If you've used minoxidil for months without much to show for it, you're not imagining things and you're not doing it wrong. Minoxidil simply doesn't work for a large share of the people who try it, and the reason has nothing to do with effort or consistency. It comes down to biology.
The Response Rate Is Lower Than Most People Realise
Minoxidil is one of only two FDA-approved treatments for androgenetic (pattern) hair loss, and it has decades of research behind it. But real-world response rates for topical minoxidil sit at roughly 30 to 40%, with some clinical reviews reporting figures as low as 50-80% depending on the population studied. Put simply, a meaningful number of consistent, correctly-applied users see little or no visible improvement.
That's not a flaw in how someone is using the product. It's a mismatch between how the drug works and what an individual scalp is capable of doing with it.
Why It Fails: The Enzyme Behind the Story
Minoxidil is technically a "pro-drug." Applied to the scalp, it does nothing on its own — it has to be converted by an enzyme called sulfotransferase (SULT1A1) into its active form, minoxidil sulfate, before it can stimulate hair follicles.
The problem is that sulfotransferase activity varies enormously from person to person, and it's largely genetic. People with high enzyme activity convert minoxidil efficiently and tend to be responders. People with low activity can't complete that conversion at any dose, so the product simply sits on the scalp without doing its job. Studies estimate that roughly half of hair loss patients fall into this lower-activity group, which lines up almost exactly with the known non-response rate.
There's no way to fix low enzyme activity by applying more product or waiting longer. It's a biochemical ceiling, not a discipline problem.
The Side Effects That Make People Stop Anyway
Even for people who are biological responders, minoxidil isn't always easy to live with. The alcohol and propylene glycol in most topical formulas are known to strip the scalp's natural oils and disrupt its moisture barrier, which is why itching, flaking, redness and irritant contact dermatitis are among the most commonly reported side effects. In some studies, irritation is the number one reason people abandon treatment altogether — not lack of results, but a scalp that simply can't tolerate the formula long enough to find out.
That's an important distinction. A compromised, inflamed, or barrier-stripped scalp is not a good environment for hair to grow in, regardless of which active ingredient you're applying to it.
Minoxidil Also Only Treats One Kind of Hair Loss
Minoxidil is approved specifically for androgenetic alopecia. It has nothing to offer if what you're dealing with is a stressed, inflamed, or nutrient-depleted scalp, seasonal shedding, product buildup, or general thinning that isn't pattern-based. A lot of people trying to solve "why is my hair not growing" are actually dealing with scalp conditions minoxidil was never designed to address in the first place.
Why the Scalp Environment Matters More Than Any Single Active
Hair doesn't grow in isolation from the skin it's rooted in. Follicles depend on a calm, balanced, well-circulated scalp: a healthy microbiome, an intact moisture barrier, low inflammation, and steady delivery of the nutrients follicles need to stay in their growth phase. Minoxidil can hold a follicle in growth phase for longer, but it can't repair a damaged barrier, calm inflammation, or supply the botanical actives that support that terrain. That's a different job entirely, and it's the one a scalp serum is built for.
This is where a botanical, oil-forward serum like sāch approaches things differently. Rather than relying on a single pharmaceutical mechanism that only works for some people, it's formulated to support the broader conditions hair needs to thrive:
- Rosemary leaf oil to support circulation at the scalp without the stripping effect of alcohol-based formulas
- Niacinamide and caffeine to support the follicle's energy supply and strengthen the skin barrier
- Oat beta-glucan to soothe and hydrate a sensitised or flaky scalp
- Sea buckthorn and fig seed oil for fatty acids and antioxidants that support scalp skin health
- Amla (Phyllanthus emblica) and pea sprout extract to support the nutrient environment around the follicle
None of this is a substitute for a dermatologist's diagnosis if you're dealing with significant hair loss, and a botanical serum isn't a drug — it isn't claiming to reverse androgenetic alopecia the way minoxidil is approved to. What it can do is address the scalp environment itself: hydration, barrier health, irritation, and the everyday conditions that any hair growth strategy depends on, minoxidil included.
