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Topical Finasteride Guide: Uses, Results & Side-Effects
Dr. Michael May (FRCS)
Medically reviewed by
Dr. Michael May (FRCS)
Updated on March 26, 2024

Topical Finasteride is a modern hair loss medication that helps tackle male pattern baldness. Applying a topical Finasteride solution to the scalp can slow hair loss and promote regrowth.

Topical Finasteride is much less widely used than oral Finasteride, with only 17% of hair restoration surgeons saying they always or often recommend it (compared to 69% who say the same of oral Finasteride) [1]. Despite this, evidence suggests topical finasteride treatment can be almost equally effective for treating male hair loss.

So should you try topical Finasteride to treat hair loss? Learn all about topical Finasteride, including how it works, how long it takes to see results, and why it’s a good alternative to oral Finasteride.

Table of Contents

What is topical Finasteride?

Topical Finasteride is a liquid solution designed to treat male pattern baldness. Patients apply the solution directly to balding areas on the scalp.

The active ingredient is Finasteride, which is found in successful oral hair loss treatments like Propecia.

Topical Finasteride is only suitable for scalp hair loss. Finasteride won’t work for beard growth or body hair.

Can topical Finasteride regrow hair?

Yes. There’s overwhelming evidence to suggest topical Finasteride can regrow hair in those with androgenetic alopecia (also known as male pattern baldness in men or female pattern baldness in women)[2-5].

A research review into the effectiveness of topical Finasteride found studies consistently demonstrated [2]:

  • A significant reduction in the rate of hair loss
  • Increase in total hair count
  • Increase in terminal hairs (thick scalp hair that usually becomes permanent)
  • Positive hair growth assessment

These images show hair growth improvements following a six-month course of 0.25% topical Finasteride and 3% Minoxidil, compared with Minoxidil alone:

treatment of topical finasteride and topical minoxidil in hair loss patients after 24 weeks
Hair loss treatments of topical finasteride and topical minoxidil in patients after 24 weeks
  • A 1997 study asked 28 men and 24 women to apply a 1 ml topical Finasteride solution (0.005%) to the scalp twice a day for 16 months. 73% of topical Finasteride users said the product had “high effectiveness”. By comparison, 60% of placebo users reported “no effect” [3].
  • A 2002 study compared topical Finasteride with oral Finasteride. It found no significant differences in terms of hair thickness, hair count, and bald area size after six months, suggesting both forms of the drug can be equally effective [4].
  • A 2016 study suggested topical Finasteride could reduce scalp DHT levels by up to 52%, while only reducing serum DHT levels (i.e. the amount of DHT in the body) by up to 26%. Because it has a less systemic impact than oral Finasteride, topical Finasteride may have fewer sexual side effects [5].

How does topical Finasteride work?

Finasteride reduces DHT levels in the body. DHT, or dihydrotestosterone, is a hormone that binds to the androgen receptors in your hair follicles. This causes your follicles to shrink and stop producing hair.
miniaturisation leading to hair loss informational graphic

Unlike oral Finasteride, which reduces DHT levels throughout your whole body, topical Finasteride only affects scalp DHT levels. That means it can positively impact your hair, without causing problems related to systemically low DHT levels.

Topical Finasteride is a DHT blocker, not a DHT cream. DHT creams actually boost DHT levels, so they’re not usually suitable for treating hair loss.

Who can use topical Finasteride?

Like oral Finasteride, topical Finasteride is generally used by male pattern hair loss patients. It can’t tackle other types of hair loss, such as alopecia areata or telogen effluvium, as these aren’t triggered by high DHT levels.

Some researchers have suggested topical Finasteride may be safe and effective for women with female pattern baldness [2]. This is an important finding, as women are usually advised to avoid oral Finasteride due to potential complications and side effects.

That said, topical Finasteride hasn’t yet been licensed for use in any patients, regardless of gender or hair loss condition. So it’s best to follow the advice given by your doctor or hair loss consultant when it comes to choosing a hair loss treatment.

Female hair loss is often difficult to diagnose, as there are many possible contributing factors. Find out more about getting a diagnosis and finding the right female hair loss treatment.

