Finasteride and Minoxidil for Hair Loss: Which Is Better?

Male pattern baldness, also known as androgenetic alopecia, is a common condition affecting many men as they age, characterized by a receding hairline and thinning on the crown. While hair loss can be distressing, medications like finasteride and minoxidil are FDA-approved treatments that can slow hair loss and promote hair regrowth. This article explores how these treatments work, their effectiveness, and how they compare in managing male pattern baldness.

What is Male Pattern Baldness?

Hair loss on the scalp (androgenetic alopecia) is a common problem that affects both men and women. Male pattern baldness is the loss of scalp hair in men. It is characterized by a receding hairline and hair thinning on the crown. Male pattern baldness typically occurs in older men due to changes in hormone levels over a man’s lifetime. 

Female pattern baldness typically affects postmenopausal women. In its advanced stages, it is characterized by a progressively widening gap at the center part line and bald spots at the front of the hairline.

Although hair loss is a normal part of aging, it can be psychologically distressing for many men and women. Medications like finasteride and minoxidil can treat androgenetic alopecia in males. Female pattern baldness, which occurs in older women, can also be treated with medication.

Around 50 million men in the United States have male pattern baldness, and by age 50, one in two men has some degree of hair loss. Experts estimate that approximately 30 million women in America have female pattern baldness. 

Minoxidil vs Finasteride Key Differences

Minoxidil and finasteride are two drugs that can help slow the progression of hair loss and promote the regrowth of lost hair. Learn more about these medications for hair loss treatment and find out how they promote hair growth. 

How They Work

Minoxidil is a vasodilator, meaning it widens the blood vessels to increase blood flow to the scalp. This action increases the supply of nutrients to the hair follicles and strengthens them, which is believed to play an important role in its ability to cause hair growth. 

Finasteride was initially approved for treating an enlarged prostate gland in men. However, it was discovered that the mechanism by which finasteride works also slows hair loss. The hair growth cycle consists of phases of active hair growth (anagen) and rest (telogen). Studies have shown that finasteride promotes hair conversion into the anagen (active growth) phase.

The key difference between minoxidil vs finasteride in terms of how they work is that minoxidil acts locally in the balding area, whereas finasteride acts systemically. Both can lead to increased hair growth and hair density in men with androgenic alopecia.

Dosage Forms

Minoxidil is a topical treatment that is applied directly to the skin in the affected area. It comes in the form of a minoxidil spray and minoxidil solution. You can also get it as a shampoo, foam, or serum. Topical minoxidil products come in 2% and 5% strengths.

Finasteride (brand name Propecia) is a prescription medication available as a pill. The recommended dose for male-pattern hair loss is 1 mg once a day. Note that a higher dose of 5 mg (brand name Proscar) is also available for benign prostatic hyperplasia.

Side Effects

Minoxidil: Common side effects of minoxidil include dizziness, fainting, and a fast heart rate. Burning or stinging at the scalp application site is also expected.

Finasteride: Potential side effects of finasteride include decreased libido, trouble getting or maintaining erections, decreased ejaculate volume, and enlarged or painful breasts. You should inform the prescribing physician if you experience these side effects.

How To Get Them: Prescription vs OTC

• Minoxidil (brand name Rogaine) is available over-the-counter. 

• Finasteride (Propecia) is a prescription drug.

Approved Uses

Minoxidil is safe for use in both men and women. 

Oral finasteride is prescribed to adult men only and is not recommended for use by women or individuals under the age of 18. Finasteride is teratogenic, meaning it can cause congenital abnormalities in the baby if taken during pregnancy. 

Results

Minoxidil: It takes an average of 6-12 months to see new hair growth after starting minoxidil use. This medication must be used indefinitely for continued benefits, meaning that discontinuing minoxidil can lead to hair loss again. 

Finasteride: After a few months of finasteride treatment, improvements in hair growth are seen. However, treatment must be continued to maintain the effect. In other words, if oral finasteride is discontinued, the balding process starts again. 

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Effectiveness of Minoxidil vs Finasteride

Do Finasteride and Minoxidil Regrow Hair?

Yes, finasteride and minoxidil regrow hair in men with male pattern baldness. Women with female pattern baldness can also benefit from minoxidil.

Finasteride vs Minoxidil: Which is Better?

According to experts at Harvard University, finasteride is more effective than minoxidil in treating hair loss. Up to two-thirds of people who use finasteride for male pattern baldness report good results in terms of new hair growth. 

