Overview
What is it?
Topical finasteride and minoxidil are two widely used treatments for hair loss, particularly for androgenetic alopecia (AGA), which is the most common form of hair loss in both men and women. Topical finasteride is a spray solution that contains 0.25% finasteride, a medication that inhibits the enzyme 5α-reductase, reducing the conversion of testosterone to dihydrotestosterone (DHT), a hormone linked to hair loss. Minoxidil, available in 5% topical solutions, is a vasodilator that promotes blood flow to hair follicles, stimulating hair growth. Neither of these compounds is naturally occurring; they are synthetic medications developed specifically for treating hair loss.
How does it work?
Topical finasteride works by targeting the hair follicles directly, inhibiting the enzyme 5α-reductase, which reduces DHT levels in the scalp. Lower DHT levels help prevent hair follicle miniaturization, a key factor in androgenetic alopecia. Minoxidil, on the other hand, works by prolonging the growth phase of hair (anagen phase) and increasing blood flow to the scalp, which nourishes hair follicles and promotes thicker, healthier hair growth .
What are the benefits?
The benefits of using topical finasteride and minoxidil for hair loss are well-documented. Topical finasteride has been shown to significantly improve hair count compared to placebo, with studies reporting an adjusted mean change of 20.2 hairs in the target area after 24 weeks of use . Minoxidil, particularly the 5% solution, has been shown to increase hair density by 12.4 hairs/cm² in women after 24 weeks of treatment . Both treatments are effective in slowing hair loss and promoting regrowth, with topical finasteride offering the added benefit of lower systemic exposure compared to oral finasteride, reducing the risk of side effects .
Effectiveness
What does the research say?
Research supports the efficacy of topical finasteride and minoxidil for treating hair loss. A phase III clinical trial found that topical finasteride 0.25% significantly improved hair count compared to placebo, with results similar to oral finasteride but with fewer systemic side effects . Minoxidil 5% has been shown to increase hair growth rate and hair density, particularly when combined with other treatments like microneedling or oral biotin . Studies also suggest that combining these treatments may enhance their effectiveness, though more research is needed to confirm this .
Side Effects
Pruritus (itching)
Pruritus, or itching, is a common side effect of topical finasteride and minoxidil, often caused by the active ingredients irritating the scalp .
Erythema (redness)
Erythema, or redness, can occur at the application site due to the vasodilatory effects of minoxidil or the local irritation caused by finasteride .
Scalp irritation
Scalp irritation, including burning or tingling sensations, is frequently reported with minoxidil use, especially at higher concentrations .
Hypertrichosis (excessive hair growth)
Hypertrichosis, or excessive hair growth in unintended areas, is a known side effect of minoxidil, particularly when applied near the face .
Loss of or reduction in libido
Loss of or reduction in libido is a rare but possible side effect of finasteride, though it is less common with topical formulations compared to oral ones .
Evidence
Clinical Studies & Trials
[1] Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial.
This study evaluated the efficacy and safety of topical finasteride 0.25% in men with androgenetic alopecia. Results showed significant improvement in hair count compared to placebo, with fewer systemic side effects than oral finasteride.
View study[2] Androgenetic Alopecia: Therapy Update.
This review discusses the use of microneedling and minoxidil for treating androgenetic alopecia. It highlights the benefits of combining these treatments for improved hair growth.
View study[3] Female-pattern hair loss: therapeutic update.
This review explores the use of topical finasteride and minoxidil for female-pattern hair loss. It highlights the efficacy of minoxidil and the potential benefits of finasteride, though its use in women is off-label.
View study[4] Efficacy of 5% topical minoxidil versus 5 mg oral biotin versus topical minoxidil and oral biotin on hair growth in men: randomized, crossover, clinical trial.
This study compared the effects of topical minoxidil 5%, oral biotin, and their combination on hair growth in men. Results showed that the combination treatment significantly increased hair growth rate.
View study[5] Topical finasteride for male and female pattern hair loss: Is it a safe and effective alternative?
This review evaluates the safety and efficacy of topical finasteride for treating male and female pattern hair loss, highlighting its potential as an alternative to oral finasteride with fewer systemic side effects.
View study