Finasteride alternatives: What can I use instead?

If Finasteride isn’t the right fit for you, there are other evidence-based options worth considering.

Table of Contents:

• What are some typical alternatives to Finasteride?

• Does Minoxidil work on its own without Finasteride?

• Do natural alternatives like Saw Palmetto actually work?

• Can I combine hair loss treatments for better results?

• Which Finasteride alternatives can I get in the UK?

• What should I do if I want to switch from Finasteride?

• Frequently asked questions about Finasteride alternatives

What are some typical alternatives to Finasteride?

Typical alternatives to Finasteride include topical Finasteride, Dutasteride and Minoxidil, each having its own distinct efficacy and side effect profile.

There are several clinically tested alternatives to Finasteride that can treat male pattern hair loss. The right choice for you will depend on what you value the most: maximum regrowth, minimal side effects or your preference for prescription treatments vs. over the counter. There is no single alternative to taking oral Finasteride, but each one fills a different gap.

*Off-label use is when a medicine is prescribed for a purpose, dose, age group, or route of administration that is different from its original licensed use.

Is topical Finasteride better tolerated than oral Finasteride?

Topical Finasteride has the same active ingredient as the oral version but it is applied directly to the scalp. A 2021 clinical trial by Dr. Piraccini and colleagues tested the topical version on over 450 people across 24 weeks (2). Those using the topical spray gained an average of 20.2 new hairs in a 1cm2 area, compared with 6.7 taking placebo and 21.1 with oral Finasteride.

Topical Finasteride is only available on prescription in the UK, and is typically only prepared by specialist pharmacies, and prescribing it is based on clinical evidence and individual assessment. For a full breakdown, read the Oxford Online Pharmacy’s comparison of Oral vs Topical Finasteride.

Is Dutasteride better than Finasteride for hair loss?

There is no “better option” when it comes to hair loss treatment as people respond differently to different medications. The main difference comes down to how the medicines work:

Your body produces an enzyme called 5-alpha reductase, which converts testosterone into DHT — the hormone responsible for hair loss. This enzyme comes in two forms: type I and type II. Finasteride only blocks type II, while dutasteride blocks both, meaning dutasteride reduces DHT levels more completely. In a 2014 clinical trial of 917 people, Dutasteride 0.5mg increased hair count and hair width more than Finasteride 1mg over 24 weeks (3).

While studies do show a possible increased hair count when comparing Dutasteride with Finasteride, both Dutasteride and Finasteride have shown evidence of sexual side effects like impotence and decreased libido and psychological side effects like depression and suicidal ideation (8). So if you were coming off Finasteride due to the side effects, this is very important to consider and Dutasteride might not be the best option for you. If you do experience these side effects on either medication it’s important to stop taking it immediately and contact a medical professional. Contact 999 if your side effects are extremely severe.

It’s also worth noting that in the UK, it is prescribed off-label (not officially approved for that medical purpose) for hair loss, given that it is licensed for benign prostatic hyperplasia (an enlarged prostate).

Does Minoxidil work on its own without Finasteride?

Minoxidil can work on its own without Finasteride. It works to promote hair growth in a different way, is available over the counter in the UK, and is not linked to sexual side effects. It usually works best when started early.

Finasteride works by lowering DHT, the hormone involved in male pattern hair loss. As minoxidil is topical, it works locally on the scalp and helps encourage hair growth by stimulating the hair follicles directly. In the UK, topical Minoxidil is available without a prescription, including under brand names such as Sons 5% Topical Minoxidil.

Topical Minoxidil comes as a foam or liquid and is usually applied to the scalp once or twice a day. The most common side effects are scalp irritation and, in some cases, unwanted facial hair growth. For people who find topical treatments time-consuming to apply, oral Minoxidil may sometimes be prescribed off-label (not officially approved for that medical purpose) for hair loss. This comes with a different set of possible side effects, including fluid retention and increased hair growth elsewhere on the body.

The main drawback is that Minoxidil does not have an effect on DHT levels. Used on its own, it may help slow hair shedding and encourage regrowth, but it does not stop the hormonal process behind hair thinning. For some people, especially those with early hair loss, that may still be enough. Others may get better long-term results from using it alongside Finasteride.

