Finasteride vs Minoxidil
It’s completely normal to lose some hair every day, but if you’re shedding more than 100 hairs a day and they’re not growing back, you may have a form of alopecia (hair loss). There are different types of hair loss, some of which are temporary. However, male pattern baldness and female pattern baldness are progressive and can require treatment.
The main treatments for male pattern baldness are finasteride and minoxidil. Both treatments work very differently and have different side effects – so which one is right for you?
Keep reading to find out more about finasteride and minoxidil and what to expect from finasteride and minoxidil results.
How does finasteride work?
Finasteride is a 5-alpha reductase inhibitor, meaning it inhibits the enzyme that converts testosterone into dihydrotestosterone (DHT). DHT is the primary hormone involved in male-pattern hair loss. When present, it causes the growth phase of your hair follicles to gradually decrease, resulting in finer, shorter hairs until the growth phase is so short that you no longer grow hair (follicular miniaturisation).
Finasteride therefore causes there to be less DHT present in the scalp (around 60% less), preventing further hair loss and, in some cases, promoting hair regrowth.
How to take finasteride
You can take finasteride around the same time every day as a pill. The usual dose is 1mg.
Historically, finasteride has been used at a higher dose to treat an enlarged prostate. To treat hair loss, you will need to get finasteride on a private prescription. This means it is not covered by the NHS, and you will need to pay the full cost of the medicine.
You may need to take finasteride for a few months to find out whether it’s working for you. If it does work, you’ll need to keep taking it or the effects will stop. Unfortunately, finasteride doesn’t always work as well for men over 60.
Finasteride isn’t usually prescribed to people born female because it can:
- interfere with the effectiveness of birth control medication
- cause changes in your menstrual cycle
- cause foetal development problems during pregnancy
How does minoxidil work?
It is not fully understood why minoxidil is effective in hair loss. Minoxidil is a vasodilator, which means it widens the blood vessels. As a result, it was originally licensed to treat high blood pressure. However, when it’s applied as a topical solution to your scalp, it causes your scalp blood vessels to widen and allow more nutrients and oxygen to flow to your follicles and stimulate hair growth.
There are likely other mechanisms at work alongside this. For example, it is known that minoxidil acts to extend the growth phase of the hair growth cycle. This means it increases both hair follicle size and hair diameter.
How to use minoxidil
Minoxidil for hair growth is available over the counter in liquid, foam and shampoo forms. It is most effective when applied to the skin of the scalp once a day (for women) or twice a day (for men).
It will take at least six months of treatment to prevent further hair loss and to start hair regrowth. It may take a few more months to tell whether the treatment is working for you. If it does work, you will need to keep taking minoxidil or the effects will stop.
Minoxidil is usually suitable for people born female, unless you’re pregnant or breastfeeding.
Finasteride and minoxidil side effects
Finasteride and minoxidil have different side effects based on their different methods of action. Because finasteride is taken orally, its side effects can appear throughout your body. Minoxidil, however, typically only produces side effects in the area it is applied to.
Here are the main side effects of finasteride and minoxidil:
| Finasteride | Minoxidil |
| Reduced sex drive | Contact dermatitis |
| Erectile dysfunction | Redness |
| Ejaculation dysfunction | Skin irritation |
| Mood changes (e.g. depression) | Rash |
| Weight gain | Hair shedding |
| Hair shedding | Excess facial hair growth |
Generally, however, both finasteride and minoxidil have a good side effects profile, meaning they are well tolerated by most users.
Can you take finasteride and minoxidil together?
As finasteride and minoxidil work in completely different ways, there is no reason why they can’t be used at the same time. In fact, a 2015 study showed that combined medication produced the best hair regrowth.
Ian Budd, one of our prescribing pharmacists, added: “Finasteride addresses the underlying hormonal cause of male pattern baldness, while minoxidil, alongside other possible mechanisms, extends your hair growth cycle and helps your follicles to get the nutrients they need to stimulate hair growth. By combining them, you are effectively taking a dual action approach to your hair regrowth.”
FAQs
Is finasteride better than minoxidil?
Multiple studies have indicated that finasteride is more effective than minoxidil at treating male pattern baldness. For example, one study found that participants treated with finasteride for five years experienced significant hair regrowth and a reduction in hair loss. Another found that 80.5% of men treated with finasteride saw a reduction in hair loss compared to 59% of men treated with minoxidil.
Do finasteride and minoxidil stop beard growth?
While high levels of DHT can prevent the hair on your head from growing, high levels of DHT can actually lead to better beard growth. In theory then, finasteride may inhibit beard growth. However, multiple studies have shown that use of 1mg finasteride a day has little to no effect on beard growth, positive or negative.
While it is not licensed to promote beard growth, there is evidence minoxidil can support beard growth if applied to the beard area. For example, one placebo-controlled study found that the minoxidil group had significantly increased hair count in the beard area compared to the placebo group after 16 weeks of treatment.
Can I stop taking finasteride and start taking minoxidil?
Yes, if you are taking finasteride for hair loss and want to try minoxidil without combining the treatments, you can stop and start taking minoxidil. However, you should speak to your prescriber before making any changes to your treatment approach, as they can help you to come off finasteride gradually before starting to use minoxidil. As finasteride only has an effect on hair growth while you take it, you should expect to see some hair loss before minoxidil starts to work.
Do finasteride and minoxidil cause erectile dysfunction?
Erectile dysfunction is a side effect associated with taking oral finasteride. This may be because having less DHT could affect the balance of hormones responsible for sexual function. Reduced DHT is also thought to affect an enzyme that helps dilate (widen) blood vessels and increase blood flow to your penis to give you an erection.
There is no association, however, between taking minoxidil and erectile dysfunction.
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