Even if you’re in the early stages of researching male hair loss treatments, chances are you’ve already come across the big two: Finasteride and Minoxidil. These are the most popular hair loss medications worldwide, with more than half of hair restoration specialists recommending topical Minoxidil, and more than two-thirds recommending oral Finasteride [1].
But a growing body of research suggests it’s actually a combination of Minoxidil and Finasteride that works best for male pattern baldness [2-5]. Topical Finasteride with Minoxidil, in particular, has become popular for treating hair loss.
So just how effective is Minoxidil combined with Finasteride? And what are the side effects of using both treatments together? In this article, we explore the evidence and review the efficacy of Finasteride-Minoxidil combination therapy for androgenetic alopecia, addressing points such as:
If you’re a man with male pattern baldness, it’s usually safe to mix Minoxidil with Finasteride. Since these medications tackle hair loss through two different mechanisms, mixing them may lead to better, longer-lasting results.
But while Minoxidil is suitable for a range of hair loss patients, Finasteride isn’t suitable for everyone. Dr Michael May, principal surgeon at the Wimpole Clinic, says:
“Finasteride for women isn’t usually recommended, especially if you haven’t yet reached menopause. It’s also advised that anyone who is trying to conceive avoids Finasteride, as the drug can pass into your semen and harm a developing foetus.”
In addition, Finasteride only works for hormone-related hair loss. It’s only effective for treating male pattern baldness (and female pattern baldness in rare cases). So people with other types of alopecia (e.g. alopecia areata or chronic telogen effluvium) probably won’t see a benefit from mixing Minoxidil with Finasteride.
Studies show that Finasteride results may be enhanced if used alongside Minoxidil [2-4]. This table shows the percentage of men who saw hair loss improvements after 12 months of treatment [3]:
5% topical Minoxidil only
1 mg oral Finasteride only
Minoxidil + Finasteride combination therapy
Another study found that combining 0.1% topical Finasteride and Minoxidil 5% could help maintain high hair density after a course of oral Finasteride [2]. 84.5% of patients maintained their hair thickness after one year of topical Finasteride and Minoxidil treatment, following two years of oral Finasteride use. Dr May explains the benefits of this:
“This is a promising development for men who want to maintain their hair without experiencing the potential longer-term effects of oral Finasteride use. However, topical Finasteride hasn’t yet been licensed for use in the UK, so anyone considering this treatment should do so with caution.”
These photos from clinical trials show the impact of Minoxidil combined with Finasteride:
Finasteride and Minoxidil are the most popular non-surgical hair restoration treatments for male pattern baldness. Both are available as oral and topical medications. Here’s a head-to-head comparison of how each treatment tackles hair loss:
Oral: 1 mg (5 mg in limited cases)
Topical: 0.1% – 1%
Topical: 2%, 5%
Oral: >1 mg – 5 mg
Topical: Skin irritation, contact dermatitis, redness.
Oral: Temporary Finasteride hair shedding, erectile dysfunction, lower libido, testicular discomfort.
Topical: Skin irritation, contact dermatitis, redness, temporary Minoxidil hair shedding.
Oral: Hypertrichosis, changes in blood pressure and heart rate.
Minoxidil is a vasodilator. This means it can widen your blood vessels, including the thin capillaries located in your scalp which nourish your hair follicles. If they are widened, they allow for more blood flow, which means they help transport more oxygen and nutrients to your hair follicles [6].
When they have all the necessary resources, the follicles can produce stronger, healthier and denser strands. This can help in a variety of conditions, such as male and female pattern baldness, milder forms of alopecia areata, chronic telogen effluvium, etc.
Finasteride is a 5-alpha reductase inhibitor. That means that it inhibits an enzyme called 5-alpha reductase from converting too much of your testosterone into dihydrotestosterone (DHT) [7]. While some DHT is needed for your body to function well, having a too high concentration in your blood can make this male hormone bind to an excessive number of androgen receptors in your hair follicles.
If this happens, the affected follicles will start to shrink and produce shorter, finer hairs, until they become unable to produce any. This is how androgenetic alopecia develops.
Finasteride and Minoxidil are complementary therapies. Finasteride tackles the underlying hormonal hair loss trigger, while Minoxidil allows more blood to flow to the scalp, providing follicles with more nutrients and oxygen. This may help them progress into the growth phase of the hair growth cycle.
