Efficacy of Topical Minoxidil for Nail Growth: A Systematic Review

Nail growth disorders can cause functional impairment and cosmetic concern, yet effective treatments remain limited. Minoxidil, a vasodilator widely used for androgenetic alopecia, has been proposed to enhance nail growth through its proliferative and vascular effects. This systematic review, conducted in accordance with PRISMA 2020 guidelines, evaluated the efficacy and safety of topical and oral minoxidil for promoting nail growth in healthy individuals and patients with nail disorders. Searches of PubMed, MEDLINE, Web of Science, Wiley, Google Scholar, and EBSCO identified eligible human studies reporting quantitative outcomes. Three studies (one randomized controlled trial and two non-randomized studies) were included. Topical minoxidil significantly increased nail growth compared to controls. In healthy participants, 5% topical minoxidil applied twice daily increased mean nail growth from 3.91 to 4.27 mm/month after one month (p=0.003). In onychomadesis, 5% minoxidil with vitamin E achieved an 81% clinical response after 12 months. Minoxidil also outperformed oral biotin (19% vs. 13% increase in growth). No serious adverse effects were reported. Overall, topical minoxidil appears safe and potentially effective, though larger trials are needed to confirm long-term outcomes.