Finasteride and Minoxidil: Should I Use One or Both?

We get it: Dealing with hair loss is rough. Frantically searching for every hair loss treatment under the sun and wondering if you can double — or even triple — up on treatments is completely understandable.

In your search for male pattern baldness solutions, two treatment options have probably come up: finasteride and minoxidil.

Minoxidil (the active ingredient in Rogaine®) and finasteride (the active ingredient in Propecia®) have both been around for decades and are commonly used to treat male pattern hair loss.

But which is most effective at encouraging hair regrowth? Will one give you a better shot of replenishing the full head of hair you had in your youth? Can you use minoxidil and finasteride together?

Below, we’ll explain how finasteride versus minoxidil works and the results they produce. We’ll also discuss whether you can use these two hair loss treatments together to stop thinning hair and regrow a thicker, fuller mop.

How Minoxidil and Finasteride Work

To understand which is better for hair loss — minoxidil versus finasteride — or whether they can be used together, let’s first talk about how each treatment option works.

Finasteride and minoxidil are both FDA-approved for the treatment of androgenetic alopecia, also known as male pattern baldness.

Each is supported by significant evidence, though there are a few major differences in the ways these medications work to stop hair loss and promote hair growth.

How Minoxidil Works

Minoxidil is available as a topical treatment, either as minoxidil foam or a liquid minoxidil solution in 2% and 5% dosages. Both formulas are applied directly to the scalp.

Originally used to treat high blood pressure, an unexpected side effect of minoxidil was discovered: hair growth.

Topical minoxidil is a vasodilator that works to stimulate hair growth by widening the blood vessels inside your scalp. This may help promote 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 the anagen phase of your hair’s natural growth cycle.

Your hair goes through a cycle, referred to, of course, as the hair growth cycle. It consists of three phases: anagen (growth phase), telogen (resting phase) and catagen (shedding phase).

Minoxidil extends the growth phase, allowing your hair to grow for a longer period before shedding. It also shifts dormant hairs, such as those in the telogen phase, into the anagen phase to stimulate hair growth.

You can think of minoxidil as a tool for stimulating hair growth and maintaining the hair you already have. While results depend on how long it takes minoxidil to work, hair regrowth can usually be seen after eight weeks of treatment.

How Finasteride Works

FDA-approved not only for male pattern baldness but also for an enlarged prostate, finasteride works by stopping your body from producing dihydrotestosterone (DHT), a hormone that causes male pattern baldness.

DHT is produced as a byproduct of testosterone. The hormone is essential in early life and adolescence, when it plays a major role in the development of genitals and secondary sex characteristics, like facial and body hair.

As an adult, DHT can attach to receptors in the scalp and cause hair follicles to gradually miniaturize. Over time, this can impact your hair’s natural growth cycle and, eventually, stop hairs from growing at all.

DHT normally affects hair follicles near the hairline and crown first. This results in the classic receding hairline that often develops in the early stages of male pattern baldness.

Finasteride is a 5-alpha-reductase inhibitor, meaning it blocks the action of the enzyme 5-alpha-reductase. This enzyme is involved in converting testosterone into DHT.

The medication is available as a topical finasteride solution, though topical finasteride is not currently approved by the FDA for hair loss treatment.

Finasteride also comes as an oral tablet prescribed in either 1-milligram (mg) or 5-milligram dosages, with the 1-milligram dose typically prescribed for hair loss.

Finasteride and minoxidil essentially treat hair loss from different angles.

Minoxidil is a topical medication that works like a fertilizer, giving your hair the nutrients it needs to grow to its full potential. Finasteride for hair loss, on the other hand, is more like a shield that protects your hair follicles from damage caused by certain hormones.

Finasteride vs. Minoxidil Side Effects

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 rare and relatively mild, common 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.

The idea of a hair loss treatment causing more hair loss seems ironic, but don’t worry — it’s usually temporary, and you should start to notice a higher hair count within a few months of use.

Side effects of finasteride are also relatively uncommon, and they can differ between oral finasteride and the topical solution.

