Finasteride vs Minoxidil

Quick Overview

Finasteride and minoxidil are the two most effective, FDA-approved treatments for male pattern baldness. They work through completely different mechanisms and can be used together for better results.

Key Differences:

• Finasteride: Oral pill that blocks DHT (the hormone causing hair loss)
• Minoxidil: Topical solution/foam applied to scalp to stimulate growth
• Effectiveness: Both work, but finasteride generally more effective at stopping loss
• Combination: Using both together provides the best results

Side-by-Side Comparison

Feature	Finasteride (Propecia)	Minoxidil (Rogaine)
Type	Oral prescription pill	Topical over-the-counter treatment
How It Works	Blocks DHT hormone	Stimulates hair follicles
Primary Effect	Stops hair loss	Promotes growth
Effectiveness	85-90% stop further loss 65% regrow some hair	60% see improvement 30-40% significant regrowth
Time to Results	3-6 months minimum Full results: 12+ months	4-6 months minimum Full results: 12+ months
Dosage	1mg pill daily	Apply 1-2ml twice daily
Prescription Needed	Yes	No (OTC)
Cost	$10-30/month (generic)	$10-25/month
Side Effects	Sexual (2-4% of men) Rare but notable	Scalp irritation, dryness Unwanted facial hair growth
Use on	Crown and front/top	Crown primarily (less effective on hairline)
Best For	Stopping progression	Regrowing existing thin hair

How They Work

Finasteride (Propecia): Blocks the Cause of Hair Loss

Mechanism:

1. Male pattern baldness is caused by DHT (dihydrotestosterone), a hormone converted from testosterone
2. DHT shrinks hair follicles, making hair thin and eventually stop growing
3. Finasteride blocks the enzyme (5-alpha reductase) that converts testosterone to DHT
4. With less DHT, hair follicles stop shrinking
5. Existing hair thickens and loss slows or stops

Think of it as: Turning off the signal that’s killing your hair follicles.

Minoxidil (Rogaine): Stimulates Growth

Mechanism:

1. Applied topically to the scalp
2. Increases blood flow to hair follicles
3. Enlarges miniaturized follicles
4. Extends the growth phase of the hair cycle
5. Stimulates dormant follicles to start producing hair

Exact mechanism not fully understood, but it works.

Think of it as: Fertilizer for your hair—stimulates what’s there to grow stronger and fuller.

Effectiveness Comparison

Finasteride Effectiveness

Clinical Study Results: Finasteride is highly effective for male pattern baldness. Clinical studies show that 85-90% of men stop losing more hair when taking finasteride. About 65% experience some hair regrowth, and 48% have moderate to significant regrowth. The medication is most effective at the crown (top and back of head) and moderately effective at frontal and temple areas. Results are maintained as long as you continue taking it—if you stop, hair loss resumes.

Best candidates: Finasteride works best for men experiencing ongoing hair loss who want to stop the progression. It’s ideal for early to moderate hair loss where follicles still exist, not completely bald areas. Men with crown and vertex thinning see the best results.

Not ideal for: Finasteride won’t help men with complete baldness since there are no follicles left to save. It’s also not the best choice if you want rapid visible regrowth—finasteride is primarily about stopping loss, not dramatic regrowth.

Minoxidil Effectiveness

Clinical Study Results: Minoxidil produces results in about 60% of men who use it consistently. Around 30-40% experience significant regrowth. Like finasteride, it’s most effective at the crown (vertex) and less effective at the hairline and temples. Results typically plateau after about one year of use. Hair loss resumes quickly if you stop using it.

Best candidates: Minoxidil works best for men with thinning hair rather than complete baldness. It’s ideal for those with diffuse thinning on the crown who want to stimulate growth of existing hair. It’s also a good option if you prefer non-prescription treatment.

Not ideal for: Minoxidil can’t regrow hair in completely bald areas since there are no follicles to stimulate. It’s less effective for receding hairlines. It also requires commitment—you must apply it twice daily, every day, indefinitely.

Using Them Together: The Combination Approach

Most effective strategy: Use both finasteride and minoxidil together.

Why Combination Works Best

Complementary mechanisms: The two medications work through completely different mechanisms. Finasteride addresses the root cause by blocking DHT, which stops hair loss. Minoxidil stimulates growth by improving blood flow to follicles and extending the growth phase. Together, you stop loss AND promote growth simultaneously.

Clinical Evidence: Studies consistently show combination therapy produces better results than either treatment alone. One landmark study found 94.1% of men using both medications had improvement, compared to 80.5% with finasteride alone and just 59% with minoxidil alone.

Typical Combination Protocol

Morning routine: Apply minoxidil to affected areas, then take your finasteride pill.

Evening routine: Apply minoxidil to affected areas again.

Ongoing commitment: Continue both treatments indefinitely—results disappear if you stop. Monitor your progress with photos every 3 months to track improvement.

