Saw Palmetto vs. Finasteride for Hair Loss

If you’re just beginning to look into hair loss treatments or are the kind of person who always tries the natural option first, you may be wondering about saw palmetto versus finasteride for hair loss.

Saw palmetto is an herbal supplement, and finasteride is a prescription medication — but the two share critical similarities and differences. While they work in similar ways and are both used in the treatment of androgenetic alopecia (male pattern baldness), saw palmetto isn’t quite a natural “dupe” for finasteride.

Below, we’ll cover how each treatment works and touch on whether saw palmetto or finasteride is more effective for hair loss.

Before we dive into how saw palmetto and finasteride work, it’s important to understand what causes male pattern baldness in the first place. For starters, male pattern hair loss is the most common type of hair loss in men, affecting 30 to 50 percent by age 50.

Also known as male androgenetic alopecia or AGA, the condition is caused by a mix of genetics and hormones. Specifically, some men have a genetic sensitivity to ‌dihydrotestosterone (DHT), an androgen (male hormone) that’s a byproduct of testosterone.

Here’s the basics of how this works:

• Men need DHT — at least early on. The male hormone helps develop male characteristics in utero and plays a vital role in growing facial hair and deepening the voice.

• But inside the hair follicles are androgen receptors. After puberty, in those who are genetically predisposed to its effects, DHT binds to those receptors and begins to shrink hair follicles.

• Too much DHT shrinks hair follicles. This process is also known as hair miniaturization. Smaller, miniaturized follicles mean patchy or thinning hair and, ultimately, hair loss in men.

Blocking DHT to Treat Hair Loss

Some ingredients are able to slow the conversion of testosterone into and block DHT’s ability to enter the follicle. That’s a good thing for your hair health.

The reason for explaining this before we even touch on saw palmetto or finasteride is that both hair loss treatments are thought to be at least partial DHT blockers.

This means they can reduce how much DHT binds to hair follicles, which, in turn, can slow or stop hair loss — and in some cases, spur new hair regrowth.

Read on for more specifics on how saw palmetto and finasteride work.

Saw palmetto is a small palm plant found mostly in the southeastern United States. It’s also called Serenoa repens.

Commonly used in herbal medicine, saw palmetto extract is made from the plant’s fruit and seeds. It’s often taken orally in a capsule, tablet, or liquid or used topically. You might also see it in tea.

How Does Saw Palmetto Work?

The dietary supplement is sometimes used to treat symptoms of an enlarged prostate gland, also known as benign prostatic hyperplasia (BPH). It seems to have an anti-inflammatory effect on the prostate, shrinking it down to a healthy size.

BPH is similar endocrinologically to androgenetic alopecia (meaning they’re both related to hormones). More specifically, both androgenetic alopecia and BPH are linked to excess DHT.

And much of the reason the plant is thought to work for hair loss is because of its effects on BPH.

Research on Saw Palmetto for Hair Loss

In some studies, saw palmetto appears to partially block DHT. It does this by inhibiting 5 alpha-reductase (5AR), the enzyme that converts testosterone to DHT.

Research on saw palmetto and hair loss is limited, but there is some. A meta-analysis looked at both oral and topical saw palmetto and found that 60 percent of those who used it showed improvement in overall hair quality, 27 percent saw an increase in total hair count, and just over 83 percent experienced more hair density.

Saw palmetto has also been used as a diuretic, sedative, aphrodisiac, and nutritional tonic. It may also help treat or prevent bladder and urinary infections or prostate cancer. While we do know a lot about its uses, there isn’t much research specifically on the effects of saw palmetto on hair loss over time.

Oral vs. Topical Saw Palmetto

If you decide to use oral saw palmetto, a liquid extract might be your best bet. Usually available in a tincture bottle with a dropper, this is considered the most potent form.

The powder (which is typically encapsulated) may not have enough fatty acids or phytosterols (plant compounds) to be effective. This means it probably won’t work for hair loss and could potentially be dangerous for those using saw palmetto to treat BPH.

The fatty acids in saw palmetto are the active ingredient — and they’re not water-soluble, so the tea probably isn’t all that effective, either.

Learn more about the botanical extract in our guide to saw palmetto and hair loss.

The best-known DHT blocker is the prescription medication finasteride, the generic version and active ingredient in Propecia®. It’s available in oral and topical form.

We offer both oral finasteride (a pill) and topical finasteride & minoxidil spray (we’ll go into that specific combo of hair loss ingredients a little later).

Finasteride is FDA-approved to treat AGA in men at a 1-milligram daily dose.

It’s also available at a higher 5-milligram dose, but that dosage is only approved for the treatment of BPH (and a higher dosage is not any more effective for treating hair loss, anyway). When used for BPH, the brand name of the drug is Proscar®.

How Does Finasteride Work?

Like saw palmetto, finasteride targets and blocks DHT. It’s very effective in treating male pattern baldness, and (unlike saw palmetto) there’s a bunch of research to back that up.

One of the cool things about finasteride is that its efficacy doesn’t seem to taper off with time. In fact, it’s especially effective if you stick with it.

For example, some research shows that men whose hair hadn’t changed after a year of using finasteride went on to see improvements with continued use. Also, it seems to work best on guys over 30 with more severe AGA.

On the other hand, finasteride only works when you take it — and if you stop taking it, you can expect to be back to your hair’s baseline in about 12 months.

