Willow Oral
A women's oral combination of minoxidil + spironolactone + biotin.
Active ingredients: Minoxidil + Spironolactone + Biotin
$79 per month
No membership fee · No clinician fee · Free shipping
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Compounded combination. Oral minoxidil and spironolactone are both used off-label for hair loss.
What it does
Oral minoxidil supports hair growth. Spironolactone blocks some androgen effects. Biotin is vitamin B7. The combination uses two different medication mechanisms in one capsule.
What's in it
Minoxidil
- What it is
- Oral vasodilator used off-label for hair loss.
- Hormone?
- Not a hormone.
- Why it's here
- Oral use exposes the whole body, not just the scalp.
Spironolactone
- What it is
- Prescription potassium-sparing diuretic with anti-androgen effects.
- Hormone?
- Not a hormone.
- Why it's here
- It blocks some effects of androgen hormones and can raise potassium.
Biotin
- What it is
- Vitamin B7.
- Hormone?
- Not a hormone.
- Why it's here
- True biotin deficiency can cause hair loss, but deficiency is uncommon and routine extra biotin has limited evidence for regrowth in people without deficiency.
Why choose this one?
Why choose this one
For women who prefer an oral treatment and want both a hair-growth medication and an anti-androgen in one formula.
Why choose another option?
A single-ingredient treatment is simpler. A topical may be preferable if you want to avoid systemic oral treatment.
Compare your options
Topical vs oral hair treatment
| Topical | Oral | |
|---|---|---|
| How it's used | Applied to the scalp, usually daily | Taken by mouth, usually daily |
| Whole-body exposure | Lower, though some is absorbed | Higher |
| Evidence context | In a 2024 trial in men, 5% topical minoxidil improved hair density at 24 weeks | In the same trial, 5 mg oral minoxidil also improved density and was not superior to topical |
| Common tradeoffs | Scalp irritation, residue, daily application | Unwanted body or facial hair with oral minoxidil; less often lightheadedness or fluid retention |
| Who may prefer it | People who want to limit whole-body effects | People who find daily application hard to keep up |
| Price at Avono | From $75 per month | From $59 per month |
Minoxidil vs DHT blockers
| Minoxidil | DHT blockers (finasteride, dutasteride) | |
|---|---|---|
| How it works | Supports the growth phase of the hair cycle | Lowers DHT, the hormone that shrinks follicles in pattern hair loss |
| Who it's for | Men & women | Mainly men |
| Hormone? | No | No, but acts on a hormone pathway |
| What to know | Must be continued; early shedding; oral forms can cause unwanted body hair | Sexual side effects in a small minority; pregnancy restrictions |
| Used together? | Often, because they work through different pathways | Often, because they work through different pathways |
Benefits and evidence
Spironolactone for female pattern hair loss
- What the study found
- About 57%
- Who was studied
- Patients with female pattern hair loss, across multiple studies
- What it means
- A systematic review found improvement in roughly 57% of patients studied, although treatment approaches and outcomes varied considerably across studies.
- Important context
- The underlying studies were heterogeneous and the review states more research is needed. This is not a guaranteed response rate. Oral spironolactone · Varied across studies
- Source
- The Efficacy and Safety of Oral Spironolactone in the Treatment of Female Pattern Hair Loss: A Systematic Review and Meta-Analysis Cureus, 2023, PMID 37719557
Evidence for Minoxidil, not for this exact formula
Topical minoxidil 5% vs 2%
- What the study found
- 45% more regrowth
- Who was studied
- 393 men with androgenetic alopecia
- What it means
- In a 48-week trial, 5% topical minoxidil produced 45% more hair regrowth than 2% topical minoxidil.
