Battling hair loss can make you desperate. You might have tried all the internet tips to no avail. Luckily, there are both over-the-counter and prescription options available that have been clinically proven to deliver results. The two leading FDA-approved medications for hair loss are finasteride and minoxidil. Some men see wondrous results with a combination while others only need one. It depends on your needs.

We know how much of an impact hair loss has on your self-confidence. To make finding the right treatment easier, we’ve compiled this guide that compares finasteride and minoxidil in terms of effectiveness, side effects, and results.

Finasteride vs. Minoxidil: What’s The Difference?

First off, let’s talk finasteride. The active ingredient in Propecia®, this drug blocks dihydrotestosterone, the sex hormone that regulates your development during puberty. In adulthood, it can cause hair loss when it binds to hair follicles and makes them unable to grow.

Finasteride is taken orally, and it stops your body from converting testosterone into DHT.

On the other hand, minoxidil is an over-the-counter, topical hair loss treatment that works as a vasodilator. This means it causes your blood vessels to expand (dilate), which improves circulation to the scalp.

Minoxidil is also available as an oral tablet, but this version requires a prescription. Finasteride always requires a prescription, and you should only take it when you have been given the okay by a licensed medical professional.

How Minoxidil Works

Minoxidil as a topical works by stimulating the hair follicles and increasing circulation to the scalp. Orally, it relaxes blood vessels so blood can flow more freely, increasing oxygenated cells and nutrients to your scalp.

Higher doses of minoxidil are used to treat blood pressure, so when it’s prescribed this way for hair loss, it is being used off-label. For this reason, it is extremely important that you work closely with a doctor to ensure you do not experience any adverse reactions or serious side effects.

The FDA has approved minoxidil as a topical treatment for male and female androgenetic alopecia. Its oral counterpart, LONITEN®, is a vasodilator used to manage high blood pressure. The FDA does not currently approve of using LONITEN to treat male pattern baldness, but some doctors will still prescribe it as they believe it can be more effective when absorbed through the digestive tract.

How Finasteride Works

Finasteride is FDA and Health Canada-approved as PROPECIA® for managing hair loss and Proscar® for treating an enlarged prostate due to benign prostate hyperplasia. It is taken as a 1-mg tablet once per day, and results tend to emerge within 90 days of treatment.

Although topical finasteride is also available, it is not currently approved by the FDA or Health Canada.

As a DHT blocker, finasteride is an 5-alpha-reductase inhibitor. This means it stops the 5-alpha-reductase enzyme from converting your body’s testosterone into dihydrotestosterone.

The goal of finasteride is to block DHT from damaging your hair follicles in hopes of promoting stronger, fuller hair.

Finasteride vs. Minoxidil Side Effects

There are possible side effects for either medication, and each one is unique depending on how you take the drug.

Potential side effects of oral finasteride are:

• Chills
• Confusion
• Cold sweats
• Dizziness or lightheadedness

Less common potential effects include swelling of the face or limbs, hives, a skin rash, redness, tingling in the hands or feet, and weight loss or gain.

In rare cases, some patients may experience an inverted nipple or bloody discharge from the nipple, dimpling of the breast tissue, a lump in the breast or under the arm, and other changes to the chest and nipple regions.

Possible side effects of topical finasteride include:

• A scalp rash (pruritus)
• A burning sensation
• Irritation
• Contact dermatitis
• Reddening of the skin (erythema)  

Oral minoxidil carries a risk of cardiovascular problems, including swelling of the tissue around the heart (pericarditis) and increased fluid around the heart (pericardial effusion). Because of this risk, the oral route of minoxidil should only be taken with careful consideration and under the supervision of a skilled doctor.

Potential topical minoxidil side effects are scalp irritation and contact dermatitis. It is important to weigh the potential effects of each drug before deciding on the right type for you.

Finasteride and Minoxidil: Should I Use One or Both?

When it comes to treating hair loss, you’re likely willing to do whatever it takes to see results. This may make combining the two most popular medications seem like a good idea, but it’s best to get a professional’s opinion.

Taking both finasteride and minoxidil can yield good results, but it can increase the risk of side effects.

It is possible to take topical or oral finasteride and minoxidil together. A doctor can help you determine which combination and dosage is right for you.  

Minoxidil vs. Finasteride: Differences and Similarities

There are several key differences to know when comparing finasteride and minoxidil:

• Finasteride is an oral prescription medication.
• Minoxidil is a topical medication that you can buy over-the-counter.
• Finasteride treats hair loss by targeting DHT.
• Minoxidil promotes hair growth by improving blood flow to the scalp.

Both drugs target hair loss but in different ways; both are available in oral and topical treatments, but finasteride is only approved to treat hair loss as an oral drug while minoxidil is only approved to treat hair loss as a topical medication.

Finasteride vs. Minoxidil Results

Both medications can be effective, but research suggests that finasteride may deliver more substantial results than minoxidil. In a random, open comparative study, both drugs performed well, but finasteride was slightly more effective than minoxidil.

A 2012 combined study of men with androgenic alopecia found that a combination of 3% minoxidil and 0.1% finasteride was more effective than individual treatments. A 2020 study further supports the increased efficacy of a combined approach.

When it comes to seeing results, finasteride typically takes three months to deliver results. Minoxidil takes between four to six months to demonstrate noticeable hair growth.

How to Choose Between Finasteride and Minoxidil

When it comes to getting the best treatment for hair loss, there are several factors to consider.

The Underlying Cause

Hormonal issues may make finasteride the better choice for some people. Minoxidil is best at targeting male and female androgenetic alopecia. Finasteride has been favored by providers for treating male pattern baldness because of its DHT-blocking approach.

Treatment Preferences

People who dislike taking oral tablets may prefer topical minoxidil over the irritability risks of topical finasteride. However, since both drugs are available in topical formats, it’s worth discussing them in detail with a doctor.

Severity of Hair Loss

Finasteride may work better in more advanced stages of alopecia in both men and women. If you have hair thinning or shedding, then minoxidil might deliver the results you’re looking for at a lower price point.

If you’d like to explore your treatment options, reach out to Phoenix. Our team of licensed doctors can walk you through the pros and cons of each to help you find the best treatment for male pattern baldness for your unique case.

We tackle two of the most personal men’s health issues: hair loss and erectile dysfunction. Connect with a provider who understands. Our conversations are always private and confidential through text. Get started with our free screening!

Sources:

• https://my.clevelandclinic.org/health/articles/24555-dht-dihydrotestosterone
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691938/
• https://www.ncbi.nlm.nih.gov/books/NBK513329/
• https://www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canada/safety-reviews/summary-safety-review-finasteride-assessing-potential-risk-serious-muscle-related-side-effects.html
• https://www.mayoclinic.org/drugs-supplements/finasteride-oral-route/side-effects/drg-20063819
• https://pubmed.ncbi.nlm.nih.gov/35238144/#:~:text=Topical%20finasteride%20reduces%20the%20potential,%2C%20contact%20dermatitis%2C%20and%20erythema.
• https://wimpoleclinic.com/blog/minoxidil-combined-with-finasteride-an-expert-review/
• https://pubmed.ncbi.nlm.nih.gov/15316165/
• https://www.semanticscholar.org/paper/Efficacy-and-safety-of-3-minoxidil-versus-combined-Tanglertsampan/a6692a473a3e6ee74f92d5384b5ba55508d17376
• https://www.semanticscholar.org/paper/The-Efficacy-and-Safety-of-Finasteride-Combined-for-Chen-Zhang/7281bc0142454cd8000b48e71d833037fb858dda

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