It is worth giving Minoxidil at least 4 to 6 months of consistent daily use before deciding how well it is working. Some shedding in the first few weeks can happen, and this is often a normal early response to treatment.

Do natural alternatives like Saw Palmetto actually work?

Saw Palmetto is one of the best-studied natural alternatives to Finasteride, but the evidence suggests it may be less effective overall. It may still appeal to people with early hair loss or those who are not keen on taking pharmaceutical medications. Saw Palmetto is thought to act as a mild 5-alpha reductase inhibitor, in a similar way to Finasteride, but it is not as potent.

In the only study to directly compare the two substances, Dr Rossi and colleagues monitored 100 people over a 24-month period (4). Hair growth improved in 38% of people taking Saw Palmetto, compared with 68% of those taking Finasteride. It works to a degree but there is a substantial difference between the two. Saw Palmetto also seemed to work mainly at the crown, whereas Finasteride improved both the crown and the hairline at the front.

There are some other natural options mentioned in the research as well. In one fairly small study of 76 people, pumpkin seed oil was linked to a 40% increase in hair count (5), although these results have not been replicated by any larger studies. Rosemary oil also gets a lot of attention online, but the clinical evidence behind it is still limited.

Overall, natural alternatives are unlikely to have the same effectiveness as scientifically proven medications like Finasteride for people experiencing hair loss. However, they may be of benefit to some people, particularly in the earlier stages of hair loss or those who do not want to go down the medication route.

Can I combine hair loss treatments for better results?

Using more than one treatment at the same time may improve results in some people. In particular, combining Oral Finasteride with Topical Minoxidil may be more effective for some patients than relying on just one treatment alone. An analysis in 2025 found that combination-treatment performed better than single treatments on their own.

The idea of combining multiple hair loss treatments has gained some traction in recent years. Hair loss is not usually caused by just one process, so targeting it from different angles may be beneficial. In an analysis in 2025 looking at multiple studies, a topical Minoxidil and Finasteride combination performed better than Minoxidil on its own (6). A separate study done in the UK also reported that 92.4% of people using a combined oral Minoxidil (off-label) and Finasteride showed stable or improved outcomes after 12 months (7).

The most common combination is Minoxidil either orally or topically + Finasteride. Minoxidil helps stimulate growth at the follicle level, while Finasteride lowers your body’s hormone levels involved in hair thinning.

Another combination that you may have heard of is Minoxidil with microneedling. Microneedling creates tiny controlled injuries in the scalp, and some evidence suggests this may help Minoxidil penetrate the skin deeper and work better overall. Evidence is growing that this combination can yield better results that Minoxidil alone.

Finasteride is also sometimes used alongside shampoo containing Ketoconazole, which is an antifungal medication. It may help by reducing scalp inflammation and it also appears to have mild anti-androgen effects. In real-world practice, Ketoconazole shampoo is usually treated as a useful add-on rather than a replacement for proven hair loss medicines.

It might be tempting to combine Finasteride and Dutasteride together to double the possible effect, but this serves no meaningful additive purpose and doubles side effect risk.

If you are thinking about combining treatments, consider discussing your situation with a pharmacist or GP first.

Which Finasteride alternatives can I get in the UK?

Minoxidil is an over-the-counter medicine that is an alternative to Finasteride in the UK, and Saw Palmetto is widely available as a supplement. Dutasteride, topical Finasteride and oral Minoxidil (off-label) all require a prescription.

See the table below for each medicine’s prescription status and how to access them.

For people who want to explore alternatives without a GP visit, Oxford Online Pharmacy offers a free online consultation.

What should I do if I want to switch from Finasteride?

If you’re thinking about stopping Finasteride, it’s worth speaking to a doctor first about what to do next. Depending on why you want to stop, you may be able to switch to alternatives like topical Finasteride or Minoxidil.

If you do not replace it with anything else, hair loss may start to progress again within around 3 to 6 months.

1. Speak to a pharmacist or GP before making any changes. They can help you decide which alternative makes the most sense for you and when the best time to switch would be.

2. If side effects are the reason you’re stopping, then you should contact a doctor as soon as you experience side effects to discuss your next steps for treatment.

