Looking for a solution to male pattern baldness? Also known as androgenetic alopecia, it affects 30-50% of men by the age of 50, making it more common than it may feel (1). Fortunately, there are treatments which could help you slow or stop hair loss.
Finasteride is a hair loss treatment clinically proven to treat male pattern baldness. It is available as both finasteride tablets and topical finasteride, but how do you know which is right for you?
Both types of Finasteride work by reducing the levels of dihydrotestosterone (DHT) in your body, which is the hormone responsible for shrinking hair follicles and causing hair to shed (2). But there are a range of differences that separate them, from how they are used and their side effects, to how they are licensed in the UK and just how effective they really are.
We know that to be able to make an informed choice about your health and medical care, you need all the available facts. This blog takes a deep dive into both options, to help you understand the difference between topical and oral Finasteride hair loss treatments.
What’s the difference between oral and topical finasteride?
Oral finasteride | Topical finasteride | |
|---|---|---|
How it's taken | Tablet swallowed usually with water | Applied directly to the scalp daily |
Dosing frequency | Taken daily | Initially daily, but always follow the dosing schedule set by your prescriber |
UK licensing status | Licensed for male pattern hair loss | Unlicensed/off-label treatment for hair loss |
Evidence base | Strong long-term clinical evidence | Emerging evidence |
Side-effects | Uncommon but recognised, including low mood and sexual dysfunction | Likely lower risk of side effects and localised to the scalp, but with less long-term data |
Best for | Reliable long-term treatment for those who prefer the convenience of a daily pill | Those concerned about side effects or with a history of sexual dysfunction or mental illness |
Now let us look at each of these areas in more detail, starting with Finasteride licensing.
Oral vs topical Finasteride: licensing in the UK
If a medicine is licensed in the UK, it means that the Medicines & Healthcare products Regulatory Agency (MHRA) has formally reviewed evidence on the dosing, safety and effectiveness for its intended purpose, and given official approval for this exact product and dose.
Oral Finasteride is the officially licensed treatment for male pattern hair loss (3).
In contrast, there is no regulator-approved topical Finasteride product currently available in the UK. This does not automatically mean that it is not safe for use, but it does mean that it has not been assessed in the same way that a licensed medicine has been. It is sometimes referred to as being “off label” as it is the same medication, instead used for a different condition, age group or dose from the one the regulator approved.
Who is Oral Finasteride and Topical Finasteride licensed for?
Oral Finasteride is prescribed to men who have been diagnosed with male pattern baldness. It is not licensed for use in women (4).
Topical Finasteride is usually prescribed to men who are unable to tolerate the side effects of the tablet form, or who prefer to avoid systemic (whole body) exposure to Finasteride.
Dosing and how to take Finasteride
Oral Finasteride vs Topical Finasteride
If you are taking oral Finasteride for male pattern baldness, the standard dose is 1 x 1mg tablet each day. It is important to note that higher doses exist, but do not improve hair outcomes – these are instead prescribed for a different condition called benign prostatic hyperplasia (an enlarged prostate).(4)
We recommend that you try to take your Finasteride tablet at the same time every day so that it becomes a habit, and you are less likely to forget a dose. A common way to do this would be to set a reminder on their mobile phone to help them. Swallow the tablet whole with water.
Topical Finasteride can be supplied as a liquid, spray or foam medication that you apply directly to the affected areas of your scalp. Which formula is best will come down to your own personal preferences. It is usually applied once daily to a clean, dry scalp. You should not apply it to sore, irritated or broken skin.
Is Oral Finasteride or Topical Finasteride most effective for hair loss?
Unsurprisingly, effectiveness is one of the biggest factors to consider when it comes to choosing which type of Finasteride you would like to use. And there are some key differences in the efficacy of oral and topical varieties of this medication.
Oral Finasteride
When it comes to clinical studies, there are far more that have tested the effectiveness of oral finasteride versus topical finasteride. In fact, there are clinical trials going back 30 years that show that oral Finasteride effectively slows hair loss, increases scalp hair count and improves hair appearance in men with male pattern baldness.
