Finasteride vs minoxidil is a common question when it comes to treating hair loss. Minoxidil and finasteride are two of the most popular men’s hair loss treatments on the market today.
Both are used by millions of patients to combat male pattern baldness and manage different types of alopecia. In 2021, the global minoxidil market size was valued at almost $991 million, while the finasteride market was worth more than $118 million [1-2].
These figures suggest that minoxidil is the more popular solution for treating hair loss, but does that mean it’s more effective or simply more widely used? In this article, we’ll compare finasteride vs minoxidil to determine which is the right non-surgical hair loss treatment for you. Discover:
Finasteride is an oral medication that stops your body from converting testosterone into DHT. DHT, or dihydrotestosterone, is the hormone responsible for both male and female pattern baldness. Blocking DHT production is a highly effective way to stop progressive balding in men.
Minoxidil, meanwhile, is a topical treatment sometimes recommended as an alternative to finasteride. It is sometimes used as an oral treatment off-label, but this is not licensed as it may result in systemic side effects.
Minoxidil mainly works as a vasodilator — it widens the blood vessels in your scalp so more nutrients can flow to the hair follicles, stimulating hair growth. It also has anti-inflammatory properties and acts as an anti-androgen [3-4], although its anti-androgenic effects are relatively weak. DHT is a powerful androgen.
You’ll need a prescription to get finasteride or oral minoxidil, while topical minoxidil is available over the counter. Finasteride and other DHT blockers (like dutasteride) aren’t suitable for everyone, so it’s important your doctor or trichologist assesses your suitability before prescribing this medication.
Minoxidil is generally more suitable for lots of different hair loss patients. Minoxidil is usually sold under the brand name Regaine in the UK, while finasteride is sold under the brand name Propecia.
For men experiencing male pattern hair loss, finasteride is widely considered to be more effective than minoxidil [5-6]. However, a combination of both hair loss treatments is often more effective than one or the other [7-9].
Finasteride can also work for women with female pattern hair loss [10]. However, finasteride isn’t usually prescribed to women because it can interfere with the effectiveness of birth control medication, cause menstrual cycle irregularities, or cause foetal development problems in pregnant women [11]. Many premenopausal women avoid finasteride, but it can be useful for addressing menopause-related hair loss [10].
Minoxidil for women is usually suitable unless you’re pregnant or breastfeeding. If necessary, seek out another minoxidil alternative to tackle your hair loss. Learn more about minoxidil use during pregnancy.
If your hair loss isn’t caused by male or female pattern hair loss, finasteride is unlikely to help. Other types of hair loss aren’t caused by hormonal changes, so adjusting your DHT levels won’t impact hair growth. In these instances, minoxidil is usually a more effective treatment.
It’s important to consider your dosage when deciding whether to use finasteride or minoxidil. Research shows that while 5mg of finasteride is more effective than 5mg of oral minoxidil, the latter can be more effective than an oral dose of 1mg finasteride [6].
Here’s how one study found dosage and medication type — i.e. oral intake or topical solution — impact effectiveness [6]:
Most to least effective
0.5 mg/d oral dutasteride
5 mg/d of oral finasteride
5 mg/d of oral minoxidil
1 mg/d of oral finasteride
Topical minoxidil 5%
Topical minoxidil 2%
0.25 mg/d of oral minoxidil
Most finasteride patients are prescribed 1mg a day. There’s a slightly higher risk of sexual dysfunction side effects if you take 5mg of finasteride each day, although these effects may reduce over time [12].
Yes. In fact, research shows that using minoxidil and finasteride together can boost hair growth results.
In two separate studies, researchers found that adding a small dose of 0.1% topical finasteride to a 5% topical minoxidil solution improved hair count and reduced the balding area [8-9].
Another study showed that this combination could help maintain hair density after using 5mg of oral finasteride for 8 to 12 months [7]. This is good news for patients who want to have a break from hair loss medication but still wish to avoid further hair loss.
Finasteride is more likely to have significant side effects than minoxidil, particularly relating to sexual function. Studies suggest this can affect anywhere from <2% to 15.8% of men [13-14]. Reported side effects include [12, 15]:
Minoxidil also has several reported side effects, although these tend to be more manageable [16-19]:
Male androgenetic alopecia patient taking 1mg Finasteride a day at baseline, 12 months and 24 months
It’s evident that both minoxidil and finasteride can give you excellent results after a few months of use. Find out how long it takes for finasteride to work. To see more photos, check out our finasteride results and minoxidil before and after galleries.
Should you use finasteride or minoxidil for your hair loss condition? Here, we compare different types of alopecia and the best medication choice for each one.
Hair loss condition
Is finasteride or minoxidil the best choice?
Finasteride
Female pattern baldness
Minoxidil (finasteride in specific cases)
Alopecia areata
Minoxidil
Chemotherapy-induced hair loss
Beard hair loss
Minoxidil (learn more about minoxidil for beard growth)
Minoxidil (learn more about minoxidil for eyebrow growth)
Although it is a licenced hair loss treatment in the UK, you can’t get minoxidil on the NHS at present. This is because hair loss is considered a cosmetic problem, and cosmetic treatments are not available on the NHS.
This is unfortunate because the potential mental health side effects of hair loss (such as anxiety and depression) are well-documented in research [20]. However, minoxidil is recommended by the NHS as a hair loss treatment.
At present, you can’t get finasteride on the NHS either as a treatment for hair loss. However, finasteride 5mg is available on the NHS as a treatment for conditions such as an enlarged prostate.
These hair loss treatments are usually the first port of call for people looking to restore their hair. However, they don’t always give you the results you’re looking for. In these cases, many people turn to hair transplants.
Hair transplants are more invasive than finasteride or minoxidil, but they offer permanent results. In many cases, these treatments can be combined with follicular unit extraction (FUE) or follicular unit transplantation (FUT) to promote new growth and preserve your existing hair.
Not sure which treatment is right for you? Get a free hair and scalp exam from our trichology team. These hair doctors use diagnostic trichology tests (such as blood tests for hair loss or a hair pull test) to discover the reason your hair is falling out.
Trichologists can also assess whether you’re a good candidate for finasteride, minoxidil, or a hair transplant. If you’re looking for a more permanent solution, you may also be a candidate for a hair transplant — we offer both FUE and FUT transplantation at the Wimpole Clinic. Book a consultation at one of our clinic locations to get started.
The answer depends on your reason for using minoxidil or finasteride. Finasteride tends to give the best results for male pattern baldness, while minoxidil tends to be better for female pattern baldness, alopecia areata, telogen effluvium, chemotherapy-induced hair loss, beard hair loss, and eyebrow hair loss.
Finasteride is usually prescribed at 1mg daily for people with male pattern baldness. 5mg a day may be prescribed in some cases, although this can come with a higher risk of side effects. It’s best to take finasteride exactly as prescribed — if you only take finasteride 3 times a week, it will likely be less effective.
If you are managing male pattern baldness with finasteride, your hair loss will likely return within 12 months if you stop taking it. However, you don’t necessarily have to take finasteride forever — if you’d like to maintain a full, healthy head of hair without medication, you may wish to consider a hair transplant. Doctors may advise continuing with finasteride after a transplant, but it’s not essential.
Yes, minoxidil is a legal, licensed medicine in the UK for the treatment of androgenetic alopecia (pattern baldness). It is available without a prescription from many shops, pharmacies, and online doctor services.
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