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Does Topical Finasteride Work? What Should You Expect

Kristin Hall, FNP

Reviewed by Kristin Hall, FNP

Written by Rachel Sacks

Published 01/12/2021

Updated 09/22/2023

Losing your hair can bring up a ton of emotions, and we’re not exaggerating when we say it can force you to reckon with how you feel about your appearance (not to mention your age). It can make you feel desperate, but luckily, there are solutions. 

You can look at hair restoration, a hair transplant and even hair pieces, but we recommend starting with a hair loss treatment that’s less disruptive and proven effective. Because if you can slow or even stop your balding with a topical medication, why would you want to do more?

Typically sold as an oral medication, finasteride is a proven hair loss treatment option. But what about a topical finasteride solution that can give you the same results and be easily incorporated into your daily hair care routine?

Our question might bring up some of your own. Does topical finasteride work? How do topical finasteride results compare to the usual oral tablet? What do reviews about these products say? We have answers.

What Is Topical Finasteride?

If you’re around 50 years old and dealing with thinning hair or a receding hairline, you’re in good company — male pattern baldness (also known as androgenetic alopecia or androgenic alopecia) affects about 30 percent to 50 percent of men by age fifty.

But no need to worry, as there are two medications approved for hair loss by the Food and Drug Administration (FDA): topical minoxidil (the active ingredient in Rogaine®) and finasteride.

Oral finasteride (sold under the brand name Propecia®) is FDA-approved for the treatment of hair loss, but for some people it can cause sexual side effects like erectile dysfunction and reduced ejaculation.

To reduce those systemic side effects, some may opt for a topical finasteride treatment instead.

But whether applied via a topical application like a spray or gel or taken orally, finasteride works to prevent male pattern baldness in the same way.

Male pattern hair loss is caused by enzymes that are responsible for the conversion of testosterone into the male sex hormone dihydrotestosterone (DHT), a major androgen.

High DHT levels cause the hair follicles — the tiny organs throughout your scalp from which your hair grows — to shrink and reduce, which leads to baldness.

Finasteride is part of a group of medications called 5-alpha reductase inhibitors, which prevent the conversion of testosterone to dihydrotestosterone.

Oral finasteride is absorbed systemically, which means every part of your body from your skin to your liver absorbs it. Topical finasteride, on the other hand, provides localized treatment and is mainly absorbed through your scalp (assuming that’s where you apply it).

Topical finasteride isn’t approved for use by the FDA, but some combination hair loss products (those that include multiple kinds of medication) may contain it in very low concentrations according to a systematic review published in the journal Natural Products and Bioprospecting.

You can learn more about this medication, including how to apply it, in our full topical finasteride 101 guide.

But before you start putting it on your scalp, you probably want to know if topical finasteride is effective. Keep reading to find out what research has been done on topical finasteride results.

Topical Finasteride Results for Hair Growth

There’s plenty of evidence for the effectiveness of oral finasteride, but what about the effectiveness of topical finasteride?

While the current topical finasteride studies are smaller in size, they do have promising results.

A quick helpful note — in the scientific world, “systematic reviews” and “meta-analysis” are words to describe scientific papers that look at multiple clinical studies from a high-level overview without getting into the details.

For example, this 2018 systematic review of seven topical finasteride studies published in the Journal of Drugs in Dermatology found that the medication was correlated with a significant decrease in the rate of hair loss, a significant increase in total hair counts and positive hair growth assessment.

The studies referenced in this review noted a decrease in both scalp DHT and serum DHT levels throughout the body, leading researchers to conclude that the finasteride results were “safe and promising” and recommend continued research and follow-up.

A 2020 review of 33 scientific articles published in the Journal of Dermatological Treatment on topical finasteride had similar findings — the studies “showed positive results with a favorable safety profile,” and the authors called for continued research.

topical finasteride

take on hair loss with an easy-to-use spray

Oral Finasteride vs Topical Finasteride

Current research, while limited, points to topical finasteride as effective at preventing future hair loss and encouraging hair regrowth.

But which should you choose: oral or topical finasteride? That depends.

If you’re wondering how effective topical finasteride is compared to oral finasteride, studies have looked at the results of both.

A study of more than 440 patients that compared the effectiveness of a topical finasteride spray and the oral tablet found that the spray significantly improved hair count compared to placebo but had less of an impact on serum DHT levels than the tablet.

Another study in the Indian Journal of Dermatology comparing the effects of topical finasteride gel against the oral tablet form was carried out on 45 men with androgenetic alopecia. 

By the end of the study, both groups saw similar positive effects on hair growth.

Both seem to be fairly efficient in regrowing hair. And if you want to learn more about the effectiveness of oral finasteride, this article on finasteride results covers all the research behind the other version of this hair loss treatment. 

Of course, only the oral medication is FDA-approved but topical finasteride is often prescribed off-label for hair loss. Many people may opt for the topical solution so they don’t have to deal with the potential side effects of finasteride taken orally.

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Topical Finasteride vs Topical Minoxidil

Topical finasteride isn’t the only topical solution for hair loss. Minoxidil, the other FDA-approved treatment, stimulates hair growth by encouraging blood flow to your hair follicles. It’s also thought that minoxidil lengthens the growth phase of your natural hair growth cycle.

You can try either a minoxidil foam or liquid minoxidil solution drops. Both are applied directly to hair and the scalp.

Typically you can see new hair growth after eight weeks of treatment.

Minoxidil is also a highly effective treatment, with the results of several large-scale studies backing up hair regrowth claims.

In a one-year study of 904 men with androgenetic alopecia, 62 percent saw a significant decrease in hair loss using minoxidil twice a day.

