Established as one of the world’s most popular treatments for male pattern baldness, Finasteride is also among the most effective. One study found approximately 90% of men see improvements in hair loss following Finasteride use [1].
While many male hair loss patients take oral Finasteride, topical Finasteride has recently become more mainstream. Recent studies have shown topical Finasteride can reduce hair loss when used on its own or in combination with topical Minoxidil [2-5].
So which is more effective at treating hair loss: topical vs oral Finasteride? And what are the benefits of using one instead of the other? In this article, we’ll explore all the differences between topical Finasteride vs oral Finasteride so you can decide which to use for your hair loss.
Finasteride is a type of drug known as a 5-alpha reductase (5AR) inhibitor. 5AR is an enzyme that stimulates the conversion of testosterone to dihydrotestosterone, or DHT.
DHT is the hormone that causes male pattern baldness. It binds to receptors in your hair follicles until the follicles shrink and stop producing hair. By inhibiting the 5AR enzyme, Finasteride limits the amount of DHT in your body, so there’s less chance of it binding to your follicle receptors.
While both oral and topical Finasteride use the same active ingredient to reduce hair loss, there are multiple differences between the two types:
Let’s take a more in-depth look at the differences between topical vs oral Finasteride.
The table below shows all the key differences between topical Finasteride and Finasteride tablets.
*Topical Finasteride is unlicensed, so there’s no approved strength. However, studies have found concentrations within this range to be safe and effective [2-3].
**International Society of Hair Restoration Surgeons
Unlike topical Finasteride, oral Finasteride is licensed as a hair loss drug by the MHRA. It’s also by far the most popular version of this drug, with more than two-thirds of ISHRS members recommending it, compared with just 17% who recommend topical Finasteride [7].
The fact that topical Finasteride isn’t yet licensed doesn’t necessarily indicate that the drug is unsafe. It just means there isn’t enough evidence yet to support its use among the general population. Since Finasteride in its topical form is a much newer formula, there isn’t yet enough research to approve it for widespread use.
That means topical Finasteride may be safe and even preferable to the oral medication in some cases. For example, some men avoid oral Finasteride because of the risk of systemic side effects. However, these risks are substantially lower with topical Finasteride.
Oral Finasteride has been linked with erectile dysfunction, as well as other adverse sexual effects. These are known as systemic side effects, as they impact parts of the body other than those you’re actively treating.
Systemic effects are only linked with oral Finasteride use, not topical Finasteride. That’s because oral Finasteride lowers DHT levels throughout your body, while topical Finasteride just reduces DHT levels in the scalp. So topical Finasteride may give you the benefits of the medication while reducing the risk of sexual side effects.
Topical Finasteride can also help you maintain your hair density after a course of oral Finasteride [8]. Switching to topical Finasteride may allow you to retain your hair without taking tablets long-term.
Evidence also suggests topical Finasteride for women with female pattern baldness may be suitable [2]. That’s because it’s unlikely to affect your hormone levels in the same way as oral Finasteride, reducing the risk for female hair loss patients. Learn more about female hair loss treatments.
Oral Finasteride has been linked with several systemic side effects, including:
While these risks are reduced with topical Finasteride, this treatment carries its own potential side effects. These are almost always limited to the scalp and include:
Most oral Finasteride users don’t experience these side effects. However, if you want to avoid the risk, consider using an alternative to Finasteride.
Oral Finasteride is a well-established hair loss treatment that’s been shown to stop hair loss in 83% of men with crown hair loss and 70% of men with frontal balding [1].
As well as stopping hair loss, oral Finasteride can also promote regrowth. Moderate regrowth is seen in 61-66% of men balding on the crown and 37% of men with a receding hairline [1].
As a newer treatment, topical Finasteride hasn’t been studied as extensively as oral Finasteride. However several studies have shown promising results for topical Finasteride as a treatment for androgenetic alopecia in both men and women [2-5].
A review of seven studies into the effectiveness of topical Finasteride concluded that topical Finasteride is “non-inferior” compared with oral Finasteride — so if you’re worried about side effects, it could be a good place to start [2].
These photos from clinical research studies show topical and oral Finasteride results for hair loss.
Results of topical Finasteride combined with Minoxidil after 24 weeks of use in a female hair loss patient.
Oral Finasteride for hair loss comes as a tablet. Simply take a 1mg Finasteride tablet once a day for at least three months to start to see the effects. Find out more about how long it takes for Finasteride to work
Apply topical Finasteride using the spray or dropper nozzle provided. Use the amount advised by your doctor. Once you’ve applied the required amount, you should spread the solution across your balding area with your fingertips to make sure it’s completely covered.
Do this twice a day, or as directed by your doctor. Learn more about the best way to apply topical Finasteride for excellent results.
While it may be possible for you to combine oral and topical Finasteride, it’s important to talk about this with a professional beforehand.
That’s because you could exceed the maximum recommended dosage of Finasteride if you use too much. This might impair your chances of effective hair growth and increase your risk of side effects. So speak to a hair loss consultant before combining these treatments.
Most men start with Finasteride tablets to treat their hair loss, as it’s a licensed drug that has been formally assessed for its safety and efficacy.
However, topical Finasteride is becoming more widely available as a commercial formula. It’s easy to access without a prescription (particularly when combined with Minoxidil) so many men now try this before oral Finasteride.
Topical Finasteride may be a good option if:
Oral Finasteride may be the better option if:
Still unsure which treatment is right for you? Book a consultation at the Wimpole Clinic to discuss your concerns with a hair loss specialist.
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