Using these treatments in isolation means you only take advantage of one hair growth mechanism. For best results, it’s generally safe and effective to use Minoxidil and Finasteride together, so you can get the benefits of both mechanisms at the same time.
Combining Minoxidil and Finasteride puts you at greater risk of experiencing side effects of both medications. But mixing these treatments in certain ways can help you control those side effects.
Topical Finasteride and oral Finasteride have different potential adverse effects. While topical Finasteride is more likely to cause mild localised issues, such as redness, irritation, and itchiness, oral Finasteride can lead to problems like erectile dysfunction and lower libido. So mixing Minoxidil with topical Finasteride may reduce the risk of more serious issues.
The same is also true for Minoxidil. Topical Minoxidil is associated with localised complaints such as contact dermatitis and skin irritation, whereas oral Minoxidil may cause cardiovascular problems like changes in blood pressure and heart rate. Those at risk of heart conditions and high blood pressure should use oral Minoxidil with extreme caution [8].
If you’re considering mixing Minoxidil and Finasteride, get a medical checkup to confirm it’s safe for you to use these medications for hair loss.
Though there are four ways to combine Minoxidil and Finasteride, only two of these have undergone clinical trials to establish safety and effectiveness. These are:
Dr May explains further:
“It’s also possible to take Finasteride and Minoxidil tablets, or mix topical Finasteride and oral Minoxidil. None of the existing research suggests there will be any dangerous interactions between these drugs. However, until these Finasteride-Minoxidil combinations have been clinically tested, it’s best to stick with those that are proven to be safe and effective.”
There’s currently no research to confirm the safety of using both oral Finasteride and oral Minoxidil together. Both treatments are generally safe to use on their own, but the risk of systemic side effects is higher with these oral treatments [8-9].
Several major hair treatment companies such as Keeps or Hims sell convenient combinations of Minoxidil and Finasteride, in different forms. Just be aware that Finasteride is a prescription medication and you will need a doctor’s recommendation to buy it even when combined with Minoxidil. Here are some options that you may find helpful:
Disclaimer: The products mentioned on this page are for reference purposes only and have been selected based on online reviews and user-reported results. Wimpole Clinic does not endorse or guarantee the effectiveness of these products.
This product combines 0.25% Finasteride and 5% Minoxidil in the same container, in topical form. You can choose either the gel variety or a slightly more expensive but easier-to-apply foam. Unlike solutions, gels and foams are less likely to run out of your hair and onto your face.
This 2-in-1 spray is easy to apply on the thinning spots in your hair and harnesses the power of both these medications combined. It contains 0.3% Finasteride and 6% Minoxidil, which makes it somewhat stronger than the usual topical hair growth solutions (5% Minoxidil is normally used). The spray dries quickly and allows for precise application.
If you would rather chew on a delicious tablet than use topical solutions on your scalp, Hims has your back. You can opt for the chewable Finasteride and Minoxidil combination, which also contains a proprietary blend of hair growth vitamins. One pill taken per day will provide the necessary dose of both medications.
This is especially useful for busy men who don’t have time to apply foams or solutions. However, you should be aware that when taken orally, hair growth medications can have more systemic side effects than when used topically.
If you would like to go the tried-and-tested topical Minoxidil and oral Finasteride route, you can get the value pack from Keeps. It contains 5% Minoxidil (you can opt between foam or solution form) and 1 mg Finasteride. Since many clinical trials performed to check the effectiveness of this drug combination have been performed using topical Minoxidil and oral Finasteride [14][15], you can rest assured that science deems this option effective.
You can buy premixed topical Finasteride and Minoxidil from online pharmacies. These solutions are better than mixing your own treatments, as the formula typically contains a safe level of active ingredients.
To apply, spray 1 ml of the solution (approximately 1-2 sprays) to your balding area(s) twice a day.
Make sure the area is clean and dry when you apply the solution.
Finasteride is a prescription medicine, so take it as instructed by your doctor. Most people are advised to take one 1 mg tablet per day.
You can then apply Minoxidil: use the applicator (foam, spray, or dropper) to apply 1 ml of the solution to your scalp, then gently spread the formula across your balding or thinning patches. Repeat twice a day.
