Finasteride vs minoxidil - which one is best?

When it comes to our hair, we want to make the best decision for us, and we know how important finding the best treatment is and that is why we are diving deep into hair loss treatment with finasteride and minoxidil. 

First signs of hair thinning 

Like all conditions, it is good to recognise the symptoms you are experiencing and treat them early. This is the same when treating hair loss.  

The most common form of hair loss is male pattern baldness. It typically begins when a man is in his twenties and early thirties and affects 85% of men by the age of 50. But it can also start in your teens through to your mid-20s. Find out more about the stages of male pattern baldness below. (1)

The chances of preventing hair loss are much higher the sooner you start treatment. 

The symptoms of balding can also differ from person to person. Some people may have temple-first hair loss, while others may experience changes to their hairline. This implies that not everyone who is experiencing hair loss will exhibit every balding indication. 

Typical indications of baldness include: 

1. Temple thinning 
   The hair around your temples starts to thin. The hair at the crown or rear of your head will also appear thinner. 
    
2. A thinning of the scalp 
   Thinning hair on top of the head might occasionally be the first indicator of hair loss. You won't see any thinning or receding on the sides of your head with this sort of hair loss. This kind of hair loss typically develops gradually. Years may pass before the top of your head develops a bald spot due to hair thinning. In some racial groups, this pattern of hair loss is extremely prevalent. 
    
3. A thinning hairline
   The process of the hair on the front and sides of your head starting to thin and move away from your face is referred to as a "receding hairline." Because the hair on the sides of their heads is thinning more quickly than the hair in the centre, persons who experience this type of hair loss frequently notice that their hairline has begun to form an "M" shape. 
    
4. Hair bunches when it sheds
   Sometimes your hair can come out in big clumps as opposed to progressively thinning and retreating. Hair loss in clumps may be a sign of an underlying medical issue. A wider section Your part line, or the line where your hair separates on top of your head, enlarges and pulls apart as a result of another form of hair loss and you should see your GP or doctor to get this investigated.
    
5. Your entire head is thinning 
   Some people lose hair uniformly across their entire heads. Without any patterns or shapes, the hair thinning is uniform.  
    
6. You're balding everywhere on your body 
   After shaving, you can discover that your body hair is thinning or not returning. Ageing can cause hair loss in your arms, legs, and other body areas. It may, however, also be a sign of other medical issues. If you encounter this kind of hair loss, let your doctor know. 

Androgenetic Alopecia 

Also known as male pattern hair loss, Androgenetic Alopecia (AGA) is a genetically predetermined condition resulting from an overactive androgen response. This disorder, which can affect up to 50% of both men and women, is characterised by a progressive loss of scalp hair that has reached its terminal stage at any point after puberty. 

Both in males and females, it is distributed distinctively. While women's frontal hairlines are often spared from diffuse hair loss at the crown and top of the head, it is frequently identified by a broader centre part. On the other hand, men experience hair loss that is most noticeable at the vertex and frontotemporal regions. 

The male pattern hair loss cycle:  

The hairline and crown are where this process usually starts, leaving you with the tell-tale receding hairline and bald patch that many men with male pattern baldness eventually notice in the mirror. Even though male pattern baldness accounts for the majority of cases of crown balding, other types of hair loss can also contribute to the condition. 

Types of receding hairline

Hair thinning at crown

Finasteride

This medication is used to treat male pattern baldness (androgenetic alopecia) at the crown and in the middle of the scalp. This medicine works by lowering the levels of DHT, a hormone produced naturally by the body. Increased hair regrowth and slower hair loss result from lowering DHT levels. Finasteride has no impact on the growth of hair in other parts of the body. This medication should not be used by women or children. 

Male pattern hair loss (androgenetic alopecia) is caused by the androgen dihydrotestosterone (DHT), which is prevented in genetically susceptible males by the 5-alpha-reductase inhibitor finasteride. In a considerable number of men with male pattern hair loss, oral finasteride 1mg/day increases hair growth and stops future hair loss, according to the findings of phase III clinical research in 1998. There is evidence to support the idea that therapy for two years maintains the increase in hair count recorded after one year. (2)

According to a 1999 review of finasteride from the National Library of Medicine, their findings suggest that in the vast majority of men with male pattern hair loss, oral finasteride encourages scalp hair growth and stops future hair loss. Finasteride is an innovative approach to the management of this condition, for which there are few treatment choices, and it has a generally good tolerability profile. Its function in relation to topical minoxidil is still unknown. (3)

How to take finasteride 

The recommended dose of finasteride is one 1mg tablet to be taken daily.

Finasteride can be taken without food but should be swallowed whole with a glass of water.

Your doctor will then continuously assess the treatment. 

How long does finasteride take to work 

It generally takes between three and six months until you will start to see the effects of finasteride, in this time the stabilisation of hair loss can be expected. 

Finasteride must be taken continuously to sustain benefits. 

Finasteride side effects 

Like all medicines, there is a chance that you may experience side effects, and some are more common than others. See below for a list of reported side effects.

Uncommon (may affect up to 1 in 100 people): 

• decreased sexual drive 
• erectile dysfunction  
• problems with ejaculation, such as a decreased volume of ejaculation  
• depression  

Not known (frequency cannot be estimated from the available data):  

• pain in the testicles  
• blood in semen  
• fast heartbeat  
• persistent difficulty having an erection after discontinuation of treatment 
• infertility has been reported in men who took finasteride for a long time and had other risk factors that may affect fertility. After stopping finasteride, reports of seminal quality returning to normal or even improving have been reported. Although, there hasn't been any lengthy clinical research on finasteride's impact on male fertility. 
• changes in the way your liver is working, which can be shown by a blood test  
• anxiety 

Often side effects may stop with regular usage of the medicine. If the side effects do not subside, you should report them to us, or your GP.  

