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We have known that minoxidil stimulates hair growth for more than 40 years, but our understanding of the mechanism of hair follicles is very limited. In animal studies, topical minoxidil shortens the resting period, causing resting hair follicles to enter the early stage of hair growth prematurely, and it may have a similar effect in humans. Minoxidil can also cause early hair growth and increase the size of hair follicles. Oral minoxidil relaxes vascular smooth muscle through its sulfated metabolite minoxidil sulfate, lowers blood pressure, and acts as an opener of muscle fiber KATP channels. There is some evidence that the stimulating effect of minoxidil on hair growth is also caused by the opening of potassium channels by minoxidil sulfate, but this idea is difficult to prove. So far, it has not been clearly proven that KATP channels are in hair follicles. Many in vitro effects of minoxidil have been described in single cultures of various skin and hair follicle cell types, including stimulation of cell proliferation, inhibition of collagen synthesis, and stimulation of vascular endothelial growth factor and prostaglandin synthesis.