Does Topical Finasteride Work? What Should You Expect

Losing your hair can bring up a ton of emotions, and we’re not exaggerating when we say it can force you to reckon with how you feel about your appearance (not to mention your age). It can make you feel desperate, but luckily, there are solutions. 

You can look at hair restoration, a hair transplant and even hair pieces, but we recommend starting with a hair loss treatment that’s less disruptive and proven effective. Because if you can slow or even stop your balding with a topical medication, why would you want to do more?

Typically sold as an oral medication, finasteride is a proven hair loss treatment option. But what about a topical finasteride solution that can give you the same results and be easily incorporated into your daily hair care routine?

Our question might bring up some of your own. Does topical finasteride work? How do topical finasteride results compare to the usual oral tablet? What do reviews about these products say? We have answers.

What is Topical Finasteride?

There are two medications approved for hair loss by the Food and Drug Administration (FDA): topical minoxidil (the active ingredient in Rogaine®) and oral finasteride.

Oral finasteride (sold under the brand name Propecia®) is FDA-approved for the treatment of hair loss. Topical finasteride is a compounded medication that can either be finasteride alone or combined with topical minoxidil.

Is Topical Finasteride FDA-Approved?

Only the oral form of finasteride is FDA-approved for the purpose of treating male pattern baldness, which means topical application of finasteride is not.

However, available research indicates the safety and effectiveness of topical finasteride and many healthcare providers still prescribe it for this use when appropriate. This is called off-label use. 

How Does Topical Finasteride Work?

Male pattern hair loss is caused by enzymes that are responsible for the conversion of testosterone into the male sex hormone dihydrotestosterone (DHT), a major androgen.

High DHT levels cause hair follicles — the tiny organs throughout your scalp from which your hair grows — to shrink and reduce, which eventually leads to baldness.

Finasteride is part of a group of medications called 5-alpha reductase inhibitors, which prevent the conversion of testosterone to dihydrotestosterone and, therefore, help delay hair loss. 

You can learn more about this medication, including how to apply it, in our full topical finasteride 101 guide.

But before you start putting it on your scalp, you probably want to know if topical finasteride is effective — and if so, how effective compared to other options. 

Next, we’ve outlined what researchers have concluded about how well topical finasteride works for treating hair loss in men.

Is Topical Finasteride Effective for Hair Growth?

There’s plenty of evidence for the effectiveness of oral finasteride, but what about the effectiveness of topical finasteride? While the current topical finasteride studies are smaller in size, they do have promising results.

For example, one 2018 systematic review of seven topical finasteride studies found that the medication was correlated with a significant decrease in the rate of hair loss, a significant increase in total hair counts, and a positive hair growth assessment.

In one of the studies included, 73 percent of treated patients reported “high effectiveness” of using 1.0 mL topical finasteride 0.005% solution twice daily to their affected scalp for 16 months, compared to 60 percent of placebo patients reporting that they experienced “no effect” on hair growth. 

The authors of the systematic review concluded that the topical finasteride results were “safe and promising” and recommended ongoing research and follow-up.

A 2020 review of 33 scientific articles using topical finasteride for the treatment of male androgenetic alopecia and female pattern hair loss had similar findings. The studies “showed positive results with a favorable safety profile” and the authors called for continued research.

Topical Finasteride Reviews

Product type: Hair loss treatment

Key ingredients: Finasteride

Purpose: Designed to prevent further hair loss and help regrow hair

Efficacy: ★★★★★ “While oral finasteride does have more data behind it, there is more and more data coming out on topical finasteride showing it can be effective as well,” says Dr. Knox. 

Side effects: ★★★★★ “The risk of side effects is very low” he adds. 

Ease of use: ★★★★★ “This comes in different forms so you can find the one that works best for your hair,” says Dr. Knox.

Overall, Dr. Knox says that topical finasteride is a great option for people who prefer a topical medication but still want a DHT blocker in their regimen.

Topical vs. Oral Finasteride: Which One is Better for You?

Current research, while limited, points to topical finasteride as effective at preventing future hair loss and encouraging hair regrowth. But should you choose topical finasteride vs oral? That depends.

If you’re wondering how effective topical vs oral finasteride is, studies have compared the results of both.

For example, a 2014 study found that scalp DHT was reduced by 68 to 75 percent with topical finasteride treatment and by 62 to 72 percent with oral finasteride treatment for men with male pattern baldness. In other words, both are effective — but the topical version may have a slight advantage for some men.