Another study found that after 16 and 26 weeks of treatment, minoxidil led to improved hair density compared to a placebo.

We talk more about the relationship between finasteride and minoxidil in our minoxidil vs finasteride guide.

Oral finasteride is often prescribed in conjunction with topical minoxidil, and evidence suggests the two medications work best side by side.

But this may also be true for a combination of minoxidil and finasteride topical solution.

A study of 50 men with androgenetic alopecia who had been using a combination of topical minoxidil and oral finasteride for two years switched to a topical solution of minoxidil fortified with finasteride. The majority of patients continued seeing improvements in hair density, even after the treatment switch.

Our topical finasteride & minoxidil spray reviews have mentioned new hair growth from this easy-to-use product, as well as a boost in confidence.

Side Effects of Topical Finasteride

Of course, like any medication, topical finasteride has potential side effects. Most often, side effects of topical finasteride are minimal and often occur where the product is applied.

The most common side effects include:

  • Redness at the application site

  • Scalp itching

  • Irritation

However, more research is needed on the potential side effects of topical finasteride

Hair loss treatments, delivered

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Finasteride & Minoxidil

This is the FDA-approved dynamic duo. When used together, men saw better results in clinical trials compared to using either alone.

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Is Topical Finasteride Effective? Final Thoughts

While a gold standard to treat male hair loss, oral finasteride can cause side effects like sexual dysfunction. So, some men may want to try topical finasteride instead. But is this alternative hair loss treatment effective?

  • Topical finasteride treats hair loss the same way as oral finasteride — by blocking the enzyme that converts testosterone into DHT, which means DHT can’t shrink hair follicles and stop new hair from growing. 

  • Although topical finasteride is relatively new (compared to oral medication, anyway) and not FDA-approved, current research shows it’s just as effective as oral finasteride at increasing hair count and density.

  • While studies on topical finasteride results are promising, oral finasteride is FDA-approved for the treatment of androgenetic alopecia, with a significant amount of research to support its safety and effectiveness.

Finasteride and minoxidil are just two ways to treat hair loss. You can also give hair a boost with a volumizing shampoo and conditioner duo.

Certain ingredients are also beneficial for hair, like biotin and saw palmetto. You can easily add these biotin gummies to your daily routine or use a thickening shampoo with saw palmetto as part of your hair care.

Or, if you’d like to learn more about hair loss, you can seek medical advice from a dermatologist or healthcare provider and discuss more hair loss treatments.

12 Sources

  1. Asfour, L., Cranwell, W., Sinclair, R. Male Androgenetic Alopecia. [Updated 2023 Jan 25]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK278957/
  2. Zito, P.M., Bistas, K.G., Syed, K. Finasteride. [Updated 2022 Aug 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513329/
  3. Mysore V. (2012). Finasteride and sexual side effects. Indian dermatology online journal, 3(1), 62–65. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3481923/
  4. Ustuner E. T. (2013). Cause of androgenic alopecia: crux of the matter. Plastic and reconstructive surgery. Global open, 1(7), e64. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4174066/
  5. Ashique, S., Sandhu, N. K., Haque, S. N., & Koley, K. (2020). A Systemic Review on Topical Marketed Formulations, Natural Products, and Oral Supplements to Prevent Androgenic Alopecia: A Review. Natural Products and Bioprospecting, 10(6), 345-365. Retrieved from https://link.springer.com/article/10.1007/s13659-020-00267-9
  6. Lee, S. W., Juhasz, M., Mobasher, P., Ekelem, C., & Mesinkovska, N. A. (2018). A Systematic Review of Topical Finasteride in the Treatment of Androgenetic Alopecia in Men and Women. Journal of drugs in dermatology : JDD, 17(4), 457–463. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6609098/
  7. Suchonwanit, P., Iamsumang, W., & Leerunyakul, K. (2020). Topical finasteride for the treatment of male androgenetic alopecia and female pattern hair loss: a review of the current literature. Journal of Dermatological Treatment, 33(2), 643-648. Retrieved from https://www.tandfonline.com/doi/abs/10.1080/09546634.2020.1782324?journalCode=ijdt20
  8. Piraccini, B. M., Blume-Peytavi, U., Scarci, F., Jansat, J. M., Falqués, M., Otero, R., Tamarit, M. L., Galván, J., Tebbs, V., Massana, E., & Topical Finasteride Study Group (2022). Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial. Journal of the European Academy of Dermatology and Venereology : JEADV, 36(2), 286–294. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9297965/
  9. Hajheydari Z, Akbari J, Saeedi M, Shokoohi L. (2009). Comparing the therapeutic effects of finasteride gel and tablet in treatment of the androgenetic alopecia. Indian J Dermatol Venereol Leprol, 75(1), 47-51. Retrieved from http://bioline.org.br/pdf?dv09011
  10. Patel, P., Nessel, T.A., Kumar, D. D. Minoxidil. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK482378/
  11. Nestor, M. S., Ablon, G., Gade, A., Han, H., & Fischer, D. L. (2021). Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. Journal of Cosmetic Dermatology, 20(12), 3759-3781. Retrieved from https://onlinelibrary.wiley.com/doi/pdf/10.1111/jocd.14537
  12. Chandrashekar, B. S., Nandhini, T., Vasanth, V., Sriram, R., & Navale, S. (2015). Topical minoxidil fortified with finasteride: An account of maintenance of hair density after replacing oral finasteride. Indian dermatology online journal, 6(1), 17–20. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314881/
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Kristin Hall, FNP

Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership. 

She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH

Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare. 

Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.

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