A landmark clinical paper, the 1998 JAAD Finasteride Study Group Trial surveyed more than 1500 men and proved that oral Finasteride significantly increased hair counts and slowed hair progression over a two-year period with 66% of men showed hair growth improvement (5).
Meanwhile, extended studies following up on treatment five and ten years later have found that Finasteride maintains efficacy over time for most users, preventing further hair loss progression (6).
Topical Finasteride
Evidence of the success of topical Finasteride is still very much in the emerging stages in comparison to oral finasteride. However, in one clinical study topical finasteride was shown to improve hair count by +20.2 hairs vs. +6.7 hairs for participants who used the placebo (7). Nevertheless, longer-term evidence is still limited when compared with oral Finasteride.
Find out more about how topical finasteride works in our blog: Does Topical Finasteride Work?
Comparing Topical and Oral Finasteride results
While both forms of the medication are proven to work, oral finasteride still has the edge when it comes to raw hair count results, with studies over 30 years old backing up its long-term effectiveness. That said, head-to-head data from the same clinical trial found that topical finasteride results were very close to oral finasteride, with hair count increase of 20.2 hairs for topical users compared with 21.1 hairs for those on the oral tablet (7).
Where they really part ways is in what happens elsewhere in the body. The same trial found that peak levels of finasteride in the bloodstream were over 100 times lower with the topical spray, and the drop in DHT (the hormone linked to hair loss, and to finasteride's side effects) was smaller too – 34.5% with topical versus 55.6% with oral (7). This is why topical finasteride is often seen as the gentler option: similar hair growth benefits, but a much lighter touch on the rest of the body.
Deciding which medication to choose is simply down to evidence and which you would prefer. Oral finasteride has three decades of long-term data behind it, including 5 and 10-year follow-up studies, while topical finasteride is still being studied in more depth.
When choosing your treatment, your choice may come down to whether you prefer to go with a more heavily studied option or one that has a lesser impact on the body.
How do side effects of Oral Finasteride and Topical Finasteride compare?
Although generally well tolerated by most people who take them, like all medicines, oral and topical Finasteride can cause some side effects, although not everyone gets them (4). However, since they are taken in different ways, the side effects that they cause can also be quite different, and in some cases, a defining factor in why some men choose one option over the other.
Side effects of Oral Finasteride vs Topical Finasteride
Because oral Finasteride travels through the bloodstream to reach the scalp, a small number of men experience side effects linked to the drop in DHT levels it causes elsewhere in the body.
Uncommon side effects (may affect up to 1 in 100 people) include (4):
Inability to get an erection
Less desire to have sex
Problems with ejaculation, such as reduced semen volume
In contrast, because topical Finasteride is applied directly to your scalp, it works in a localised area. This means that side effects tend to be localised too. A clinical study showed that around 97% of side effects associated with topical Finasteride use are mild to moderate (7).
Although not everyone gets them, side effects of topical Finasteride could include (7):
Scalp irritation
Itching
Dryness or redness at the application site
For this reason, topical finasteride may be a better option if you’re worried about side effects or have a history of sexual dysfunction or mental health conditions.
If you’re experiencing side effects while taking finasteride tablets, it is also possible to switch to a topical application. Always speak to your prescriber before switching to a new type of medication.
Note: you should stop taking Oral and Topical Finasteride and seek immediate medical attention if you experience the symptoms of an allergic reaction. These include:
Swelling of your face, lips, throat or tongue
Difficulty breathing or swallowing
Lumps under your skin or a rash
Although extremely rare, you should also speak to your doctor if you notice any changes in your breast/chest tissue, such as lumps, pain, enlargement, nipple changes or discharge as these could be signs of a more serious condition, such as male breast cancer (8).
Oral Finasteride vs topical Finasteride: mental health side effects
As of May 2026, the MHRA has released new warnings for Finasteride and its psychological effects, citing that sexual dysfunction (such as decreased sex drive, erectile problems, or ejaculation difficulties) may itself contribute to mood disorders, and that mood changes have also been reported without any accompanying sexual side effects (9).