- Important context
- Compared two strengths of topical minoxidil. It does not apply to oral minoxidil. Topical minoxidil 5% versus 2% and placebo · 5% and 2% topical solutions · 48 weeks
- Source
- A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men Journal of the American Academy of Dermatology, 2002, PMID 12196747
Sources
- Vano-Galvan S et al. Safety of low-dose oral minoxidil for hair loss: a multicenter study of 1404 patients. J Am Acad Dermatol. 2021
- Penha MA et al. Oral vs topical minoxidil for male androgenetic alopecia: a randomized clinical trial. JAMA Dermatol. 2024
- Oral spironolactone for female pattern hair loss: systematic review and meta-analysis. Cureus. 2023
Common side effects
Unwanted facial/body hair, fluid retention, dizziness or faster heart rate from oral minoxidil; increased urination, breast tenderness, menstrual changes, lower blood pressure or elevated potassium from spironolactone.
What may help
General measures that may help:
- Stand up slowly if you feel lightheaded.
- Tell your clinician about blood-pressure medicines or supplements you take.
- Unwanted facial or body hair is the most common side effect of oral minoxidil. Let your clinician know if it bothers you, because the plan can be reviewed.
- Temporary shedding in the first one to two months can happen as hair cycles reset (9% of men taking oral minoxidil in one trial).
General measures that may help:
- Stand up slowly if you feel lightheaded, and stay hydrated.
- Avoid potassium supplements and potassium-based salt substitutes unless your clinician approves them.
- Tell your clinician about blood-pressure, heart or kidney medicines you take.
- Menstrual changes or breast tenderness are common. Mention them at follow-up.
Your clinician may recommend blood tests depending on your health history.
Important safety information
Pregnancy and fertility. Not used during pregnancy. Based on how it works and animal studies, spironolactone may affect the development of a male fetus, so clinicians usually discuss reliable contraception. Oral minoxidil is also not recommended during pregnancy or breastfeeding.
Kidney function, potassium levels and interacting medications matter. Spironolactone may affect fetal sex differentiation and is generally avoided in pregnancy. Oral minoxidil is off-label for hair loss.
This is a compounded medication. Compounded medications are prepared by licensed pharmacies and are not FDA-approved.
Prescription treatments require evaluation by a licensed clinician and are not appropriate for everyone. Some ingredients are not appropriate during pregnancy or for people who may become pregnant. Compounded formulas are not FDA-approved. Not available in all states.
When to contact your clinician
Contact your clinician promptly about swelling of the ankles, feet or face, rapid weight gain, a fast or pounding heartbeat, or dizziness or fainting.
Contact your clinician promptly about muscle weakness, an irregular heartbeat, severe dizziness or passing much less urine (these can be signs of high potassium or dehydration). Tell your clinician right away if you could be pregnant.
When to seek urgent care
Seek urgent care for chest pain, shortness of breath or feeling faint.
Questions people ask
Is this a hormone?
No. Spironolactone is not a hormone, but it has anti-androgen effects. Biotin is a vitamin.
Does biotin actually regrow hair?
True biotin deficiency can cause hair loss, but deficiency is uncommon, and evidence that extra biotin improves hair in otherwise healthy people is limited.
Oral vs topical minoxidil: what is the difference?
Both use the same medicine. In a 2024 randomized trial in men, oral minoxidil 5 mg daily was not superior to 5% topical minoxidil used twice daily after 24 weeks; both improved hair density. Oral treatment avoids daily scalp application but acts on the whole body. In a study of 1,404 people taking low-dose oral minoxidil for hair loss, unwanted body or facial hair was the most common side effect (about 15%), while lightheadedness, fluid retention and a fast heartbeat each affected fewer than 2%.
Why am I shedding more at first?
Minoxidil can push resting hairs out as new growth starts, so some people shed more in the first one to two months. In one trial this happened in 16% of men using topical minoxidil and 9% using oral minoxidil. It is usually temporary. Tell your clinician if shedding continues beyond a few months.
How long before I see results?
Hair grows slowly, so changes usually take months. In the finasteride trials and the 48-week topical minoxidil trial, results were measured over the better part of a year or longer. Your clinician can tell you when a review makes sense.
Discuss Willow Oral with a licensed clinician
Your clinician reviews your health history and decides whether this option, or another, is appropriate.
$79 per month
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Willow Oral $79 per month