Detailed Breakdown: Finasteride

Dosage & Administration

The standard dose is 1mg daily. You can take it anytime, with or without food. Consistency matters—don’t miss doses if you want best results. Generic finasteride is available and much cheaper than brand-name Propecia.

Timeline for Results

Finasteride works slowly. At 3-6 months, you’ll notice hair loss slowing down. At 6-12 months, your hair may start thickening. Maximum benefit becomes visible at 12-24 months. You must continue taking it ongoing to maintain results.

Side Effects

Sexual Side Effects (Most Concerning): Sexual side effects are the most concerning aspect of finasteride, though they affect only 2-4% of men. These can include decreased libido (reduced sex drive), erectile dysfunction, and reduced ejaculate volume. The good news is that these side effects usually resolve when stopping the medication. There is a controversial and rare condition called “post-finasteride syndrome” that some men report, though the medical community debates its existence and prevalence.

Other Side Effects: Other side effects are rare but can include breast tenderness or enlargement, depression or mood changes (though this connection is debated in medical literature), and testicular pain. All of these occur infrequently.

Important Notes: Most men (96-98%) experience no side effects at all. When side effects do occur, they usually appear early in treatment and may resolve with continued use. All side effects reverse when the medication is stopped.

Who Should Avoid Finasteride

Women should never take finasteride, especially if pregnant or trying to conceive, as it causes severe birth defects. Men with prostate cancer, those with liver disease, and anyone who has had a previous adverse reaction to finasteride should also avoid this medication.

Cost

Generic finasteride costs $10-30 per month, while brand-name Propecia runs $70-90 per month. Telehealth services typically charge $15-40 per month including the consultation and prescription.

Detailed Breakdown: Minoxidil

Dosage & Administration

The standard strength for men is 5% solution or foam. Apply 1ml twice daily to a dry scalp. To apply correctly, put the solution on thinning areas, massage it into your scalp, leave it on (don’t wash it off), and wash your hands after application. Foam is less greasy and dries faster than liquid, so many men prefer it.

Timeline for Results

You’ll see initial improvement at 4-6 months. Maximum benefit appears at 8-12 months. Don’t panic if you experience a shedding phase with increased hair loss at 2-8 weeks—this is normal. Miniaturized hairs are falling out to make room for new, healthier growth.

Side Effects

Common side effects: The most common issues are scalp irritation, itching, and dryness. Some men experience flaking or dandruff. Unwanted facial or body hair growth can occur if the medication spreads to other areas during application.

Less common side effects: Rarely, minoxidil can be absorbed systemically, causing rapid heartbeat. Some men experience dizziness or lightheadedness. Weight gain or swelling is possible. If you experience chest pain, stop immediately and see a doctor.

Application Tips to Minimize Side Effects: Apply only to your scalp, not other areas. Wash your hands thoroughly after application. Don’t let it run onto your face. Use foam if the liquid causes irritation—it’s less likely to drip.

Who Should Avoid Minoxidil

Women who are pregnant or breastfeeding shouldn’t use minoxidil (though it’s safe for other women). Those with heart conditions should consult a doctor first. Avoid it if you have scalp conditions like psoriasis or severe dermatitis.

Cost

Generic 5% solution or foam costs $10-25 per month. Brand-name Rogaine runs $30-50 per month. It’s available at most pharmacies with no prescription needed.

Which Should You Choose?

Choose Finasteride If:

Choose finasteride if you want to stop hair loss from getting worse. It’s ideal if you have ongoing, active hair loss and don’t mind taking a daily pill. You need to be willing to accept a small risk of sexual side effects. Finasteride is the most effective single treatment available.

Best for: Stopping progression, especially at the crown and mid-scalp.

Choose Minoxidil If:

Choose minoxidil if you want to stimulate new growth rather than just stop loss. It works well if you have thinning but not complete baldness. It’s a good choice if you prefer non-prescription treatment or you’re concerned about systemic medication side effects. Minoxidil is most effective if you have only crown thinning.

Best for: Regrowing existing miniaturized hair, especially at the crown.

Choose Both If:

Choose both if you want the best possible results. This approach is for men who are serious about treating hair loss and can commit to a daily pill plus twice-daily topical application. You’ll both stop loss AND promote growth.

Best for: Maximum effectiveness—this is the most recommended approach.

Choose Neither If:

Skip treatment if hair loss doesn’t bother you or you’re okay with shaving your head. Don’t bother if you have complete baldness with no follicles left to treat. Also skip it if you can’t commit to ongoing treatment—results require consistent use.

Common Questions

Do I have to use them forever?

Yes. Both treatments maintain hair only as long as you continue using them. If you stop:

• Finasteride: Hair loss resumes within 6-12 months; you’ll return to where you would have been without treatment
• Minoxidil: New growth falls out within 3-6 months

Hair loss is ongoing, so treatment must be ongoing to maintain results.