The updated advice states that anyone taking oral Finasteride should stop treatment immediately if they develop depression or suicidal thoughts and contact their doctor as soon as possible. Doctors are also being asked to check patients' history of depression or suicidal ideation before prescribing, and to review them regularly for both psychiatric and sexual side effects throughout treatment (9).
Currently, there is extremely limited evidence to suggest that topical Finasteride has any impact on mental health (12).
If you have a history of low mood, anxiety or other mental health disorders, oral Finasteride may not be a suitable treatment for you. If you notice any mood changes while taking Finasteride, stop treatment immediately and seek the advice of your prescriber. If you experience suicidal thoughts, seek emergency mental health support or call 999.
Oral Finasteride vs Topical Finasteride: Which one gives faster results?
Both forms of Finasteride work on a similar early timeline: most men notice reduced shedding after around three to six months of consistent daily use, whether taking the oral tablet or applying the topical spray.
With oral Finasteride, hair then continues to thicken gradually over the following 12 to 24 months before reaching its full effect, based on the long-running clinical trials that have followed men for several years (10). Topical Finasteride shows a comparable early pattern. In a phase III clinical trial, men using the spray saw a significant increase in hair count by week 12, which continued to improve through to week 24 (7). However, because it's a newer treatment, the trials behind it haven't yet run as long as those for the oral tablet. This means there isn't the same depth of evidence for what happens beyond six months, so while early signs point to a similar trajectory, longer-term data is still needed to confirm whether topical Finasteride follows the same 12-to-24-month path to full effect.
Is a tablet or topical treatment easier to use?
Whether a tablet or topical treatment is “easier” comes down to personal preference.
Oral Finasteride is the more convenient option for many men, as it is much quicker to swallow a tablet than to apply a solution to the scalp every day. But while more time-consuming, some men forget to take a daily pill and find it easier to remember to apply topical treatment.
As with any hair loss treatment, consistency and long-term use are important for maintaining results. When choosing between them, the best option is usually the one you feel most comfortable using regularly.
Can you use oral and topical finasteride together?
No, it’s not recommended to use oral and topical Finasteride together. Both treat hair loss by lowering DHT levels, so combining them increases the amount of Finasteride in the body, potentially worsening side effects without evidence of any extra benefit.
If you want to try combining hair loss treatments, consider taking Oral Finasteride 1mg with Topical Minoxidil. Minoxidil treats hair loss by improving blood flow to the scalp and lengthening the growth phase of the follicles. As it targets different pathways to stimulate hair growth, it can be safely taken alongside Finasteride (11).
There are a few different ways to combine these two evidence-based treatments:
Oral finasteride taken alongside topical Minoxidil
Combination sprays that contain topical Finasteride and Minoxidil
Oral finasteride and oral Minoxidil
Regardless of the method of delivery, one clinical study showed that using finasteride and minoxidil together improves hair count and thickness compared with using either treatment alone (11).
Supportive haircare products like Alpecin C1 Shampoo or Sons DHT Blocking Shampoo and Sons Strengthening Conditioner may also improve the appearance of hair alongside medical treatment.
How can you get oral or topical Finasteride in the UK?
Both oral and topical Finasteride require a prescription to make sure the treatment is safe and suitable. However, the NHS does not prescribe Finasteride for treating hair loss. Instead, you will have to get a private prescription following an in-person or online consultation.
Many private clinics and prescribing pharmacists, including Oxford Online Pharmacy, can prescribe both oral and topical formulations, but only oral Finasteride is licensed in the UK for male pattern hair loss (4).
That is not to say that topical Finasteride is unsafe or ineffective. It purely means it has not yet gone through the full regulatory approval process for use as a hair loss treatment, so prescriptions of Finasteride solutions, gels, and sprays are considered “off label.”
Which option is right for you?