A study of more than 440 patients that compared the effectiveness of a topical finasteride spray and the oral tablet found that the spray significantly improved hair count compared to placebo (and approximately the same amount as the oral version) but had less of an impact on serum DHT levels than the tablet.

In a 2009 study, researchers compared the effects of topical finasteride gel against the oral tablet form among 45 men with androgenetic alopecia. 

By the end of the study, both groups saw similar positive effects on hair growth, finding a significant increase in total hair count and terminal hair (thick, coarse hair that grows on your scalp, eyelashes, and eyebrows). 

The bottom line is that both oral and topical finasteride seem to be pretty good at helping you regrow lost hair. 

If you want to learn more about the effectiveness of oral finasteride, this article on finasteride results covers all the research behind the oral version of this hair loss treatment.

Topical Finasteride vs Topical Minoxidil: Which is Better?

As we mentioned, minoxidil is the other FDA-approved topical solution for hair loss. So, how does topical minoxidil compare to topical finasteride? We’re glad you asked. 

Minoxidil stimulates hair growth by boosting blood flow to your hair follicles. 

Fun fact: minoxidil was originally formulated in the ‘60s as a vasodilator — a medication that relaxes and opens up your blood vessels for better circulation — to treat high blood pressure. It wasn’t until 1988 that a formulation was approved specifically as a first-line treatment for men with mild-to-moderate male pattern baldness. 

It’s also thought that minoxidil lengthens the growth phase of your natural hair growth cycle, giving it more time to flourish. 

It can be used topically as either a minoxidil foam or liquid minoxidil solution drops, both of which are applied directly to your hair and scalp.

Minoxidil is also highly effective for hair loss, with the results of several large-scale studies backing up hair regrowth claims. Typically, you can expect to see new hair growth after eight weeks of consistent application.

In a one-year-long study among 904 men with androgenetic alopecia, 62 percent saw a significant decrease in hair loss from baseline after using 5% topical minoxidil twice a day.

Another study found that after 16 and 26 weeks of treatment, minoxidil led to a 70 percent improvement in mean hair density compared to a placebo.

We talk more about the relationship between finasteride and minoxidil in our minoxidil vs finasteride guide.

Oral finasteride is often prescribed in conjunction with topical minoxidil, and evidence suggests the two medications work best side by side. However, this may also be true for a combination of minoxidil and finasteride topical solutions.

For instance, a study of 50 men with androgenetic alopecia who had been using a combination of topical minoxidil and oral finasteride for two years switched to a topical solution of minoxidil fortified with finasteride. The majority of patients continued seeing improvements in hair density, even after the treatment switch.

Our topical finasteride & minoxidil spray reviews have mentioned new hair growth from this easy-to-use product, as well as a boost in confidence.

Side Effects of Topical Finasteride

Of course, like any medication, topical finasteride has potential side effects. 

The most common adverse effects include:

• Redness at the application site

• Scalp itching

• Irritation or dermatitis

• Erectile dysfunction (ED), ejaculatory dysfunction, and loss of libido

• Depressive symptoms and suicidal thoughts

However, more research is needed on the potential side effects of topical finasteride. 

In addition, topical finasteride poses specific risks during pregnancy, particularly for male fetuses. Women who are pregnant or may become pregnant should avoid coming in contact with topical finasteride, as the medication can be absorbed through the skin and may cause birth defects in male babies. 

Does Topical Finasteride Work? Final Thoughts

When weighing your hair loss treatment options, here are some key points to consider about topical finasteride:

• The oral and topical forms work the same way. Both forms of finasteride treat hair loss by blocking the enzyme that converts testosterone into DHT, which means DHT can’t shrink hair follicles and stop new hair from growing. 

• Both are effective. Although topical finasteride is relatively new (compared to oral medication, anyway) and not FDA-approved for male hair loss, available research shows it’s just as (if not sometimes more) effective as oral finasteride at increasing hair count and density.

• There are other options. Finasteride and minoxidil are just two ways to treat hair loss. For instance, you can also give your existing hair a boost with a volumizing shampoo and conditioner duo or consider adding a supplement like our biotin gummies to your daily routine.

Curious if topical finasteride is right for your hair goals? Take our free hair loss quiz and get matched with hair loss treatment plans backed by science.