Finasteride vs Minoxidil: Which Hair Loss Treatment Should You Use?
Finasteride and minoxidil are the two most proven treatments for male pattern hair loss. They work completely differently—and for many men, using both together delivers the best results. Here's everything you need to know to choose the right approach.
The Quick Answer
Finasteride blocks DHT (the hormone causing hair loss) — best for stopping hair loss at the source.
Minoxidil stimulates blood flow to follicles — best for regrowing hair and increasing density.
Best results: Use both together. Studies show the combination is more effective than either alone.
Head-to-Head Comparison
| Factor | Finasteride | Minoxidil |
|---|---|---|
| How it works | Blocks DHT production | Increases blood flow to follicles |
| Primary benefit | Stops hair loss | Stimulates regrowth |
| Form | Oral pill (1mg daily) | Topical (2-5%) or oral (off-label) |
| Prescription required | Yes | No (topical); Yes (oral) |
| Success rate (monotherapy) | ~80-90% stop hair loss | ~60-70% see improvement |
| Time to results | 3-6 months | 4-6 months |
| Main side effects | Sexual (1-2%) | Scalp irritation (topical); body hair (oral) |
| Works for women | No* | Yes |
| Cost (monthly) | $16-40 | $15-35 |
*Finasteride is not FDA-approved for women and can cause birth defects. Some dermatologists prescribe it off-label for post-menopausal women.
How Finasteride Works
Finasteride attacks hair loss at its root cause: DHT (dihydrotestosterone). Here's the mechanism:
- 1. Your body converts testosterone into DHT using an enzyme called 5-alpha reductase
- 2. DHT binds to hair follicles and causes them to shrink (miniaturization)
- 3. Shrunken follicles produce thinner, shorter hairs until they stop producing visible hair
- 4. Finasteride blocks 5-alpha reductase, reducing DHT levels by ~60-70%
- 5. Less DHT = follicles stop shrinking = hair loss stops
Finasteride is primarily a defensive treatment—it stops further loss. Some men also see regrowth, but that's a secondary benefit. The real power is halting progression.
How Minoxidil Works
Minoxidil was originally developed as a blood pressure medication. Doctors noticed patients were growing more hair as a side effect. Here's how it helps hair loss:
- Vasodilation: Widens blood vessels, increasing blood flow to hair follicles
- Nutrient delivery: More blood = more oxygen and nutrients reaching follicles
- Extends growth phase: Lengthens the anagen (growth) phase of hair cycle
- Stimulates VEGF: Promotes new blood vessel formation around follicles
- Possibly anti-inflammatory: May reduce scalp inflammation
Minoxidil is primarily an offensive treatment—it stimulates growth. However, it doesn't address the underlying cause (DHT), which is why many men see better results adding finasteride.
Effectiveness: What the Research Shows
Finasteride Alone
- • 80-90% of men stop further hair loss
- • 65% see some regrowth
- • One 12-month study: 80.5% improved with finasteride vs 59% with minoxidil
- • 5-year studies show continued effectiveness with sustained use
Minoxidil Alone
- • 60-70% see improvement in hair density
- • 5% solution more effective than 2%
- • Oral minoxidil may be slightly more effective than topical
- • Works best for early-to-moderate hair loss
Finasteride + Minoxidil Together
- • 92%+ see stable or improved hair (2025 study of 502 men)
- • 57% show marked improvement
- • Combination significantly outperforms either alone
- • Different mechanisms = complementary effects
Side Effects Compared
Finasteride Side Effects
Most are rare (1-2% of users):
- • Decreased libido
- • Erectile dysfunction
- • Ejaculation issues
- • Breast tenderness (rare)
Most side effects resolve after stopping. Rare cases of persistent effects have been reported.
Minoxidil Side Effects
Topical:
- • Scalp irritation/dryness
- • Itching or flaking
- • Unwanted facial hair
Oral (off-label):
- • Body hair growth (15%)
- • Fluid retention
- • Lightheadedness
Which Should You Choose?
Choose Finasteride If:
- ✓ You're focused on stopping further loss
- ✓ You prefer a simple once-daily pill
- ✓ You're in early-to-moderate stages of hair loss
- ✓ You want to address the root cause (DHT)
- ✓ You're comfortable with potential (rare) sexual side effects
Choose Minoxidil If:
- ✓ You want to stimulate regrowth
- ✓ You're concerned about finasteride side effects
- ✓ You're a woman (finasteride not approved)
- ✓ You prefer OTC treatment (no prescription needed for topical)
- ✓ You didn't respond to finasteride alone
Use Both Together If:
- ✓ You want maximum results
- ✓ You've plateaued on one treatment alone
- ✓ You have moderate-to-advanced hair loss
- ✓ You're serious about preservation and regrowth
Using Finasteride and Minoxidil Together
Because finasteride and minoxidil work through completely different mechanisms, they're safe and effective to use together. In fact, combination therapy is considered the gold standard for treating male pattern hair loss.
Why Combination Works Best
- Finasteride addresses the cause (DHT) → stops loss
- Minoxidil stimulates growth → adds density
- No overlapping mechanisms = no increased side effect risk
- Studies consistently show better outcomes than either alone
Many telehealth platforms now offer combination products (topical finasteride + minoxidil) that make this easier than ever.
Get Hair Loss Treatment Online
Finasteride, minoxidil, or both. Free consultations, home delivery.
Timeline: What to Expect
Key Takeaways
- 1. Different mechanisms: Finasteride blocks DHT; minoxidil stimulates growth
- 2. Finasteride is better for stopping loss (~80-90% effective)
- 3. Minoxidil is better for stimulating regrowth (~60-70% see improvement)
- 4. Combination is most effective – 92%+ see stable or improved hair
- 5. Side effects differ: Finasteride = sexual (rare); Minoxidil = scalp/body hair
- 6. Give it time: 4-6 months minimum to see results
- 7. Treatment is ongoing: Stop and you'll lose gains
- 8. Start early: Both work best before significant loss
Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Finasteride is a prescription medication with potential side effects. Consult with a qualified healthcare provider before starting any hair loss treatment to determine what's appropriate for your situation.