Does Topical Finasteride Work for Hair Loss?

If you’re dealing with thinning hair or a receding hairline, you’re not alone — male pattern baldness (AKA androgenetic alopecia or androgenic alopecia) affects about 30 percent to 50 percent of men by age 50. 

While some men choose to embrace their hair's natural evolution, others seek ways to help restore hair loss. There’s no right or wrong here, but if you fall into the latter group, you may have already looked into options like hair restoration, a hair transplant, and even hair pieces. 

Alternatively, you might choose a proven hair loss treatment like finasteride. While typically sold as an oral medication, topical finasteride solution is also available and can be easily incorporated into your daily hair care routine.

Does topical finasteride work? Yes! Keep reading to learn more about its proven effectiveness for male pattern baldness, including how to use it for best results, potential side effects, and how it compares to other topical hair treatment options.

There are two medications approved for hair loss by the Food and Drug Administration (FDA): topical minoxidil (the active ingredient in Rogaine®) and oral 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. While the topical version is not FDA-approved, it may be prescribed off-label for treating hair loss.

However, 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 hair follicles — the tiny organs throughout your scalp from which your hair grows — to shrink and reduce, which eventually leads to baldness.

Finasteride is part of a group of medications called 5-alpha reductase inhibitors, which prevent the conversion of testosterone to dihydrotestosterone and, therefore, help delay hair loss. 

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

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 — and if so, how effective compared to other options. 

Next, we’ve outlined what researchers have concluded about how well topical finasteride works for treating hair loss in men. 

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.

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

In one of the studies included, 73 percent of treated patients reported “high effectiveness” of using 1.0 mL topical finasteride 0.005% solution twice daily to their affected scalp for 16 months, compared to 60 percent of placebo patients reporting that they experienced “no effect” on hair growth. 

The studies referenced in this review also 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 ongoing research and follow-up.

A 2020 review of 33 scientific articles using topical finasteride for the treatment of male androgenetic alopecia and female pattern hair loss had similar findings. The studies “showed positive results with a favorable safety profile” and the authors called for continued research.

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 vs oral finasteride is, studies have compared the results of both.

For example, a 2014 study found that scalp DHT was reduced by 68 to 75 percent with topical finasteride treatment and by 62 to 72 percent with oral finasteride treatment for men with male pattern baldness. In other words, both are effective — but the topical version may have a slight advantage for some men.

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.

In a 2022 study, researchers compared the effects of topical finasteride gel against the oral tablet form among 45 men with androgenetic alopecia. 

By the end of the study, both groups saw similar positive effects on hair growth, finding a significant increase in total hair count and terminal hair (thick, coarse hair that grows on your scalp, eyelashes, and eyebrows). Most participants also saw a reduction in bald spots by around one to three centimeters after completing treatment.

The bottom line is that both oral and topical finasteride seem to be pretty good at helping you regrow lost hair. 

If you want to learn more about the effectiveness of oral finasteride, this article on finasteride results covers all the research behind the oral version of this hair loss treatment.

As we mentioned, minoxidil is the other FDA-approved topical solution for hair loss. So, how does topical minoxidil compare to topical finasteride? We’re glad you asked. 

Minoxidil stimulates hair growth by boosting blood flow to your hair follicles. 

Fun fact: minoxidil was originally formulated in the ‘60s as a vasodilator — a medication that relaxes and opens up your blood vessels for better circulation — to treat high blood pressure. It wasn’t until 1988 that a formulation was approved specifically as a first-line treatment for men with mild-to-moderate male pattern baldness. 

It’s also thought that minoxidil lengthens the growth phase of your natural hair growth cycle, giving it more time to flourish. 

It can be used topically as either a minoxidil foam or liquid minoxidil solution drops, both of which are applied directly to your hair and scalp.

Minoxidil is also highly effective for hair loss, with the results of several large-scale studies backing up hair regrowth claims. Typically, you can expect to see new hair growth after eight weeks of consistent application.

In a one-year-long study among 904 men with androgenetic alopecia, 62 percent saw a significant decrease in hair loss from baseline after using 5% topical minoxidil twice a day.

Another study found that after 16 and 26 weeks of treatment, minoxidil led to a 70 percent improvement in mean 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. However, this may also be true for a combination of minoxidil and finasteride topical solutions.

For instance, 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.

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. 

As mentioned, topical finasteride also comes with a lower risk of sexual side effects than oral finasteride due to its localized use.

The most common adverse effects include:

• Redness at the application site

• Scalp itching

• Irritation or dermatitis

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

While oral finasteride is one of only two FDA-approved hair loss treatments for male pattern baldness, it can cause side effects like sexual dysfunction. So, some men may want to try a more localized topical finasteride instead. 

When weighing your options, here are some key points to consider:

• The oral and topical forms work the same way. Both forms of finasteride treat hair loss by blocking the enzyme that converts testosterone into DHT, which means DHT can’t shrink hair follicles and stop new hair from growing. 

• Both are effective. Although topical finasteride is relatively new (compared to oral medication, anyway) and not FDA-approved for male hair loss, available research shows it’s just as (if not sometimes more) effective as oral finasteride at increasing hair count and density.

• There are other options. Finasteride and minoxidil are just two ways to treat hair loss. For instance, you can also give your existing hair a boost with a volumizing shampoo and conditioner duo or consider adding a supplement like our biotin gummies to your daily routine.

If you’d like to learn more and choose a hair loss treatment plan, start by taking our free online hair quiz. From here, you can seek medical advice from a dermatologist or healthcare provider and discuss more hair loss treatments.