For a full list of side effects and warnings, see the finasteride patient information leaflet. 

How to reduce the side effects of finasteride 

Take finasteride with a meal. Finasteride can be taken with or without food, however, based on anecdotal research, taking it with meals may assist to lessen some of the more prevalent side effects. 

Check out our article on finasteride side effects here.

Finasteride before and after articles 

We would like to introduce you to our customers Mukesh and Ed who have experienced hair loss since their early 20s and are using finasteride to treat and prevent hereditary hair loss.  

Check out their articles, before and after images and even YouTube videos below for more information

 Mukesh

• Finasteride: Before and After Images
• My experience taking Finasteride 1mg Tablets
• My experience taking Finasteride 1mg tablets - Part 2

 Ed

• Ed's Hair Loss and Treatment Journey – Introduction
• Ed's Hair Loss Treatment Journey - 3 Months Progress
• Ed's Hair Loss Treatment Journey 6-Month Update

Minoxidil 

Topical minoxidil, otherwise known as Regaine has been approved by the Food and Drug Administration (FDA) for the treatment of Androgenetic Alopecia (AGA). 

Minoxidil has been used for hair loss treatment for several decades. The medication affects follicular cells by enhancing hair growth and reducing hair loss.   

Although its exact mechanism of stimulating hair growth is unknown, minoxidil can assist androgenetic alopecia sufferers stop losing their hair by doing the following:  

• Follicle miniaturisation is reversed 
• Enhances the blood flow surrounding the follicles 
• Encourages follicular growth phase movement 
• Extends each follicle growth phase 

Clinical studies in AGA patients treated with 2% or 5% minoxidil solution showed a notable increase in hair growth and a decrease in hair loss, with the 5% formulation producing superior outcomes. (4)  

How to apply Regaine Solution 

Use Regaine Extra Strength for Men after thoroughly drying your hair and scalp.

Apply a single 1ml dose to the scalp area where your hair is thinning using your favourite applicator.

After lightly massaging it into the desired area, let the solution air dry. Then you can comb your hair if required.

Apply the Regaine hair treatment twice daily, in the morning and the evening, with a break of about 12 hours in between. It's ideal to do it around 30 minutes before going to bed so that the treatment has time to completely dry.

How long does Regaine take to work? 

Typically, you will start to see results by 16 weeks after their first application, this will vary depending on the person. You will see the best results from Regaine if it is used consistently, twice a day. 

Minoxidil side effects 

Like all medicines, this medicine can cause side effects, although not everybody gets them. 

See a list of the potential side effects below: 

Very common (may affect more than 1 in 10 people)  

• Headache

Common (may affect up to 1 in 10 people)  

• Itching or dermatitis  
• Unwanted non-scalp hair has been reported (including facial hair growth in women). Always wash your hands thoroughly after application and if you accidentally apply the solution to parts of your body other than the scalp, rinse thoroughly with plenty of water

Uncommon (may affect up to 1 in 100 people)  

• Nausea

Finasteride vs minoxidil cost 

Finasteride tablet price

*These prices are as of 26.04.2023 and are subject to change.

These tablets are taken continuously, once a day, so a pack of 28 tablets will last you 28 days. 

Propecia, the branded version of Finasteride and Finasteride Accord are also available at OxfordOnlinePharmacy. 

Minoxidil solution price 

*These prices are as of 26.04.2023 and are subject to change.

Minoxidil Solution 1ml should be applied twice daily (leaving at least 12 hours between application), a 60ml bottle could last around 30 days. 

The isn’t a generic topical Minoxidil solution, however, you can get topical minoxidil solution as the branded version, Regaine, this medication comes in a foam or solution form.

Can I use finasteride and minoxidil together? 

Yes, you can, and it has been proven to be a more successful treatment option than using one or the other alone.

Buy our hair loss treatment pack with Finasteride and Minoxidil here.

Minoxidil vs finasteride conclusion 

A randomised and comparative study evaluated the efficacy of oral finasteride and 5% topical minoxidil treatment for 12 months in 65 male patients with mild to severe AGA.  

The results showed that both medicines were shown to be effective and safe in this comparative research of systemic finasteride and topical minoxidil for the treatment of mild to severe Androgenetic alopecia (AGA) while oral finasteride treatment was more effective (p 0.05). Adverse events were also dismissed as unimportant, and once the medication stopped being taken, these negative effects went away. (5)

References

1. Alopecia UK, Androgenetic Alopecia (Pattern Hair Loss)
2. National Library of Medicine, Finasteride in the treatment of men with androgenetic alopecia. Finasteride Male Pattern Hair Loss Study Group, J Am Acad Dermatol. 1998 Oct;39(4 Pt 1):578-89. doi: 10.1016/s0190-9622(98)70007-6.
3. National Library of Medicine, Finasteride: a review of its use in male pattern hair loss, 1999 Jan;57(1):111-26. doi: 10.2165/00003495-199957010-00014.
4. National Library of Medicine, Changes in hair weight and hair count in men with androgenetic alopecia, after application of 5% and 2% topical minoxidil, placebo, or no treatment ,J Am Acad Dermatol. 1999 Nov;41(5 Pt 1):717-21. doi: 10.1016/s0190-9622(99)70006-x.
5. PubMed, Topical minoxidil fortified with finasteride: An account of maintenance of hair density after replacing oral finasteride, Indian Dermatol Online J. 2015 Jan-Feb; 6(1): 17–20.doi: 10.4103/2229-5178.148925

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