3. Topical Finasteride may be the first option to consider. It contains the same active ingredient, but blood concentrations are reported to be more than 100-times lower than with oral Finasteride (2). If you’re concerned about persistent symptoms, it may also be worth reading more about post-Finasteride syndrome.

4. If you want to avoid DHT blockers like Finasteride altogether, Minoxidil is usually the main alternative. It works in a different way and is not associated with sexual side effects.

5. Combination treatment may also be worth considering. Options such as Minoxidil + microneedling, or Minoxidil + ketoconazole shampoo, may help support results after stopping a DHT blocker like Finasteride.

If you’re not sure where to start, Oxford Online Pharmacy offers a free online consultation.

Frequently asked questions about Finasteride alternatives

What can I take instead of Finasteride for hair loss?

The main alternatives to oral Finasteride are topical Finasteride (same substance, but much lower systemic absorption), Dutasteride (more potent off-label prescription oral medication), Minoxidil (topical treatment, with no sexual side effects and available over the counter), and Saw Palmetto (natural supplement). Which one makes the most sense depends on what you’re looking for. Some people want the strongest option possible. Whereas others are more concerned about side effects or would rather avoid taking prescription medications if they can.

Is there a natural alternative to Finasteride?

Saw Palmetto is the most well-known natural option, and it’s the one with the most research behind it. In one head-to-head trial against oral Finasteride, 38% of people taking Saw Palmetto saw an improvement, compared with 68% of people taking Finasteride (4). Pumpkin seed oil has also shown some promise in a small study. That being said, natural options tend to be weaker in potency than pharmaceutical medications. They may still be worth considering if your hair loss is in the very early stages or if you don’t want to take a prescription medication.

Is Dutasteride better than Finasteride?

If you’re talking purely about hair growth, Dutasteride does seem to be stronger. In a study conducted in 2014 involving 917 people, Dutasteride increased hair count and hair width more than Finasteride. The downside is that it also suppresses DHT more strongly, so it has a similar sexual side effect profile to Finasteride as well as similar psychological side effects like mood changes, depression and suicidal ideation. If you’re thinking about switching because you’re worried about side effects, Dutasteride may not be a suitable choice.

Does Minoxidil work without Finasteride?

Yes, it does. Minoxidil works directly on the scalp by stimulating the hair follicles, whereas Finasteride lowers DHT levels in the bloodstream. In the UK, you can buy topical Minoxidil over the counter (including the brand Regaine), and it isn’t linked to any sexual side effects. However, Minoxidil doesn’t have an effect on DHT levels, which can be one of the main drivers behind male pattern hair loss.

What is the best treatment for hair loss without side effects?

There isn’t a medication that comes with no possible side effects. If you want an option with one of the most predictable side effect profiles, topical Minoxidil may be one of the best choices. For most people, the most common side effect is scalp irritation. Non-surgical procedures like low-level laser therapy and microneedling may also have very little in the way of side effects on the body. The natural supplement Saw Palmetto is generally well tolerated too.

If you’re trying to find a good balance between results and side effects, topical Finasteride may be worth looking into. The evidence so far suggests it may give hair count improvements close to oral Finasteride, but with lower systemic absorption (2).

Is topical Finasteride safer than oral?

In the pharmacy world, we typically don’t like to use phrases like “safe”, as a medication that could have few side effects for one person may affect another person differently. What we can say with more confidence is that the levels in the blood are much lower with topical treatment. In a 2021 study of 458 patients, topical Finasteride was associated with blood levels that were more than 100 times lower than oral Finasteride, while hair count improvements were very similar (20.2 vs. 21.1)(2). However, blood DHT levels were also reduced less with topical treatment vs. oral treatment.

What are the side effects of Finasteride?

Finasteride is associated with both sexual and psychological side effects, although rates reported in placebo-controlled trials were relatively low.

In 12-month studies from the product's official information sheet, reduced libido was reported in 1.8% of people taking Finasteride compared with 1.3% on placebo. Erectile dysfunction was reported in 1.3% vs. 0.7%, and reduced ejaculate volume in 0.8% vs. 0.4%.

