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Finasteride vs Minoxidil: Which Is Better For Hair Growth?

Finasteride and Minoxidil are two of the most popular hair loss treatments on the market today. Both are used by millions of patients to manage a variety of hair loss conditions. 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 — 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:

  • the key differences between Finasteride vs Minoxidil, and which is more effective
  • whether you can combine Finasteride and Minoxidil
  • whether Finasteride or Minoxidil is right for you.

What’s the difference between Finasteride and Minoxidil?

Finasteride is an oral medication that stops your body converting testosterone into DHT. DHT, or dihydrotestosterone, is the hormone responsible for male pattern baldness. Blocking DHT production is a highly effective way to stop progressive balding in men.

Minoxidil, meanwhile, is a topical treatment. It widens the blood vessels in your scalp so more nutrients can flow to the follicles, stimulating hair growth. It also has anti-inflammatory properties, and acts as an anti-androgen [3-4]. DHT is a powerful androgen.

You’ll need a prescription to get Finasteride, while 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. Finasteride is sold under the brand name Propecia.

Finasteride vs Minoxidil: which is more effective for hair loss?

For men experiencing male pattern baldness, Finasteride is widely considered to be more effective than Minoxidil [5-6]. But a combination of both 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, 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 isn’t recommended for women who are pregnant or breastfeeding, but is suitable for most other women.

If your hair loss isn’t caused by pattern baldness, 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.

How does dosage impact results?

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 a 1mg dose of oral Finasteride [6].

Here’s how one study found dosage and medication type — i.e. oral intake or topical solution — impact effectiveness:

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
5% topical Minoxidil
2% topical Minoxidil
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].

Can you use Finasteride and Minoxidil at the same time?

Yes. In fact, research shows that using Minoxidil and Finasteride together can boost 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 don’t want to take oral Finasteride indefinitely, but still wish to maintain their hair.

Side effects of Finasteride vs Minoxidil

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]:

  • Finasteride-related erectile dysfunction
  • Loss of libido
  • Reduced ejaculatory volume
  • Anxiety and depression
  • Gynecomastia (increased development of breast gland tissue in men)
  • Increased risk of breast cancer in men.

Minoxidil also has several reported side effects, although these tend to be more manageable [16-18]:

  • Dermatitis and other scalp problems
  • Headaches
  • Excessive body hair growth, also known as hypertrichosis (this may be more likely at higher concentrations)
  • Itchy skin (pruritus)
  • Skin irritation
  • Dry/scaly skin
  • Folliculitis
  • Minoxidil-related hair colour changes.

Oral Minoxidil has been linked with some cardiovascular symptoms [3, 19]. So patients with angina or other heart conditions may need to avoid this treatment.

Both treatments can cause hair shedding after a few weeks or months of use. This can be disheartening, but don’t worry — it’s a normal part of the regrowth process. Learn more about Minoxidil hair shedding and Finasteride shedding.

Finasteride vs Minoxidil: photo results

Male pattern baldness

finasteride patient results at baseline, 12months, 24months

Male androgenetic alopecia patient taking 1mg Finasteride a day at baseline, 12 months and 24 months

male pattern baldness oral minoxidil before and after

Man with androgenetic alopecia patient taking 5mg oral Minoxidil a day at baseline and after 3 months

fphl minoxidil before and after

Female androgenetic alopecia patient using 5% topical Minoxidil at baseline and after 6 months

female finasteride results after 1 year

Female androgenetic alopecia patient taking 5mg oral Finasteride at baseline and after 12 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?

Hair loss condition/type Is Finasteride or Minoxidil the best choice?
Male pattern baldness Finasteride
Female pattern baldness Minoxidil (Finasteride in limited cases)
Alopecia areata Minoxidil
Telogen effluvium Minoxidil
Chemotherapy-induced hair loss Minoxidil
Beard hair loss Minoxidil (learn more about Minoxidil for beard growth)
Eyebrow hair loss Minoxidil (learn more about Minoxidil for eyebrow growth)

What happens if I don’t get results from Finasteride or Minoxidil?

These hair loss treatments are usually the first port of call for people looking to restore their hair. But 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 excision or strip surgery to promote new growth and preserve your existing hair. Learn everything you need to know about how hair transplants work.

Not sure which treatment is right for you? Get a free hair and scalp exam from our trichology team. They’ll diagnose your hair loss condition and assess whether you’re a good candidate for Finasteride, Minoxidil, or a hair transplant. Book your free consultation to get started.

Finasteride vs Minoxidil: Which Is Better For Hair Growth?, Wimpole Clinic

Sources:

  1. Market Watch | Minoxidil Market Size
  2. Market Watch | Finasteride Market Size
  3. Comparison of oral minoxidil, finasteride, and dutasteride for treating androgenetic alopecia
  4. Minoxidil Acts as an Antiandrogen: A Study of 5α-reductase Type 2 Gene Expression in a Human Keratinocyte Cell Line
  5. An open, randomized, comparative study of oral finasteride and 5% topical minoxidil in male androgenetic alopecia
  6. Relative Efficacy of Minoxidil and the 5-α Reductase Inhibitors in Androgenetic Alopecia Treatment of Male Patients
  7. Topical minoxidil fortified with finasteride: An account of maintenance of hair density after replacing oral finasteride
  8. A New Topical Formulation of Minoxidil and Finasteride Improves Hair Growth in Men with Androgenetic Alopecia
  9. Comparative study of efficacy of topical minoxidil versus topical minoxidil with finasteride in androgenetic alopecia
  10. Finasteride and Its Potential for the Treatment of Female Pattern Hair Loss: Evidence to Date
  11. Pregnancy and neonatal outcome with maternal exposure to finasteride: Case series
  12. Finasteride and sexual side effects
  13. Long-term (5-year) multinational experience with finasteride 1 mg in the treatment of men with androgenetic alopecia
  14. Adverse Effects and Safety of 5-alpha Reductase Inhibitors (Finasteride, Dutasteride): A Systematic Review
  15. An observational retrospective evaluation of 79 young men with long-term adverse effects after use of finasteride against androgenetic alopecia
  16. Minoxidil and its use in hair disorders: a review
  17. Androgenic alopecia: The use of minoxidil and its adverse effects
  18. Minoxidil
  19. Side effects of low-dose oral minoxidil for treating alopecia
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