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Minoxidil Combined With Finasteride: An Expert Review
Dr. Michael May (FRCS)
Medically reviewed by
Dr. Michael May (FRCS)
Updated on April 9, 2024

Even if you’re in the early stages of researching male hair loss treatments, chances are you’ve already come across the big two: Finasteride and Minoxidil.

These are the most popular hair loss medications worldwide, with more than half of hair restoration specialists recommending topical Minoxidil, and more than two-thirds recommending oral Finasteride [1].

However, a growing body of research suggests it’s actually a combination of Minoxidil and Finasteride that works best for male pattern baldness [2-5]. Topical Finasteride with Minoxidil, in particular, has become popular for treating hair loss and promoting hair regrowth.

So just how effective is Minoxidil combined with Finasteride? And what are the side effects of using both treatments together? In this article, we explore the evidence and review the efficacy of Finasteride-Minoxidil combination therapy for androgenetic alopecia.

Table of Contents

What are Finasteride and Minoxidil?

Finasteride and Minoxidil are the most popular non-surgical treatments for male pattern baldness. While Finasteride blocks hormonal changes that contribute to hair loss, Minoxidil stimulates blood flow to your hair follicles, ensuring they can produce healthy hair. Both are available as oral and topical medications.

Here’s a head-to-head comparison of how each treatment tackles hair loss:

How do you use it?Usually oral (topical versions available off-label)Usually topical (oral versions available off-label)
StrengthsOral: 1mg (5mg in limited cases)Topical: 2%, 5%
How does it reduce hair loss?Reduces production of dihydrotestosterone (DHT), the hormone responsible for pattern balding in menDilates scalp blood vessels and activates potassium channels, ensuring a healthy supply of blood and nutrients and stimulates cell proliferation in the hair follicles
How soon can you see results?3-6 months3-6 months
What are the side effects?

Topical: Skin irritation, contact dermatitis, redness.

Oral: Temporary Finasteride hair shedding, erectile dysfunction, lower libido, testicular discomfort.

Topical: Skin irritation, contact dermatitis, redness, temporary Minoxidil hair shedding

Oral: Hypertrichosis, changes in blood pressure and heart rate.

Which hair loss conditions can it treat?Male pattern baldness only

Male pattern baldness

Female pattern baldness

Telogen effluvium

Traction alopecia

Anagen effluvium

Alopecia areata

Can I mix Minoxidil with Finasteride?

If you’re a man with male pattern baldness, it’s usually safe to mix Minoxidil with Finasteride. Since Minoxidil and Finasteride tackle hair loss through two different mechanisms, mixing these treatments may lead to better, longer-lasting results.

While Minoxidil is suitable for a range of hair loss patients, Finasteride unfortunately isn’t suitable for everyone. Dr. Michael May, the principal surgeon at the Wimpole Clinic, says:

Finasteride for women isn’t usually recommended, especially if you haven’t yet reached menopause. It’s also advised that anyone who is trying to conceive avoids Finasteride, as the drug can pass into your semen and harm a developing foetus.”

In addition, Finasteride only works for hormone-related hair loss. It’s only effective for treating male pattern baldness (and female pattern hair loss in rare cases). So people with other types of alopecia probably won’t see a benefit from mixing Minoxidil with Finasteride.

Does Finasteride work better with Minoxidil?

Studies show that Finasteride results may be enhanced if used alongside Minoxidil [2-4]. This table shows the percentage of men who saw hair loss improvements after 12 months of treatment [3]:

5% topical Minoxidil only1mg oral Finasteride onlyCombination therapy

Another study found that combining 0.1% topical Finasteride and Minoxidil 5% could help maintain high hair density after a course of oral Finasteride [2]. 84.5% of patients maintained their hair thickness after one year of topical Finasteride and Minoxidil treatment, following two years of oral Finasteride use. Dr. May explains the benefits of this:

“This is a promising development for men who want to maintain their hair without experiencing the potential longer-term effects of oral Finasteride use. However, topical Finasteride hasn’t yet been licensed for use in the UK, so anyone considering this treatment should do so with caution.”

  • Study [2] investigated the effects of switching to a combined topical Finasteride and Minoxidil topical treatment (5% Minoxidil and 0.1% Finasteride) after two years of combining oral Finasteride and topical Minoxidil. Of the 50 men with male androgenetic alopecia who were treated, 84.44% maintained their hair density after 12 months of topical-only treatment.
  • A study of 450 male Chinese androgenetic alopecia patients compared the effectiveness of 1mg oral Finasteride, 5% topical Minoxidil, and a combination of treatments over a 12-month period [3]. After one year, 94.1% of combination therapy users showed improvement, compared with 80.5% of Finasteride-only users and 59% of Minoxidil-only users.
  • Study [4] reviewed five other research studies to establish the efficacy and safety of combining oral (1mg/day) or topical (0.1-0.25%) Finasteride and topical Minoxidil (2-5%). Researchers concluded that combined Finasteride and topical Minoxidil have better efficacy than monotherapy for hair loss. They also noted that the optimum concentrations and combinations are yet to be established.
  • Study [5] compared the efficacy and safety of 3% Minoxidil with a combined 3% Minoxidil and 0.1% topical Finasteride in 40 men with male pattern hair loss. Results showed no significant difference in side effects or hair count, though global photographic assessment found the combination group was significantly more effective.

