in the skin, but twice-daily application is much better. It keeps a steadier level of the medication at the hair roots, overcomes issues like uneven absorption, sweating, or washing off, and ensures the added ingredients (like tretinoin for penetration) work more consistently. Studies on topical minoxidil show that switching from twice to once daily can lead to losing about 40-50% of the hair gains over time—for example, in men using a similar minoxidil solution, those who stuck with twice daily kept more hair (around 335 extra hairs after nearly 3 years) compared to those who went to once daily (dropping to about 213 hairs after 6 months on the reduced schedule). In women, once-daily higher-strength minoxidil foam was about as good as twice-daily lower-strength solution, but twice daily often provides more reliable results. Sticking to twice daily with 82M, 82F, or 82D maximizes your chances of better hair regrowth and maintenance, but if you stop or cut back, benefits can fade in 3-6 months. Always follow your prescriber’s instructions, as these are custom-compounded prescription compounds.

If you or someone you know has hair loss, hair thinning, baldness, or eyebrow / eyelash concerns, click to start either a long-distance virtual consultation OR an in-person, in-office consultation with Dr. Bauman. You can also Ask Dr. Bauman a Question or simply call Bauman Medical Group  at +1-561-394-0024.

*Each individual's treatment and/or results may vary

References:

1. https://www.baumanmedical.com/product/minoxidil-formula-82m/
2. https://www.baumanmedical.com/product/topical-finasteride/
3. https://www.carieboyd.com/hair-and-scalp-health/82d-hair-loss-treatment-for-men/
4. https://www.sciencedirect.com/science/article/abs/pii/S0190962287700899
5. https://www.sciencedirect.com/science/article/abs/pii/S0190962210018116
6. https://www.ncbi.nlm.nih.gov/books/NBK482378/
7. https://www.sciencedirect.com/topics/chemistry/minoxidil
8. https://www.realself.com/question/los-angeles-ca-life-proscar-minoxidil
9. https://pmc.ncbi.nlm.nih.gov/articles/PMC10504650/