What if I miss doses?

• Finasteride: Missing occasional doses is okay, but consistency is important
• Minoxidil: Try not to miss applications, but one missed dose won’t ruin results

Don’t double up if you miss—just continue with next scheduled dose.

Can I stop once my hair regrows?

No. The treatments don’t cure hair loss; they only work while you’re using them. Think of it like managing high blood pressure—ongoing maintenance is required.

Are there natural alternatives?

Some supplements and natural treatments claim to help (saw palmetto, biotin, caffeine shampoos), but:

• No natural alternatives have proven effectiveness comparable to finasteride and minoxidil
• May help marginally as adjunct treatments
• Don’t rely on them as primary treatment if you’re serious about results

Can women use these treatments?

• Finasteride: No (causes birth defects; not approved for women)
• Minoxidil: Yes (but use 2% or 5% formulation; FDA-approved for women)

Will hair grow back exactly as before?

Usually no. Treatment:

• Stops further loss
• Thickens existing thin hair
• May regrow some hair in thinning areas
• Cannot revive completely dead follicles

The earlier you start treatment, the better your results.

Starting Treatment: Practical Advice

When to Start

Start treatment as soon as you notice thinning or loss. Earlier treatment equals better results because you have more follicles to save. Don’t wait until you’re significantly bald—by then, many follicles have already died.

Monitoring Progress

Take photos every 3 months using the same lighting and angle. Progress is slow, so photos help you see changes you might miss day-to-day. Don’t get discouraged by the “shedding phase” at weeks 2-8—it’s normal and means the treatment is working.

Setting Realistic Expectations

Results take 6-12+ months to become visible. Your goal should be stopping loss and thickening existing hair, not restoring your teenage hairline. Most men see stabilization plus some regrowth. However, some men are non-responders—these treatments don’t work for everyone.

If Treatment Doesn’t Work

After 12+ months with no improvement, you have options. Add the other treatment if you’re using only one. Consider a hair transplant, which can be combined with medications for best results. Try dutasteride, which is stronger than finasteride (though it’s off-label for hair loss). Or accept it—shave your head and own the look.

Where to Get Treatment

Finasteride (Requires Prescription) - Best Through Telehealth

Best Overall: Hims offers finasteride starting at $15/month with minoxidil bundled for comprehensive treatment. Same-day consultations, flexible subscriptions, and discreet delivery. Great for most men seeking affordable, convenient hair loss care.

Best for Premium Care: Keeps specializes exclusively in hair loss with personalized treatment plans, dermatologist consultations, and premium formulations. Ideal if you want specialized hair loss expertise and don’t mind paying more.

Best for Combination Treatment: Ro provides finasteride + minoxidil bundles with ongoing physician support and treatment tracking. Perfect if you want comprehensive medical supervision.

International Options:

• Manual (UK) - Finasteride and minoxidil for UK residents
• Numan (UK) - Comprehensive hair loss programs

Compare all hair loss services to find the best option for your needs.

Other options: You can also see your primary care doctor or dermatologist for an in-person exam, which may be covered by insurance. Hair loss specialist clinics are another option, though typically more expensive.

Minoxidil (No Prescription Needed)

Minoxidil is available over-the-counter at pharmacies like Walmart, CVS, and Walgreens for $20-40 per month. You can buy it online through Amazon or telehealth services, often bundled with finasteride. Hims, Keeps, and Ro all offer convenient combination treatments.

Cost Savings

Generic finasteride costs $15-30 per month, much cheaper than brand-name Propecia. Generic minoxidil runs $10-30 per month, cheaper than brand-name Rogaine. Telehealth bundles are often cheaper than buying the medications separately. Buying in bulk (3-6 month supply) reduces costs further.

Summary

For most men serious about treating hair loss:

• Use both finasteride and minoxidil together for best results
• Start as early as possible (more hair to save = better outcome)
• Commit to long-term use (results only last while using)
• Be patient (takes 6-12+ months to see full results)

Single treatment preference:

• Finasteride if you mainly want to stop loss (most effective single treatment)
• Minoxidil if you prefer non-prescription or want to stimulate growth

Realistic expectations:

• Won’t restore hair to teenage levels
• Will stop further loss and thicken existing hair for most men
• Results vary individually
• Ongoing maintenance required

Talk to a healthcare provider to determine the best approach for your situation.

Related Resources

Hair Loss Guides:

• Understanding Male Pattern Baldness
• Finasteride Results Timeline
• Minoxidil Results Timeline
• Does Hair Loss Treatment Work? Evidence

Service Reviews:

• Hims Review - Best value for combination treatment
• Keeps Review - Hair loss specialists
• Ro Review - Comprehensive programs

Popular Comparisons:

• Hims vs Keeps - Which offers better value?
• Hims vs Manual - US vs UK options

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This guide is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before starting hair loss treatment.