Finasteride vs. Minoxidil: Which Is Best For Treating Hair Loss?

By age 35, two-thirds of all American men will experience hair loss, and 85% will have significantly thinning hair at age 50. [1]

With androgenetic alopecia, or male pattern baldness, being so common, there are many treatment options available to help slow the thinning process, and even promote hair regrowth. Choosing the right one is important to help you take it consistently and get the best results possible.

Let's look at two of the most popular hair loss treatments: finasteride (Propecia) and minoxidil (Regaine). We'll explore how they work, which is more effective, and what their differences are so you can decide which is best for you.

How does finasteride work?

Finasteride prevents the conversion of testosterone into another hormone, dihydrotestosterone (DHT). [2] High levels of DHT can have a number of effects on the body, including causing male pattern hair loss. When DHT is in your bloodstream, it can bind to hair follicles on your scalp and shrink them over time. This reduces both hair diameter and density, leading to thinner, more brittle hair that sheds faster.

By blocking the enzyme that helps create DHT, finasteride can aid hair regrowth. In clinical trials, 83% of men taking finasteride 1 mg/day for two years experienced no further hair loss, and 66% showed increased hair growth. [3]  It's shown to increase both hair count and hair density compared to placebo, resulting in a thicker, fuller head of hair than those not taking finasteride. [2]

How does minoxidil work?

Minoxidil works differently to finasteride. It's a peripheral vasodilator, which simply means it helps widen blood vessels to increase blood flow through them. [4] This allows more oxygen, blood and nutrients to reach your hair follicles, which stimulates hair growth. It also extends the time each follicle spends in the growth phase of the hair growth cycle, resulting in increased hair thickness. [5]

Clinical trials show that 84.3% of men find that minoxidil helps them achieve hair regrowth, with 5% topical minoxidil being the most effective strength. [6, 7]

Which is better: finasteride or minoxidil?

Here’s how finasteride and minoxidil compare side by side:

Neither finasteride nor minoxidil is definitively the most effective hair loss treatment. They work in different ways, and the most suitable option for you depends on several factors, including: age, pattern of hair loss, general health and tolerance of side effects. 

Finasteride tablets are the most effective oral option among clinically approved treatments for men with male pattern hair loss. They’re prescription only, and often come with more side effects than topical treatments.

Oral minoxidil also requires a prescription, but liquid and foam formulations can be purchased over the counter. These topical treatments come with fewer side effects than oral medications. 

Whichever medication you choose, the key to successful treatment is consistency. 

For maximum effectiveness, you need to apply topical minoxidil directly to your scalp twice a day. Similarly, oral finasteride is only effective as long as you’re taking it. It only takes 24 hours for the levels of finasteride in your system to become too low to stop DHT production, so skipping doses could lead to more hair loss. Keep this in mind when you start treatment. 

It can take up to six months to notice visible improvements, so stick with it to get the best results possible. 

Take control of hair loss

Our expert clinicians can prescribe you a treatment that could slow hair loss, and even help you regrow your hair. Start a consultation here. 

References

1. Men’s Hair Loss [Internet]. American Hair Loss Association. Available from: https://www.americanhairloss.org/mens-hair-loss/
2. McClellan KJ, Markham A. Finasteride. Drugs. 1999;57(1):111–26.
3. Kaufman KD, Olsen EA, Whiting D, Savin R, DeVillez R, Bergfeld W, et al. Finasteride in the treatment of men with androgenetic alopecia. Journal of the American Academy of Dermatology [Internet]. 1998 Oct 1;39(4):578–89. Available from: https://www.sciencedirect.com/science/article/abs/pii/S019096229870007
4. Badri T, Nessel TA, Kumar D D. Minoxidil [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482378/
5. Suchonwanit P, Thammarucha S, Leerunyakul K. Minoxidil and its use in hair disorders: a review. Drug Design, Development and Therapy. 2019 Aug;Volume 13:2777–86.
6. Rundegren J. A one-year observational study with minoxidil 5% solution in Germany: results of independent efficacy evaluation by physicians and patients. Journal of the American Academy of Dermatology. 2004 Mar;50(3):P91.
7. Olsen EA, Dunlap FE, Funicella T, Koperski JA, Swinehart JM, Tschen EH, et al. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. Journal of the American Academy of Dermatology. 2002 Sep;47(3):377–85.