Finasteride vs minoxidil: which one, or both?
Updated
These are the two treatments with the strongest evidence for male pattern hair loss. They are not competitors: they work in different ways, and many dermatologists suggest using both.
How they work
- Finasteride blocks the enzyme that turns testosterone into DHT, the hormone that shrinks hair follicles. It goes after the cause, so its main job is stopping loss.
- Minoxidil extends the growth phase of hair and widens blood vessels. It does not touch DHT, so its main job is growth and thickness.
Side by side
- Prescription: finasteride yes; topical minoxidil no (oral minoxidil yes).
- Best at: finasteride at stopping loss, especially at the crown; minoxidil at regrowth and thickening.
- Time to judge: finasteride about 12 months; minoxidil about 6 months.
- Main downsides: finasteride has a small risk of sexual and mood side effects; topical minoxidil can irritate the scalp and causes an early shed.
- Cheapest legit price: generic finasteride about $5–$10 a month; generic 5% minoxidil about $4–$8 a month.
Why many men use both
Because they work differently, the effects add up. In a randomized study comparing the two with the combination, men using both had better results than men using either one alone.
If you only want one: finasteride if you are comfortable with a prescription and your main goal is keeping what you have; topical minoxidil if you would rather avoid hormones or prescriptions.
Either way, they only work while you keep using them, so pick a routine you can actually stick to.
If you are still losing hair on finasteride after a year, the next step many dermatologists consider is dutasteride. See dutasteride vs finasteride.
Common questions
Which is better, finasteride or minoxidil?
Finasteride is better at stopping loss and minoxidil is better at regrowth. For most men with active pattern loss, using both works better than either alone.
Can you take finasteride and minoxidil together?
Yes. They are commonly combined, and studies support the combination. Check with your doctor, especially if you are considering oral minoxidil.
Do I need a prescription for minoxidil?
Not for the topical foam or liquid, which is sold over the counter. Low-dose oral minoxidil needs a prescription.
Sources
- Hu et al., 2015, Dermatologic Therapy: Combined treatment with oral finasteride and topical minoxidil
- Kaufman et al., 1998, J Am Acad Dermatol
- Olsen et al., 2002, J Am Acad Dermatol
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