Certain types of alopecia cannot be treated more effectively by a combination of Minoxidil and Finasteride than by Minoxidil alone. Some of these are:
No — you don’t have to combine Minoxidil and Finasteride unless you want to.
While multiple studies have shown this to be the most effective route to regrowth, both Minoxidil and Finasteride have good success rates on their own, especially if they’re used early. So if you’re worried about side effects, you can use one or the other to minimise the risk.
If you feel like Minoxidil is not enough to curb your alopecia and provide sufficient hair growth, Finasteride isn’t the only other treatment you can combine it with for an extra boost. Here are some other mixed therapies which have proven themselves effective:
If you are experiencing androgenetic alopecia, you might be a good candidate for a hair transplant. While there is no baldness cure at this time, a natural-looking hair restoration surgery is as close as it gets, because a hair transplant is permanent.
So if you are struggling to fill out your bald spots by trying medication combinations, getting your hairline or crown surgically restored can get you there more effectively and with long-term results. While other hair growth treatments are only effective while you are taking them, a hair transplant can look as good after 10 years.
Combining hair restoration surgery with topical Minoxidil (you can resume treatment approximately 1 week after your procedure) can help you see better results sooner. So get ready to say goodbye to that receding hairline or bald spot on the crown and get reacquainted with your youthful, full-haired appearance.
Also known as derma-rolling for hair growth, this therapy involves using a small, handheld device to make minuscule punctures in your scalp. This stimulates your body’s healing processes which can help repair damaged follicles.
Moreover, studies show that using Minoxidil and a derma-roller together can enhance both their effectiveness. That is because the small punctures make it easier for the topical solution to be absorbed into your scalp [16].
This form of low-level laser therapy involves exposing the scalp to beams of red or near-infrared light. They are absorbed into the skin and help improve blood flow, as well as increase the amount of energy that reaches your hair follicles.
Several studies have demonstrated that combining red light therapy for hair growth with topical Minoxidil can yield improved results compared to each of these stand-alone treatments [17][18].
Getting PRP hair treatment can help improve your strand health and density. This procedure involves extracting a little blood from your arm and separating the PRP from the other blood fractions. Then, this plasma is injected into your balding spots.
Since it is filled with growth factors, PRP can stimulate your hair follicles for growth. Combining this treatment with Minoxidil has been found to produce promising results in patients with androgenetic alopecia [19].
To discover which hair loss treatment is right for you, book a free consultation with our team at your most convenient central London clinic location. Our skilled and experienced trichologists will provide a thorough examination to ensure that your androgenetic alopecia is correctly diagnosed and to determine its stage on the Norwood scale.
Then, they will work together with you to provide the most effective personalised treatment that fits your scalp and hair conditions, as well as your lifestyle and preferences.
Are there still questions you’d like to ask regarding the Minoxidil and Finasteride combination? Here are the answers to some frequent patient queries that you may find helpful:
It depends on the type of hair loss you are using the medication for. If you are experiencing androgenetic alopecia, then yes, research shows that Finasteride is more effective than Minoxidil in improving hair density and thickness [14].
However, if you are using it for other types of hair loss, such as alopecia areata or for a patchy beard, Minoxidil is significantly more effective (because Finasteride is not effective against those conditions).
Yes, you can effectively combine Minoxidil with other DHT blockers as well, such as Dutasteride [20] (however, Dutasteride is not yet approved for hair loss so it must be prescribed off-label).
Moreover, it is likely that combining Minoxidil with rosemary oil for hair growth may yield good results (however, more research is needed). This hair growth oil contains natural DHT blockers and has proven efficiency against androgenetic alopecia [21].
While you theoretically could mix 10% Minoxidil with Finasteride, you don’t have much reason to do so. Research says that 5% Minoxidil is actually more effective than the 10% concentration and it also carries fewer side effect risks [22]. So it is best to use the lower dose, as it will not negatively impact your results.
It largely depends on what you understand to be better. Studies show that oral and topical Minoxidil have similar effects at comparable doses [23]. Topical Finasteride seems to have a slightly diminished effectiveness in lowering blood DHT levels compared to the oral variety [24]. However, oral medication presents a higher risk of systemic side effects than topical forms.
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