Study results also suggest that finasteride is better than minoxidil. A small randomized, open study of oral finasteride vs minoxidil solution found finasteride to be superior to minoxidil. In this study, men with androgenetic alopecia either took finasteride 1 mg per day or used minoxidil solution 5% twice a day. After 12 months, 80% of men in the finasteride group reported increased hair density compared to 52% in the minoxidil group.

Which Is Better For Treating Your Male Pattern Baldness?

Several factors can drive the choice between minoxidil vs finasteride for male pattern baldness. 

For example, a treatment plan of finasteride for hair growth can be expensive in the long term. Remember, you need to continue taking the medication for continued benefits. Compared to a monthly cost of around $10-15 for minoxidil, finasteride treatment costs approximately $50-75. 

Also, finasteride can cause rare sexual side effects such as erectile dysfunction (impotence) and decreased libido, as well as mood changes in some men. The sexual dysfunction can persist after finasteride is discontinued.

Can I Use Minoxidil and Finasteride Together?

Yes, men can use both medications (Propecia and Rogaine) to improve hair growth. Both finasteride and minoxidil are FDA-approved treatments for male hair loss. 

Studies have shown that taking finasteride and minoxidil together is safe and beneficial for hair loss. Each medication has a different mechanism of action: Minoxidil increases blood flow to the hair follicles and promotes new hair growth, whereas finasteride protects the hair follicles from the effects of DHT (the testosterone hormone).

Is There a Finasteride Minoxidil Combined Product?

Yes, you can obtain finasteride and minoxidil as a compounded topical product. You can also combine topical minoxidil and oral finasteride to improve male pattern baldness. 

One randomized, double-blind controlled study compared a mixture of finasteride minoxidil solution (0.25% and 3%) to minoxidil solution (3%) alone. The results showed that the finasteride minoxidil combination significantly promoted hair growth and increased hair density in male androgenetic alopecia. 

Getting professional medical advice before starting either of these drugs is important for a proper diagnosis and risk-benefit analysis. You should know that minoxidil and finasteride do not work for other forms of hair loss, such as hair loss due to stress, hypothyroidism (underactive thyroid), chemotherapy, postpartum hair thinning, or medication side effects.

Read next: Does Levothyroxine Cause Hair Loss? What to Know

Alternatives Options

Alternative treatments for balding include minimally invasive treatments like platelet-rich plasma (PRP) and hair transplants, although no strong scientific evidence supports the use of PRP.

Another option is a hair transplant, which is a surgical procedure that carries some minor risks. 

Men who are looking for less invasive hair loss treatments can use minoxidil and finasteride to promote hair growth. 

Both finasteride and minoxidil are FDA-approved treatments for promoting hair growth on the scalp. They have been proven to be an effective treatment for hair loss when used according to healthcare professional’s medical advice. If you do not get satisfactory results after a year of therapy with minoxidil and finasteride, a hair transplant may be an option. 

Frequently Asked Questions About Minoxidil and Finasteride

Is Finasteride Worth The Risk?

Finasteride is potentially worth the risk. For most men, finasteride is safe and effective in treating male pattern baldness. The benefits of hair regrowth usually outweigh the risks of side effects, which are typically mild and temporary in most men who take finasteride. However, it is important to consult a healthcare provider to discuss potentially serious side effects such as an increased risk of prostate cancer, decreased sex drive, erectile dysfunction, depressed mood, and suicidal thoughts. 

Is It Good To Use Minoxidil and Finasteride Together?

Yes, using minoxidil and finasteride together is an effective treatment for male-pattern baldness. It is safe and has proven more effective than either medication alone. This effect happens because finasteride and minoxidil have different mechanisms of action and can complement each other in promoting hair growth and hair density. 

What Has Worse Side Effects, Minoxidil vs Finasteride?

In general, finasteride has worse side effects than minoxidil. 

Finasteride being an oral medication, can have systemic (body-wide) side effects, including sexual dysfunction and mood changes in rare cases. Studies have also shown an increased risk of prostate cancer in people who took finasteride and other similar drugs. 

On the other hand, minoxidil, being a topical medication, primarily causes localized side effects, such as skin irritation and itching at the site of application. 

Is Minoxidil Pointless Without Finasteride?

Minoxidil is not pointless without finasteride. It can still be effective, and you may get some results from minoxidil alone. However, the bottom line is that you are likely to get much better results if you use minoxidil and finasteride together for male pattern baldness.