Combined Minoxidil & Finasteride treatment photos

These photos from clinical trials show the impact of Minoxidil combined with Finasteride:

Finasteride comibined with topical Minoxidil
Hair at baseline (a), then after eight months of treatment with oral Finasteride only (b). Image (c) shows a decline in hair density after stopping treatment. Image (d) shows hair density maintenance following treatment with topical Minoxidil (5%) fortified with Finasteride (0.1%).
Finasteride combined with Minoxidil
Hair at baseline (a), then after treatment with oral Finasteride only (b). Image (c) shows a decline in hair density after stopping treatment for eight months. Image (d) shows hair density improvement following treatment with topical Minoxidil (5%) fortified with Finasteride (0.1%).
Minoxidil vs. Finasteride results
Images (a-c) show a patient treated with Finasteride 1mg once daily at baseline, then after six and 12 months. Images (d-f) show the same intervals for a patient treated with 5% Minoxidil. Images (g-i) show the same intervals for a patient treated with combined Minoxidil and Finasteride.

How do Finasteride and Minoxidil work together for hair loss?

Finasteride and Minoxidil are complementary therapies. Finasteride tackles the underlying hormonal hair loss trigger, while Minoxidil allows more blood to flow to the scalp, providing hair follicles with more nutrients and oxygen. This may help them progress into the growth phase of the hair growth cycle.

Chart of the normal hair growth cycle

Using these treatments in isolation means you only take advantage of one hair growth mechanism. For best results, it’s generally safe and effective to use Minoxidil and Finasteride together, so you can get the benefits of both mechanisms at the same time.

What are the side effects of combining Minoxidil with Finasteride?

Combining Minoxidil and Finasteride puts you at greater risk of experiencing side effects of both medications. However, mixing these treatments in certain ways can help you control those side effects.

Topical Finasteride and oral Finasteride have different potential adverse effects. While topical Finasteride is more likely to cause mild localised issues, such as redness, irritation, and itchiness, oral Finasteride can lead to problems like erectile dysfunction and lower libido. So mixing Minoxidil with topical Finasteride may reduce the risk of more serious issues.

The same is also true for Minoxidil. Topical Minoxidil is associated with localised complaints such as contact dermatitis and skin irritation, whereas oral Minoxidil may cause cardiovascular problems like changes in blood pressure and heart rate. Those at risk of heart conditions and high blood pressure should use oral Minoxidil with extreme caution [6].

If you’re considering mixing Minoxidil and Finasteride, get a medical checkup to confirm it’s safe for you to use these medications for hair loss.

How can I mix Minoxidil and Finasteride?

Though there are four ways to combine Minoxidil and Finasteride, only two of these have undergone clinical trials to establish safety and effectiveness. These are:

  • Topical Finasteride & topical Minoxidil — Studies show this is a safe, effective way to combine these treatments, especially if you want to minimise the systemic side effects of Finasteride [2, 5].
  • Oral Finasteride & topical Minoxidil — This combination is one of the most effective solutions for male hair loss, and may be a good first-line approach [3-4].

Dr. May explains further:

“It’s also possible to take Finasteride and Minoxidil tablets or mix topical Finasteride and oral Minoxidil. None of the existing research suggests there will be any dangerous interactions between these drugs. However, until these Finasteride-Minoxidil combinations have been clinically tested, it’s best to stick with those that are proven to be safe and effective.”

Can I take both oral Finasteride and oral Minoxidil?

There’s currently no research to confirm the safety of using both oral Finasteride and oral Minoxidil together.

Both treatments are generally safe to use on their own, but the risk of systemic side effects is higher with these oral treatments [6-7]. So it’s best to avoid this combination unless you’re advised to do so by a qualified hair loss specialist.

How to apply topical Finasteride and Minoxidil

You can buy premixed topical Finasteride and Minoxidil from online pharmacies. These solutions are better than mixing your own treatments, as the formula typically contains a safe level of active ingredients.

To apply, spray 1 ml of the solution (approximately 1-2 sprays) on your balding area(s) twice a day.

Make sure the area is clean and dry when you apply the solution.

Find out more about the best way to apply topical Finasteride for excellent results.

How to take oral Finasteride with topical Minoxidil

Finasteride is a prescription medicine, so take it as instructed by your doctor. Most people are advised to take one 1mg tablet per day.

You can then apply Minoxidil: use the applicator (foam, spray, or dropper) to apply 1ml of the solution to your scalp, then gently spread the formula across your balding or thinning patches. Repeat twice a day.

Do I have to use Minoxidil with Finasteride?

No — you don’t have to combine Minoxidil and Finasteride unless you want to.

While multiple studies have shown this to be the most effective route to hair regrowth, both Minoxidil and Finasteride have good success rates on their own, especially if they’re used early to prevent further hair loss. So if you’re worried about side effects, you can use one or the other to minimise the risk.

To discover which hair loss treatment is right for you, book a free consultation with our team. Get a free hair and scalp exam, along with free, impartial advice on the right course of treatment for your level and rate of hair loss.

Minoxidil Combined With Finasteride: An Expert Review, Wimpole Clinic

Dr. Michael May (FRCS)
Medically reviewed by Dr. Michael May (FRCS)Updated on April 9, 2024
The Wimpole Clinic offers FUE Hair, Beard & Eyebrow Transplants & Trichology.
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