Finasteride vs. Minoxidil: What's Right for Me?

Approximately half of all men in the UK experience pattern baldness before they turn 50, and by 65, half of all women have too. The condition is extremely common, and occurs in the majority of us simply due to ageing, but factors such as your genetics, diet, and stress can contribute to more severe hair loss or hair loss occurring at a younger age. If you’re suffering from stress-related hair loss, check out our article explaining how severe stress can cause telogen effluvium here. Thankfully, there are two effective hair loss treatments approved by the Medicines & Healthcare products Regulatory Agency (MHRA) for pattern baldness, which are clinically proven to slow or halt the loss of hair, and in some cases prompt regrowth.

What’s Finasteride and How Does it Work?

Whilst both attempt to treat the same condition, the two substances approach hair loss reduction from different angles.

Finasteride affects the androgen (male sex hormone) called Dihydrotestosterone (DHT), which has been found to be largely responsible for male hair loss. Our bodies naturally convert testosterone into DHT, which binds to the hair follicles causing them to shrink and thin. Finasteride blocks this process from occurring, with DHT unable to bind to the hair follicles. Recent clinical studies have shown finasteride to be effective in 90% of male participants, resulting in either their hair loss stopping or their hair regrowing^[1].

It is important to note that Finasteride is effective in men only, so we do not prescribe Finasteride to women. However, Minoxidil is effective in combating female hair loss, so read on to learn more about the options.

What’s Minoxidil and How Does it Work?

Minoxidil interrupts the hair growth cycle and encourages the growth (anagen) phase. To understand this fully, it helps to be familiar with the hair growth cycle.

1. The Growth Phase (Anagen) - Lasting between two and seven years, this is where your hair actively grows approximately half an inch per month.
2. The Transition Phase (Catagen) - Lasting two to three weeks, the hair stops growing and is detached from the blood supply, becoming a ‘club’ hair.
3. The Rest Phase (Telogen) - Lasting for around three months, the hair remains on the head in this non-growth state.
4. The Shedding Phase (Exogen) - A new hair pushes the hair in the follicle, causing it to detach and shed. This restarts the cycle.

Minoxidil works by widening the blood vessels in the hair follicles, allowing them to transport more important nutrients to the hair. In doing this, hairs in the resting phase are shed as new hairs are promoted to start growing^[2].

Which Hair Loss Treatments are Available for me?

Another key difference between the two treatments is the method of administering. Finasteride is taken daily as a tablet, swallowed whole with water. Minoxidil is a topical treatment that’s applied directly to the scalp twice daily. Below we explore the available treatments where these active ingredients are utilised:

Finasteride

Generic Finasteride

The generic finasteride contains the same 1mg quantity of the active ingredient as in the branded alternatives, but comes in at a lower price point. This makes the generic finasteride one of the most cost-efficient methods of effectively tackling hair loss. It is suitable for men between the ages of 18 and 65 who are suffering from androgenetic alopecia (hereditary hair loss), and who aren’t taking any other medications that may interfere with Finasteride. By swallowing one tablet at around the same time each day, you may need to take Finasteride for three months before beneficial effects are visible, and up to a year before assessing whether it is having the desired effect for you. If you stop taking the medication as prescribed, the hair gained from the treatment can disappear nine to twelve months later, so it’s important to continue the treatment to maintain hair growth.

Propecia

With the active component being chemically-equivalent to the generic treatment, Propecia is a popular brand of finasteride suitable for the same demographic as mentioned above. However, the well-known brand demands a higher price per tablet compared to generic Finasteride. Take one tablet per day to achieve the desired effect; you must not take two tablets to make up for a missed day.

Minoxidil

Regaine Solution

Targeting the hair follicle itself, Regaine Extra Strong 5% Solution has been clinically proven to be effective in stopping further hair loss in 80% of men, and encouraging hair regrowth in 60% of men^[3]. Taking the popular branded treatment can result in visible results in as little as two months, but can take up to four months in some individuals. To administer the treatment, massage directly onto a dry scalp and leave for 12 hours.

Regaine Foam

Regaine Extra Strong Foam contains the same 5% concentration of Minoxidil as Regaine Solution, but differs in the dispensing method and age demographic. This treatment comes in a pressurised canister and produces a foam, whilst Regaine Solution comes in spray bottles. Additionally, Regaine Foam is suitable for men between 18 and 49, but Regaine Solution can be used by men up to the age of 65.

Regaine Solution for Women

This treatment option is designed specifically with women in mind, containing a lower 2% strength solution, as the stronger 5% solution can sometimes cause irritation to the scalp. For best results, use the applicator to apply about 1ml of the solution to the affected area twice daily.

Regaine Foam for Women

Similar to the men’s treatment, Regaine for Women Extra Strength Foam provides an alternative method of application to the solution. This treatment is the strong 5% concentration, and it’s advised that women administer it once per day for best results, versus twice per day for men.

Can You Take Finasteride and Minoxidil Together?

Both treatments have proven highly effective in clinical trials, and can help to achieve the desired outcome on their own. However, because finasteride and minoxidil target different aspects of hair growth - finasteride targets testosterone to DHT conversion, and minoxidil targets the follicles directly - they are safe to use together. A 2002 study found the combination of both treatments to be the most effective way of preventing further hair loss whilst also stimulating new hair growth, and found there to be no additional risk in using them in tandem^[4].

Conclusion

Although it’s a natural occurrence, thinning or receding hair can often take its toll on your self-confidence. Fortunately, Finasteride and Minoxidil are two tried and tested methods for effectively treating hair loss, although the way in which they operate differs. If you’re female, Minoxidil is definitely your best route to fuller hair, but if you’re male then it depends on your ultimate goal and how your body responds to the two treatments. A combination of both treatments has proven the most effective way of halting hair loss and promoting hair growth. If you’re just starting your hair re-growth journey, keep in mind the common two-to-three month delay before you start seeing noticeable results; patience and perseverance will often pay dividends six months to a year down the line.