Highlights
- Finasteride results and minoxidil results for hair loss aren’t vastly different, though the two drugs work differently.
- Both are FDA-approved medications for the treatment of male pattern baldness.
- Finasteride treats the underlying hormonal causes of hair loss.
- Minoxidil is a topical vasodilator that may also have some anti-androgenic effects.
- Patients may obtain better results by using the two drugs in combination.
Finasteride and minoxidil are two FDA-approved hair loss medications that work differently.
Minoxidil is a predominantly topical solution, which works like a fertilizer. It boosts the flow of nutrients to the hair follicles in ways not even doctors understand yet. Finasteride works by protecting the hair follicles from the miniaturizing effects of dihydrotestosterone (DHT).
The two medications are the gold standard of alopecia solutions, but does one work better than the other?
Finasteride Results vs. Minoxidil Results
Contrary to what a non-expert may believe, neither medication works in 100 percent of male pattern baldness sufferers. In some alopecia sufferers, either drug can cause outstanding hair regrowth. The hair loss community calls these patients “super-responders.”
While either drug will work for some people, others choose to use both medications at once, which for some, will boost the effectiveness of either drug used alone.
Finasteride Results
The typical horseshoe-shaped hair loss doctors call male pattern baldness (MPB) is a result of high DHT, which can cause both acne and hair loss in men. Finasteride suppresses a hormonal compound called 5-alpha reductase that converts testosterone into DHT. Thus, it can shield the hair follicles from the effects of this potent androgen, or male sex hormone.
Interestingly, it doesn’t work in all hair loss sufferers. Several medical studies have confirmed the efficacy of this drug, but they have also proved that finasteride is not a hair loss superdrug.
A 2011 study looked at more than 3,000 Japanese men suffering from hair loss. Researchers gave study participants 1 milligram of finasteride per day. After three years, 11 percent of participants reported spectacular regrowth.
A further 36.5 percent reported moderate regrowth, and 39.5 percent found that finasteride caused a slight improvement in their male pattern baldness. Overall, the results were positive and showed that finasteride could at least stop hair loss in almost all patients who took it.
Another study yielded more promising results. Researchers discovered that finasteride may work better in patients who have body hair.
Almost 90 percent of patients with body hair found finasteride to cause good or excellent hair regrowth. Only about 32 percent of patients in the body hair-less group reported similarly impressive results. Overall, the percentage of good responders in the study was almost 60 percent.
It bears repeating that finasteride tends to halt hair loss even in patients who fail to regrow hair.
Topical Finasteride
Although it is an oral drug, finasteride may work topically as well. Because the skin absorbs finasteride, the topical, targeted administration of the drug may help with alopecia.
Crushing finasteride pills and making a topical finasteride solution at home is not a reasonable option, however. Pharmaceutical companies have not optimized oral finasteride for topical absorption. And the targeted, topical administration of the drug involves many chemical and physical variables.
Minoxidil Results
As a topical hair loss drug, pharmaceutical companies have made minoxidil available in different concentrations. The most widely used concentrations are 2 percent and 5 percent. Researchers have experimented with 10 percent minoxidil but found that the 5 percent solution regrows more hair.
5 percent minoxidil is better for hair growth than the 2 percent solution. The stronger, 5 percent version of the drug is also faster-acting. Treatment response rates to minoxidil are relatively low. A 2013 study found a response rate of 30 to 40 percent
The problem with minoxidil is that it does not work in people with low levels of a compound called sulfotransferase in their scalps.
Until recently, men have had to treat their scalps for months to find out whether they are minoxidil responders. Fortunately, researchers have created a test that can measure sulfotransferase levels in patients’ scalps to determine who responds to minoxidil and who doesn’t.
Defining how effective minoxidil is for hair loss is difficult. It stops hair loss progression in many users, and it helps some people regrow hair. In a smaller subset of users, it causes cosmetically significant regrowth.
Unlike finasteride, minoxidil does not affect the hormonal system. Researchers believe, however, that in addition to many other effects, it may have a significant 5-alpha reductase-inhibiting effect. It may act as an anti-androgen and inhibit the formation of DHT.
Oral Minoxidil
Minoxidil’s oral form is a vasodilator used to treat high blood pressure. Doctors noticed incidentally that patients who took minoxidil for their blood pressure regrew hair.
A 2020 study confirmed the hair-growing effects of oral minoxidil. According to this study, oral minoxidil may work better for hair growth than the topical version of the drug.
Every man who took part in the study regrew hair. In 43 percent of study participants, the regrowth was excellent. Patients regrew hair in the vertex area as well as the frontal hairline.
The researchers did record a few unpleasant side effects, however, like edema (swelling) and increased hair growth all over the body.
Finasteride Side Effects vs. Minoxidil Side Effects
The body tolerates finasteride and minoxidil well, which is why the FDA has approved both drugs. Finasteride has FDA approval for hair loss as an oral medication, and minoxidil has been approved as a topical. As with nearly any drug, however, both medications can cause side effects.
Finasteride Side Effects
Because it inhibits the production of a potent androgen, finasteride’s most feared side effects are sexual. Science does not yet understand how big a sexual impact finasteride can have on hair loss users.
Studies have observed sexual side effects in 2.8 percent to 38 percent of users, a significant interval that leaves a lot of room for error.
The most common sexual side effects of the drug include erectile dysfunction, ejaculation problems, and reduced libido.
In addition to these side effects, finasteride may also cause depression. However, the incidence of depression in finasteride users is so low that the drug label doesn’t mention it.
Minoxidil Side Effects
Oral minoxidil can cause many unpleasant side effects. Researchers have concluded that its benefits as a hair loss drug don’t outweigh its risks when taken orally.
The topical version is a better choice and is the only FDA-approved form of the drug for hair loss.
Topical minoxidil can cause some side effects as well. Some of its common side effects are:
- Scaly changes, irritation, and seborrheic dermatitis of the skin
- Unwanted body hair growth or increased hair growth on the face
- Minoxidil-induced telogen effluvium, or increased hair shedding
- Allergic reactions
- Contact dermatitis
Finasteride vs. Minoxidil – Which Works Better?
Finasteride and minoxidil are different medications that attack the male pattern baldness problem from different angles. We understand the action of finasteride better, and we know it acts on the root of the problem, on a deeper level than minoxidil.
The bottom line is that the effectiveness rates of the two medications are similar. Because the two are so different, however, many men take both drugs to compound the hair-growth effects.
Combination treatments often provide better outcomes.
eDrugstore Can Help
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As the only FDA-approved oral medication for male pattern baldness, finasteride is your safest and best weapon against hair loss. Combination therapy regimens for hair loss nearly always include finasteride.
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James spent the better part of the last decade studying and writing about the physiology of sleep and its correlations with dreams. He studied various drugs, natural substances, and hallucinogens that can impact the intensity and frequency of dreams.
For two years, he busted dietary supplement scams, analyzing various performance-enhancing compounds, nootropics, etc.