Some other studies have reported wider ranges of side effect frequencies. For example, one study reported erectile dysfunction in the range of 4.9% to 15.8% of people taking Finasteride, reduced libido in 3.1% to 5.4%, and ejaculation problems in 2.1% to 7.7% (3). Longer-term data suggests that sexual side effects were seen in fewer than 2% of people, falling to 0.3% by year 5. In most cases, side effects improve after stopping treatment.

Psychological side effects have also been reported, including low mood, depression, and suicidal thoughts. In May 2026, the MHRA updated its safety guidance for Finasteride following a review of the evidence, noting that sexual dysfunction may contribute to mood disorders in some patients, and that depression and suicidal ideation have been reported. If you experience any psychological symptoms while taking Finasteride, you should stop taking it and contact your doctor as soon as possible.

What is post-Finasteride syndrome?

Post-Finasteride syndrome is the name used for ongoing sexual, neurological and psychological symptoms that some people experience after stopping Finasteride. Its validity is still up for debate but some researchers and patient groups believe it describes a genuine pattern of persistent symptoms, while others point out that it hasn’t been formally recognised as a medical diagnosis.

If it’s something you’re worried about, it’s worth bringing it up with a pharmacist or GP before you start any treatment or if you’re thinking about stopping.

Can you stop hair loss without Finasteride?

Yes, sometimes you can stop hair loss without Finasteride but it depends on how advanced the hair loss is and how well you respond to certain treatments. Minoxidil can help with regrowth and may slow down any further losses without affecting DHT levels in the bloodstream. Some people also do well with combinations like Minoxidil and microneedling. If the hair loss is mild or in the early stages, other treatments may be enough. If the hair loss is more established, treatments that lower DHT in the bloodstream usually give the strongest results. That could be oral Finasteride, Dutasteride (off-label) or even topical Finasteride to an extent, depending on what’s appropriate for you.

How long do I need to try Minoxidil before deciding it doesn’t work?

As a general rule of thumb, Minoxidil needs at least 4 to 6 months of regular daily use before you can assess the results properly. Hair growth goes in cycles and is a slow process, and the first few weeks can be a bit confusing because some people notice hair shedding, but this can be a sign that the product is actually working. If you’ve used it consistently for 6 months and still aren’t seeing any results, it may be time to speak to a pharmacist or doctor about other options or whether a combination of treatments might be beneficial for you.

References

1. Kaufman KD, Olsen EA, Whiting D, Savin R, DeVillez R, Bergfeld W, et al. Finasteride in the treatment of men with androgenetic alopecia. J Am Acad Dermatol. 1998;39(4 Pt 1):578-89.

2. Piraccini BM, Blume-Peytavi U, Scarci F, et al. Efficacy and safety of topical Finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial. JEADV. 2022;36(2):286-294.

3. Gubelin Harcha W, Barboza Martínez J, Tsai TF, et al. A randomized, active- and placebo-controlled study of the efficacy and safety of different doses of Dutasteride versus placebo and Finasteride in the treatment of male subjects with androgenetic alopecia. J Am Acad Dermatol. 2014;70(3):489-498.

4. Rossi A, Mari E, Scarno M, et al. Comparitive effectiveness of Finasteride vs Serenoa repens in male androgenetic alopecia: a two-year study. Int J Immunopathol Pharmacol. 2012;25(4):1167-1173.

5. Cho YH, Lee SY, Jeong DW, et al. Effect of pumpkin seed oil on hair growth in men with androgenetic alopecia: a randomized, double-blind, placebo-controlled trial. Evid Based Complement Alternat Med. 2014;2014:549721.

6. Li Y, Huang Q, Zhou Z, Zhang Y. Comparing minoxidil-finasteride mixed solution with minoxidil solution alone for male androgenetic alopecia: a systematic review and meta-analysis of randomized controlled trials.Front Med (Lausanne). 2025;12:1632139.

7. Johnson H, Huang D, Clift AK, et al. Effectiveness of combined oral minoxidil and finasteride in male androgenetic alopecia: a retrospective service evaluation. Cureus. 2025;17(1):e77549.

8. Medicines and Healthcare products Regulatory Agency. Finasteride and dutasteride – updated safety warnings for psychiatric side effects and sexual dysfunction. Drug Safety Update. 2026;19(10):1.