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

• Erectile dysfunction (ED)

• Changes in ejaculatory volume

• Decreased libido

Meanwhile, a few rare topical finasteride side effects have been reported, including:

• Lightheadedness

• Headaches

• Testicular pain

There can also be drug interactions between oral or topical finasteride and other medications, vitamins or supplements you take that cause unusually high concentrations of the drug in your blood.

While not considered serious side effects, these finasteride interactions may result in skin irritation, reduced libido or allergic reaction.

Finasteride vs. Minoxidil Results

Now for the question you really want answered: How do minoxidil and finasteride results compare? Who’s the winner in the finasteride versus minoxidil showdown?

Drumroll, please…the answer is: both.

Sorry if you were expecting a more partial opinion. But the fact is, several studies on minoxidil and finasteride results show both hair loss treatments are highly effective.

• A study looked at 904 men with androgenetic alopecia. After using a minoxidil 5% dosage twice a day for a year, 62 percent saw a significant decrease in hair loss.

• Other studies found that both the 2% and 5% minoxidil concentrations showed improved hair density compared to a placebo after 16 and 26 weeks.

• After 48 weeks of treatment, 45 percent of 278 patients saw more hair growth using 5% minoxidil versus the 2% concentration.

Meanwhile, finasteride results are comparable to minoxidil and just as noteworthy.

• A study carried out in Japan looked at over 500 men with male pattern baldness. It found that more than 99 percent of participants experienced no worsening of their hair loss during treatment with 1 milligram of finasteride.

• In the same study, 91.5 percent of the men experienced improvements in hair growth while using finasteride.

• In another large Japanese study of over 3,000 men, over 36 percent experienced moderate hair regrowth, while 11 percent had significant hair growth over three years.

• Topical finasteride was also found to significantly increase hair growth in over 300 men compared to a placebo. These results were similar to the DHT-blocking effects of oral finasteride.

Results of Finasteride and Minoxidil Together

Minoxidil versus finasteride offer very similar results, but what about using them together?

Fortunately, research says a combined treatment is not only safe but may also slightly improve hair loss.

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

• A review of several randomized controlled trials found that a combined treatment of oral finasteride and topical minoxidil 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 combo group showed a greater appearance of reduced hair loss, although there wasn’t a difference in actual new hair growth.

Since they work in different parts of the body, there’s no risk in taking finasteride and minoxidil together.

In fact, as the above studies show, you might get better results using finasteride and minoxidil together than by only taking one medication to treat hair loss.

How to Choose Between Finasteride and Minoxidil

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:

• Both minoxidil and finasteride are options for anyone starting to notice thinning hair, a receding hairline or other signs of male pattern baldness.

• You don’t need to have a minimum level of hair loss to use minoxidil or finasteride. However, you should have realistic expectations about what minoxidil and finasteride can do and understand that you may not be able to get all your hair back.

• 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 without having to visit a healthcare provider.

• Minoxidil foam may be preferable compared to the topical minoxidil solution. Why? It dries faster, plus the foam speeds up the delivery of the medication to the hair follicles.

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

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

Minoxidil vs. Finasteride: Choose One or Use Both?

If hair loss treatments were advertised like boxing matches, this one might be called “Finasteride vs. Minoxidil: Battle Royal.”

In reality, both treatments are incredibly effective and can even be used together. We’d like to reimagine the duo as partners, not competitors, in “Finasteride & Minoxidil: A Match Made in Hair Loss Heaven.” Certainly not as entertaining, though.

• Minoxidil, available as a foam or liquid solution, is a topical vasodilator that works by increasing blood flow to the scalp and shifting hair follicles into the growth phase of the hair growth cycle.

• Meanwhile, finasteride is a DHT blocker that works by protecting your hair follicles from damage that causes male pattern baldness in the first place. You can get finasteride as an oral medication in tablet form or as a topical solution.

• Plenty of studies show that both treatments are highly effective at hair restoration — they’re generally well-tolerated too. Research also shows that they work best together to treat hair loss from multiple angles (externally and internally).

There are several ways to treat hair loss.

Supplements like biotin gummies might encourage hair growth if you have a biotin deficiency. And using products like thickening shampoo with saw palmetto or volumizing shampoo and conditioner for thinning hair can give your locks some lift.

Want to learn more about slowing or reversing hair loss? Browse our hair loss treatments for more information and products.