Finasteride & Minoxidil: The Most Effective Hair Loss Combo?

Out of all of the hair loss treatments out there, two options stand out among the rest: finasteride and minoxidil. But what’s the difference between the two? And is it possible to use both at the same time? Let’s look at finasteride vs. minoxidil.

Below, we’ll explain how finasteride and minoxidil work, review the research on both medications and explore their potential side effects. We’ll also discuss how you can use these two hair loss treatments together to stop thinning hair and help regrow thicker, fuller hair.

Minoxidil (the active ingredient in Rogaine^®) and finasteride (the active ingredient in Propecia^®) have both been around for decades, and plenty of research supports the claim that they can slow down male pattern hair loss.

The Food and Drug Administration has approved both oral finasteride and topical minoxidil for treating male androgenetic alopecia, also known as male pattern baldness. Topical finasteride and oral minoxidil are also available with a prescription for treating hair loss, though they’re not specifically FDA-approved, at least not yet.

Significant evidence supports both minoxidil and finasteride as effective treatments for hair loss. However, there are a few major differences in how these medications stop hair loss and promote hair growth, so it’s important to understand the differences between minoxidil and finasteride.

How Minoxidil Works

Before we dive into finasteride vs. minoxidil, we’ll do a quick recap on how each medication works.

Topical minoxidil is a hair loss treatment and is available as foam or a liquid solution. Both formulas are applied directly to the scalp.

Topical minoxidil is a vasodilator, which means it widens your blood vessels. It stimulates hair growth by boosting the circulation in your scalp, which promotes blood flow to your hair follicles — the tiny organs throughout your scalp from which individual hairs grow.

In addition to increasing blood flow, experts think minoxidil lengthens your hair growth cycle's anagen phase (the growth phase), allowing your hair to grow for a longer period before shedding.

One of the benefits of minoxidil is that it can treat other types of hair loss, including female pattern hair loss and stress-related hair loss.

How Finasteride Works

Finasteride stops your body from producing dihydrotestosterone (DHT), which causes male pattern baldness.

DHT is an androgen (male hormone) that’s essential in early life and adolescence. But when you’re an adult, DHT can attach to receptors in your scalp and gradually cause hair follicles to shrink. Over time, this can impact your hair’s natural growth cycle and stop hairs from growing.

Some men have higher DHT levels, and thanks to genetics, the androgen receptors in your scalp might be particularly sensitive to DHT.

An enzyme called 5-alpha-reductase plays an important role in converting testosterone into DHT. Finasteride 5-alpha-reductase inhibitor, which means it reduces testosterone's conversion into DHT. Unlike minoxidil, which can treat a range of hair loss, finasteride is only recommended for male pattern baldness.

Now for the question that brought you here: is minoxidil or finasteride more effective?

Not to be Switzerland, but when it comes to finasteride vs. minoxidil, there really isn’t a better or worse option.

One old 2004 comparative study found that oral finasteride was slightly more effective than minoxidil in treating androgenetic alopecia — but the authors point out that this difference was only slight.

There are a few things that may help you decide when it comes to finasteride vs. minoxidil:

• Finasteride is only approved for men, whereas minoxidil can be used by men and women (there are different formulas for each sex).

• Because it works on a hormone-level, finasteride can only treat male pattern baldness, whereas minoxidil can treat many types of hair loss including telogen effluvium and certain types of alopecia.

• In rare cases, oral finasteride may cause sexual side effects, whereas the side effects of topical minoxidil tend to be localized to the application site (aka your scalp).

• The two medications work comparably — the jury’s out on whether either minoxidil or finasteride is more effective at stopping hair loss or encouraging regrowth.

• The most effective hair loss medication is actually finasteride and minoxidil used together.

Minoxidil and finasteride offer similar results, but what about using them together? Team work really does make the dream work, because finasteride and minoxidil are more effective together than either used alone.

There’s a lot of research indicating that a combined treatment is safe and may be more effective than one alone. In fact, since finasteride and minoxidil work in different parts of the body, there's no risk in taking them together.

• A study published in the Indian Dermatology Online Journal found that switching from oral finasteride to topical finasteride allowed patients to maintain good hair density when combined with ongoing use of topical minoxidil.

• A review of several randomized controlled trials found that a combined oral finasteride and topical minoxidil treatment had better results and was just as safe as using either treatment alone.

• A small 2012 double-blind study of 40 men compared topical minoxidil with a combination of topical finasteride and minoxidil. The group who took the combo seemed to have a greater reduction in hair loss, although there wasn’t a difference in new hair growth.

Doctors also agree that this combination is best.

“Finasteride and minoxidil work synergistically to help with hair growth,” says Dr. Knox Beasley, a board-certified dermatologist and a fellow of the American Academy of Dermatology (and one of our medical reviewers). “I recommend using the combo to my patients whenever possible."

Now that you’re up to speed on all things finasteride and minoxidil, how do you choose which one to use?

Here’s what to keep in mind when weighing your options:

• If you only have mild hair loss, you might want to start with minoxidil before trying other medications. As an over-the-counter drug, minoxidil is easy to add to your hair loss prevention routine.

• Finasteride and minoxidil are both safe to use, but side effects are always possible. If one causes uncomfortable side effects, the other might be a better option.

• If you want to try a combination treatment, consider this topical finasteride and minoxidil spray. It might even be the only hair loss treatment you need as an easy-to-use, two-in-one product.

• Or, if you don’t mind taking separate hair loss medications, you can try oral finasteride, which can be safely used with topical minoxidil.

• We also offer access to a prescription hair loss chewable which combines finasteride and minoxidil with other supplements for hair health.

• These medications work best before you’ve lost a significant amount of hair, so it’s best to start treatment at the first sign of hair loss (but it’s better late than never).

Clinical trials have shown that both medications are relatively safe and effective for hair loss. But like all prescription and over-the-counter drugs, there’s still a chance of experiencing finasteride and minoxidil side effects.

Although uncommon and relatively mild, the potential side effects of minoxidil include:

• Skin irritation

• Burning sensation

• Dry, itchy skin

• Exacerbation of seborrheic dermatitis

• Excessive hair growth

Since minoxidil interrupts the hair growth cycle, it may cause you to shed slightly more hair during the first few months of use. This is usually temporary, and you should notice a higher hair count within a few more months.

The side effects of finasteride treatments can differ depending on whether you’re using oral finasteride or a topical solution.

The oral tablet can lead to sexual side effects that may affect your sexual function or enjoyment, like:

• Erectile dysfunction (ED)

• Changes in ejaculatory volume

• Decreased libido

Topical finasteride side effects are uncommon, but a few have been reported, including:

• Lightheadedness

• Headaches

• Testicular pain

Although weighing the merits of minoxidil vs. finasteride is tempting, both hair-loss medications are incredibly effective and can even be used together.

We’d like to reimagine the duo as partners, not competitors — a match made in hair growth heaven.

Here’s what you need to know:

• Minoxidil works by increasing blood flow to the scalp and shifting hair follicles into the growth phase of the hair growth cycle.

• Finasteride is a prescription treatment. It’s available as a topical or oral medication. Both work by protecting your hair follicles from DHT, a hormone that damages your hair follicles and causes male pattern baldness.

• They’re effective — especially when used together. The combination of finasteride and minoxidil is safe and can help you restore some of the hair you’ve lost and keep you from losing more.

Whether you choose finasteride, minoxidil, or a combination of the two, time is of the essence. Delaying your treatment can lead to further hair loss.

We can help you book an online consultation with a healthcare professional, which means you can get medical advice on hair loss from your home. Together, you can assess your hair loss and determine a suitable treatment plan.