According to the FDA (U.S. Food & Drug Administration), while finasteride starts working on DHT levels immediately, it takes about three months of daily use to see benefits in hair (because it takes time for new hair to be visible).

Research on Finasteride for Hair Loss

A 2019 study of 532 Japanese men looked at the effectiveness of 1 milligram of daily finasteride over a 10-year period. A whopping 99 percent of participants experienced no worsening of hair loss during treatment, and 91 percent showed improvements in hair growth. There were also no significant adverse effects.

Another 2012 study (also on Japanese men) showed that just over 87 percent of those treated with finasteride experienced some degree of hair growth.

If you’re wondering what to expect from finasteride, check out our guide to the typical finasteride results timeline.

There’s little significant evidence supporting the use of saw palmetto for AGA. This news definitely has a womp, womp vibe, but just because there’s not much evidence doesn’t necessarily mean saw palmetto isn’t effective in hair loss — it just means it hasn’t been studied at length.

This is true of many herbal medicines — and still, lots of folks swear by their efficacy (think things like echinacea, vitamin C, ginseng, or valerian root).

Finasteride Is FDA-Approved for Hair Loss

As mentioned, finasteride is FDA-approved. This is promising because the approval process is extensive and rigorous. For any medication to be approved, it has to go through animal studies and clinical trials on humans to prove it does what the manufacturer claims it does.

For this reason, finasteride has far more research backing it than saw palmetto. That’s just the nature of FDA-approved medications versus herbal supplements.

One of the reasons we say finasteride works better for hair loss than saw palmetto is simply that we know so much more about it. But it also does appear to be more efficacious.

Finasteride Is Backed by Clinical Trials

Looking for some stats? We got you.

One clinical trial of 100 male patients compared the efficacy of saw palmetto versus finasteride in treating androgenetic alopecia. Half were treated with 320 milligrams of saw palmetto, while the other half got 1 milligram of finasteride (notably, there was no control group, which is a flaw in the study).

After 24 months, 38 percent of the saw palmetto group and 68 percent of the finasteride group showed an increase in hair growth. Finasteride was effective in the front area of the scalp and on the vertex (that’s the crown area), while saw palmetto was most prominent on the vertex.

Does Saw Palmetto Actually Block DHT?

To answer the question, saw palmetto blocks DHT. But maybe only partially — it’s hard to determine what extent it blocks the hormone.

Even finasteride doesn’t completely block DHT — studies show it blocks prostatic DHT levels by around 90 percent and serum DHT levels by roughly 70 percent.

And if you’re wondering if saw palmetto blocks testosterone, the answer is pretty clear: no. Saw palmetto only partially stops the conversion of testosterone to DHT. It doesn’t lower testosterone levels.

To learn more, check out our guide to saw palmetto benefits.

Consider Combining Finasteride and Saw Palmetto for Hair Growth

One might work better than the other (see: finasteride), but you don’t have to choose between saw palmetto and finasteride. The two can be used together.

For instance, you can pair oral finasteride with a topical solution, like our thickening shampoo with saw palmetto.

Saw palmetto and finasteride aren’t the only hair loss treatments available. If your hair loss doesn’t have a strong hormonal component (like telogen effluvium or traction alopecia), they may not be the right remedies, anyway.

Here’s what else might work for hair loss.

Minoxidil

Topical minoxidil is an over-the-counter vasodilator that brings blood, oxygen, and nutrients to the scalp to assist with healthy hair growth.

This medication also shortens the telogen (resting) phase of the hair growth cycle and extends the anagen (growth) phase. Not only that, but it’s been shown to increase hair length and diameter — as in, the thickness of each stand.

We offer a topical minoxidil foam and a liquid minoxidil solution. They have the same active ingredient and are both 5% strength, but some people with longer hair think the liquid solution with its dropper is easier to get onto the scalp.

Following a consultation with a licensed healthcare provider who can decide what treatment makes sense for you, we also offer a chewable version of oral minoxidil.

Minoxidil and Finasteride Together

As mentioned, you can also pair minoxidil and finasteride. They can be used separately, at the same time, or literally together in a product containing both, like our topical finasteride & minoxidil spray or our finasteride + minoxidil chews.

A 2019 meta-analysis found that the combo of finasteride and topical minoxidil is more effective and similarly safe compared to using one or the other on its own.

Other Hair Loss Treatments

Other medications can help with hair loss, like dutasteride, which also inhibits the 5AR enzyme. Then there’s spironolactone, which is usually only prescribed to women for female pattern hair loss.

Some men might consider hair transplant surgery, platelet-rich plasma treatment, or low-level light therapy (LLLT). But topical minoxidil and oral finasteride are currently the only two FDA-approved hair loss medications.

Saw palmetto and finasteride are both 5-alpha reductase inhibitors. Put differently, both slow the conversion of testosterone to DHT (which causes hair loss in men). But finasteride is much more potent.

Here’s what to know when considering saw palmetto versus finasteride:

• If you’re not interested in medication for hair loss (or you might be at some point but prefer to try a botanical option first), saw palmetto is a good place to start.

• Finasteride is more powerful than saw palmetto in treating hair loss. Not only is there much more research backing it, but studies comparing the two show that finasteride is more effective.

• Saw palmetto and finasteride are both generally well-tolerated. Side effects of finasteride and saw palmetto vary but may include gastrointestinal issues or sexual dysfunction, including low libido (reduced sex drive). These side effects are definitely not the norm, though.

Ready to take the next step? Explore hair loss treatments from Hims or connect with a healthcare provider online about your options.