Topical Finasteride vs oral Finasteride

Here are the key differences between topical vs oral Finasteride:

  • Effectiveness: studies suggest oral and topical Finasteride may have similar levels of effectiveness [4-5].
  • Side effects: topical Finasteride has fewer systemic and sexual side effects than oral Finasteride [5].
  • Eligibility: unlike oral Finasteride, topical Finasteride may be suitable for women with female pattern baldness and men who are planning to try for a baby soon [2].
  • Licensing: unlike oral Finasteride, topical Finasteride hasn’t yet licensed for use as a hair loss drug.

How long does topical Finasteride take to work?

Topical Finasteride can start to visibly reduce hair loss in just six months [4]. This is slightly longer than it takes to see results from oral Finasteride, which can have a noticeable impact within four months [4].

Can you make topical Finasteride?

Some online tutorials claim to show you how to make topical Finasteride. This usually involves crushing oral Finasteride tablets and dissolving them in liquid to make a solution.

However, it’s not a good idea to make topical Finasteride at home. Here’s why:

  • Oral Finasteride doesn’t contain the same active ingredient concentration as topical Finasteride
  • Several ingredients in oral Finasteride aren’t approved for topical use
  • Side effects are unknown, so this approach could actually impair hair growth
  • It could cause skin irritation and other problems
  • Finasteride is a prescription medication that should only be used as advised by your doctor or hair loss consultant

If you want to try a topical Finasteride solution, it’s best to ask your hair loss clinic for advice.

Can you use topical Finasteride and Minoxidil together?

Yes. In fact, studies suggest combining topical Finasteride with Minoxidil can be more effective than using one or the other [5-6]. Minoxidil is a licensed topical hair loss solution that’s widely used to tackle multiple types of hair loss.

Using a topical Finasteride-Minoxidil solution can also maintain your results after a course of oral Finasteride [6].

This patient’s results show his hair loss before treatment (a), after oral Finasteride treatment (b), after discontinuing oral Finasteride (c), and after using a topical Finasteride-Minoxidil solution to improve hair growth (d):

Results of topical finasteride fortified with Minoxidil

Why is topical Finasteride not FDA-approved?

Topical Finasteride solutions aren’t yet licensed by the US Food and Drug Administration (FDA), or any national medical approval body.

Although early studies show promising results, there isn’t yet enough evidence to suggest topical Finasteride is safe and effective for widespread use.

The FDA requires drugs to go through a rigorous testing process with thousands of users before they’re approved. Most topical Finasteride studies so far have only been tested on very small population samples.

Even though topical Finasteride hasn’t yet been licensed for hair loss, private hair loss specialists can prescribe it for you off-label if they believe it could be an effective treatment.

How to apply topical Finasteride

Topical Finasteride usually comes in a spray or dropper bottle, so it’s really easy to apply. Here’s a quick step-by-step guide:

  1. Clean your scalp — make sure the area is clean and dry before application.
  2. Use the spray nozzle or dropper to apply — use the amount prescribed by your doctor (usually one drop or spray).
  3. Cover your bald spots — don’t rub it in, but use your fingertips to help the solution reach all your balding areas.
  4. Repeat as prescribed — repeat these steps once or twice a day, depending on your prescription.

You can also follow these steps if you’re using a topical Finasteride-Minoxidil combination spray. Read more about the best way to apply topical Finasteride for excellent results.

What are the side effects of topical Finasteride

Topical Finasteride appears to have fewer significant adverse effects than the oral version. But there are a few topical Finasteride side effects to be aware of [7]:

  • Itchy or burning scalp
  • Skin irritation
  • Contact dermatitis
  • Erythema (red patches)

These side effects are usually localised to the scalp and don’t spread to other areas of the body.

Where to get topical Finasteride

The Wimpole Clinic can prescribe topical Finasteride (plus a range of other hair loss treatments) to men and women experiencing pattern baldness.

In your in-person or video consultation, we’ll establish the cause of your hair loss, and work with you to find the best possible treatment for your hair loss. If this includes topical Finasteride, we’ll talk you through how to apply it for best results, and discuss the results you can expect to see.

Book a consultation to get started.

Topical Finasteride Guide: Uses, Results & Side-Effects, Wimpole Clinic

Dr. Michael May (FRCS)
Medically reviewed by Dr. Michael May (FRCS)Updated on March 26, 2024
The Wimpole Clinic offers FUE Hair, Beard & Eyebrow Transplants & Trichology.
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