Finasteride vs Minoxidil: Which Reigns Supreme?

Thinning hair can have a debilitating effect on your self-confidence. This is especially true for people genetically predisposed to baldness who start losing hair at a young age. If you're struggling with thinning hair, you've probably searched high and low for a solution. Fortunately, science has provided us with several options to help slow and replenish hair loss. But choosing between hair loss treatments, like Finasteride vs. minoxidil, may feel daunting.

Read on to learn more about the similarities and differences between these two popular hair loss medications to determine which one is right for you.

Finasteride vs. Minoxidil: What's the Difference?

Finasteride and minoxidil are popular medications for male pattern baldness, also known as androgenic alopecia (AGA). AGA is considered the most common cause of male baldness (Ho, 2021). Both of these drugs help prevent hair loss and encourage hair growth. The main difference between these two drugs is their mechanism for treating baldness. Finasteride is available in the form of a pill that needs a physician's prescription. On the other hand, minoxidil is applied topically and is readily available as an over-the-counter solution or foam.

You can find finasteride with the brand name Prophecies and minoxidil as Rogaine. Let's take a deeper look at the differences and similarities between these two drugs.

How Does Finasteride Work?

Male pattern baldness or AGA is caused by an androgen called dihydrotestosterone (DHT). This hormone is produced from another androgen, testosterone. DHT is present in higher amounts in the scalps of people experiencing hair loss. DHT causes miniaturization of the hair follicles, causing the hairs to become thinner, shorter, and easier to fall out, eventually leading to hair loss (Ho, 2021; Zito, 2022).

However, it can take from 6 to 12 months for the results to be visible. One good thing about this medication is that these results can last up to a year after you stop taking these tablets (Zito, 2022).

How Does Minoxidil Work?

Minoxidil helps stimulate hair growth. But the exact mechanism for its benefits is still unknown. One theory explaining its efficacy on hair growth relates to its vasodilating effects. Minoxidil is known to widen the blood vessels, resulting in an increased blood flow to the hair follicles. This increase in blood flow improves the scalp's nutrient supply, strengthens the hair follicles, and promotes hair growth (Badri, 2021).

Minoxidil also helps prevent hair loss by making the anagen phase (the growth phase of the hair cycle) longer. It might take about eight weeks of minoxidil usage to see the signs of improvement. The more notable changes can take about four months (Badri, 2021).

What Forms Do Finasteride and Minoxidil Come in?

Finasteride was initially used to treat benign prostatic hyperplasia (BPH). It was later on tested for its effects on hair growth. Different doses are used to treat both conditions. A daily dose of 1 mg is typically recommended to treat hair loss. While for the BPH, the recommended dosage is higher (5 mg per day) (Zito, 2022)

Minoxidil does not need a physician's prescription. It is readily available over-the-counter in either of two forms: a liquid solution or foam (aerosol formulation). The foam is available in 5% strength in the United States. You can find the solution formulation in either 2% or 5% strengths. 5% topical solution is only approved for men by NHS. At the same time, the 2% topical solution and 5% topical foam are both NHS-approved for men and women (Badri, 2021).

The oral formulation of minoxidil is also available. But, the research regarding its efficacy in treating alopecia is highly variable. Different studies have tested 0.25 to 10 mg of daily minoxidil oral intake for 6 to 12 months, but the evidence to support the positive impact of oral minoxidil on hair growth is low, and this treatment method is not NHS-approved (do Nascimento, 2020).

Side effects of Finasteride vs. Minoxidil

Like all medications, you need to weigh the hair loss benefits of finasteride and minoxidil against their potential side effects.

Side Effects of Finasteride

Common side effects of finasteride include (Zito, 2022):

  • Decreased libido or sex drive
  • Erectile dysfunction
  • Breast enlargement in males (gynecomastia)
  • Low semen volume
  • Depression and suicidal thoughts

Other less common side effects include (Zito, 2022):

  • Dizziness Weakness Shortness of breath
  • Allergic reactions, like skin rash or itching

Side Effects of Minoxidil

In the first few weeks of using topical minoxidil, it is normal to experience some hair shedding; a condition called telogen effluvium. Fortunately, this effect is temporary, and the shedding stops as you continue to use the medication (Badri, 2021).

Other common side effects of minoxidil include (Badri, 2021):

  • Scalp irritation or itching
  • Burning sensation
  • Allergic contact dermatitis at the application site
  • Hair growth in untreated areas (hypertrichosis)
  • Rarely some people may notice a drop in blood pressure (hypotension).

Can You Take Finasteride and Minoxidil Together?

In short, yes. Studies suggest that using finasteride and minoxidil together might be more effective at slowing hair loss and improving hair growth than either therapy alone. But we need more research to determine the best dosages for combination treatment (Chen, 2020)

Finasteride vs Minoxidil: Which One is better?

Finasteride and minoxidil have proven to be effective in treating male pattern baldness. So, which one is the better choice for your hair loss problems?

Only a few studies have made a head-to-head comparison of these two treatment options. According to one small study, minoxidil shows faster results after starting the treatment. But finasteride results are slightly better than minoxidil if we talk about long-term usage effects (Sarawat, 2003). Choosing the right treatment option also not only depends on the advantages but also the disadvantages. Choosing the proper hair loss treatment depends on certain factors like your needs, tolerance for the side effects, the severity of your problem, gender, etc. It is advisable to contact your healthcare provider and discuss the best suitable treatment for your hair loss.


Please talk to your healthcare provider if you have any medical questions or concerns. The articles on Health Guide are underpinned by peer-reviewed research and information from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.