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Management of patients with alopecia is still a challenging task. Minoxidil is a pyrimidine derivative, a potent KATP channel opener, and has been shown to act as a vasodilating agent. Minoxidil enhances the synthesis of growth factors, not only VEGF (vascular endothelial growth factor), but also FGF (fibroblast growth factor), IGF-1 (insulin-like growth factor), which stimulate growth processes in the hair follicle and trigger the anagen phase. The topical minoxidil formulations have been proven to be particularly efficient to a greater extent in androgenic alopecia (AGA) and to a lesser extent in nasal alopecia (GA).The best hair regrowth has been detected in early stages of alopecia. It generally takes 4-6 months before results are visible, and 12 months to stabilize the hair growth, which is maintained by a regular use of minoxidil. The level of the sulfotransferase enzyme in the hair follicles may predict the outcome of topical minoxidil therapy. The topical use of minoxidil does not cause any systemic side effects, and adverse effects in the form of skin reactions, irritation and dryness are short-term and rare. The article also presents the data of its own clinical experience in using minoxidil for the treatment of alopecia.