Oral Finasteride is usually recommended first because it has the strongest long-term evidence and is licensed in the UK for treating male pattern hair loss. But topical Finasteride may be a better option for some people if you are concerned about systemic side effects, have had previous bad experiences with the pill but want to restart, or just prefer this method of administration.
The right treatment depends on your medical history, treatment goals, and personal preferences. Through our online doctor service, our independent UK clinicians can help you decide whether oral or topical Finasteride is most suitable for you and discuss whether combining treatment with options like minoxidil may improve results.
Visit our Hair Loss Hub for more advice or start a consultation to see what is suitable for you.
References
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Zito PM, Bistas KG, Syed K. Finasteride [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2021 [cited 2026 Aug 10]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513329/
MHRA Products | Product results [Internet]. Mhra.gov.uk. 2026 [cited 2026 Aug 10]. Available from: https://products.mhra.gov.uk/product/?product=FINASTERIDE%201%20MG%20FILM-COATED%20TABLETS
Package leaflet: Information for the user Finasteride 1 mg film-coated tablets finasteride. In [cited 2026 Aug 10]. Available from: https://www.medicines.org.uk/emc/files/pil.13542.pdf
Kaufman KD, Olsen EA, Whiting D, Savin R, DeVillez R, Bergfeld W, et al. Finasteride in the treatment of men with androgenetic alopecia. Journal of the American Academy of Dermatology [Internet]. 1998 Oct 1 [cited 2026 Aug 10];39(4):578–89. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0190962298700076
Long-term (10-year) efficacy of finasteride in 523 Japanese men with androgenetic alopecia [Internet]. www.oatext.com. [cited 2026 Aug 10]. Available from: https://www.oatext.com/Long-term-(10-year)-efficacy-of-finasteride-in-523-Japanese-men-with-androgenetic-alopecia.php
Piraccini BM, Blume‐Peytavi U, Scarci F, Jansat JM, Falqués M, Otero R, et al. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial. Journal of the European Academy of Dermatology and Venereology. 2021 Oct 25;36(2):286–94. [cited 2026 Aug 10] https://pmc.ncbi.nlm.nih.gov/articles/PMC9297965/
Medicines and Healthcare products Regulatory Agency. Finasteride and dutasteride – updated safety warnings for psychiatric side effects and sexual dysfunction [Internet]. London: GOV.UK; 2026 May 11 [cited 2026 Sep 1]. Available from: https://www.gov.uk/drug-safety-update/finasteride-and-dutasteride-updated-safety-warnings-for-psychiatric-side-effects-and-sexual-dysfunction
Medicines and Healthcare products Regulatory Agency. The risk of male breast cancer with finasteride [Internet]. London: MHRA; 2009 Dec [cited 2026 Sep 1]. Available from: https://assets.publishing.service.gov.uk/media/5df7610c40f0b60959adc737/Finasteride_risk_of_male_breast_cancer.pdf
Finasteride Male Pattern Hair Loss Study Group. Long-term (5-year) multinational experience with finasteride 1 mg in the treatment of men with androgenetic alopecia. European journal of dermatology: EJD [Internet]. 2002 [cited 2026 Aug 12];12(1):38–49. Available from: https://pubmed.ncbi.nlm.nih.gov/11809594/
Bharadwaj A, Vibhu Mendiratta, Rehan H, Tripathi S. Comparative efficacy of topical finasteride (0.25%) in combination with minoxidil (5%) against 5% minoxidil or 0.25% finasteride alone in male androgenetic alopecia: A pilot, randomized open-label study. International Journal of Trichology. 2023 Jan 1;15(2):56–6. [cited 2026 Aug 12]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10495069/
Bai JQA, Geng RSQ, Donovan J. Adverse events of topical finasteride for male androgenetic alopecia: a systematic review and meta-analysis of randomized controlled trials. JAAD Rev. 2025;6:72-74. doi:10.1016/j.jdrv.2025.09.003 Available from: https://www.sciencedirect.com/science/article/pii/S2950198925000893