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Topical Vs Oral Finasteride: What’s The Difference?
Dr Meena Zareie (GMC)
Medically reviewed by
Dr Meena Zareie (GMC)
Updated on February 21, 2024

Established as one of the world’s most popular treatments for male pattern baldnessFinasteride 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.

Table of Contents

What is Finasteride?

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.

graphic showing how Finasteride works on the chemical structures of testosterone and DHT

What’s the difference between oral Finasteride and topical Finasteride?

While both oral and topical Finasteride use the same active ingredient to reduce hair loss, there are multiple differences between the two types:

  • Application method — Topical Finasteride is applied to the scalp, while oral Finasteride is taken in tablet form.
  • Side effects — Topical Finasteride tends to have localised side effects on the scalp, while side effects from oral Finasteride can impact other areas of the body.
  • Licensing — Oral Finasteride is licensed as a hair loss drug by the Medicines and Healthcare Products Regulatory Agency (MHRA), while topical Finasteride isn’t.
  • Clinical evidence for use — Both products can stop hair loss, but oral Finasteride has been more widely studied.

Let’s take a more in-depth look at the differences between topical vs oral Finasteride.

Topical Finasteride vs Finasteride tablets: head-to-head

The table below shows all the key differences between topical Finasteride and Finasteride tablets.

 Topical FinasterideOral Finasteride
Strength/dosage0.005% to 1%*1mg per day
Side effects
  • Itchy or burning scalp
  • Skin irritation
  • Contact dermatitis
  • Erythema (red patches)
  • Temporary Finasteride hair shedding
  • Erectile dysfunction
  • Decreased sex drive
  • Ejaculation disorder
  • Testicular discomfort
  • Skin rashes
Effectiveness
  • Reduces scalp DHT levels by up to 70% [6]
  • Significantly increases hair count and density [2]
  • Reduces scalp DHT levels by up to 50% [6]
  • Significantly increases hair count and density [2]
Recommended always/often by ISHRS** members [7]17%69.1%
Eligibility Suitable for men and womenSuitable for men only
Licensed for useNoYes

*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

Why take topical Finasteride instead of oral Finasteride?

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.

Topical vs oral Finasteride: side effects

Oral Finasteride has been linked with several systemic side effects, including:

  • Temporary hair shedding
  • Erectile dysfunction
  • Decreased sex drive
  • Ejaculation disorder
  • Testicular discomfort
  • Skin rashes

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:

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

Most oral Finasteride users don’t experience these side effects. However, if you want to avoid the risk, consider using an alternative to Finasteride.

How effective is topical Finasteride vs oral 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].

Topical vs oral Finasteride: patient photos

These photos from clinical research studies show topical and oral Finasteride results for hair loss.

Results of using Finasteride combined with topical Minoxidil for 24 weeks in a female patient with androgenetic alopecia

Results of topical Finasteride combined with Minoxidil after 24 weeks of use in a female hair loss patient.

photos showing the improvement in hair density when taking oral Finasteride in treatment for androgenetic alopecia
A: Hair at baseline. B: After eight months of oral Finasteride treatment. C: Slight decrease in hair density after stopping oral Finasteride. D: Hair loss plateau after topical Finasteride use.
effects of taking and stopping oral Finasteride
A: Hair at baseline. B: Improved density following oral Finasteride treatment. C: Substantial decrease in hair density after stopping oral Finasteride for eight months. D: Visible regrowth after starting topical Finasteride treatment.
Patient before and after 6 months of taking 1mg oral Finasteride per day.
Patient before and after 6 months of taking 1mg oral Finasteride per day.
Hair density improvements after one year of oral Finasteride use.
Hair density improvements after one year of oral Finasteride use.

How to use oral Finasteride

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

How to use topical Finasteride

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.

Can you combine oral and topical Finasteride?

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.

Topical vs oral Finasteride: which is right for you?

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:

  • You’re concerned about the systemic side effects of oral Finasteride.
  • You’re a woman with female pattern baldness.
  • You are taking another medication that may interact with oral Finasteride.
  • You want to maintain your hair density after a course of oral Finasteride.

Oral Finasteride may be the better option if:

  • You’re a man with male pattern hair loss.
  • You only want to use MHRA-approved hair loss treatments.
  • You accept there’s a small risk of systemic side effects.
  • You’d prefer to use a treatment that’s been studied more extensively.

Still unsure which treatment is right for you? Book a consultation at the Wimpole Clinic to discuss your concerns with a hair loss specialist.

Topical Vs Oral Finasteride: What’s The Difference?, Wimpole Clinic

Dr Meena Zareie (GMC)
Medically reviewed by Dr Meena Zareie (GMC)Updated on February 21, 2024
The Wimpole Clinic offers FUE Hair, Beard & Eyebrow Transplants & Trichology.
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