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Your Guide to the Top Hair Loss Treatments for 2023 (Yes, They Really Work!)

2022 was a big year for advancements in the medical field. Scientists learned how to track rapidly changing Covid variants, promising medications for prostate cancer were identified, and breakthroughs were made in diabetes management. JAK inhibitors were found to be successful in helping patients with severe alopecia areata regrow their hair. (01)

We’ve been busy too. In addition to seeing patients throughout the year, Dr. Ben Behnam and Dr. Sean Behnam, board-certified dermatologists and hair specialists, were behind the scenes developing, testing, and marketing stronger treatments for male and female pattern hair loss based on scientific data and their clinical experience.

If bald spots, thinning hair, or hairballs in the shower are stressing you out, now is the time to stop the shedding and start regrowing your hair. Here’s our guide to the Top Hair Loss Treatments for 2023. We’ll also share the science behind the formulas so you can make smart decisions about the products you use.

Top Oral Medications for Hair Loss

The most effective hair loss medications are prescription drugs discovered by accident. During testing for high blood pressure and benign prostatic hyperplasia, researchers found that the medicines had a peculiar side effect. Balding men suddenly started to regrow their hair. Further research was conducted, and sure enough, the findings were confirmed. Finasteride is now FDA approved to use by men with male pattern hair loss. Although all the other medications listed below have been tested for efficacy, they are currently prescribed off-label at low doses. Oral hair loss medications are easy to take and are relatively inexpensive.

Oral Minoxidil

Oral Minoxidil was recently touted in the New York Times as a “cheap treatment” that “restores hair in many patients.” (02) Minoxidil works by opening the blood vessels. More oxygen flows to the scalp, expanding the blood vessels and enlarging the hair follicles. Topical liquid or foam works for many people, but it does not work for some. People who do not respond to the topical formula may have better luck with the pill. A specific enzyme must be present in the skin and hair roots to convert topical Minoxidil to an active form. Oral Minoxidil does not need to be converted.

Oral Finasteride

Low-dose oral Finasteride is a first-line DHT blocker that can be used by both men and women who are not pregnant or planning to become pregnant. DHT blockers prevent testosterone from converting to a hormone called dihydrotestosterone (DHT). DHT binds to your hair follicles, makes them shrink during a process called miniaturization, and makes your hair fall out. When DHT production is blocked, your hair follicles remain healthy. Oral Finasteride has minimal side effects on women who qualify to take the medication. Although not common, some men report sexual side effects from the pills. Switching to topical Finasteride is a good solution for men who are concerned.

Oral Dutasteride

Oral Dutasteride is similar to Finasteride. The main difference is the number of isoenzymes inhibited. Finasteride inhibits Type 2 isoenzyme of 5a-reductase (5AR). Dutasteride inhibits Type 1 and Type 2. 5AR is the enzyme that converts testosterone to dihydrotestosterone (DHT). Research indicates that Dutasteride reduces more serum DHT than Finasteride. (03) Should you skip the Finasteride and go straight to Dutasteride? Not necessarily. Finasteride is effective for many users and can be taken at a lower dose. It’s typically recommended to step up to stronger medications as needed. Of course, there are always exceptions, so your dermatologist should guide you.

Oral Spironolactone

Oral Spironolactone, a medication used to treat high blood pressure and heart failure, is used off-label at low doses to treat hair loss. Spironolactone falls into the category of mineralocorticoid receptors (MRAs). The medication slows the production of androgen to block DHT production. It’s usually only prescribed to women because it can cause side effects such as enlarged breasts in men.

Combination Oral Medications

Over time, dermatologists have discovered that treating male or female pattern hair loss requires multiple approaches working simultaneously. Many people need a cocktail of medications to stop their hair loss and to grow new hair. However, taking numerous medications usually isn’t convenient. That’s where SuperCapsules play a role. These medications combine a Minoxidil (a vasodilator), Finasteride or Dutasteride (a DHT blocker), and vitamin D.

Why Vitamin D? Because the number of people with Vitamin D deficiencies is more significant than you would imagine. Vitamin D deficiency affects about 40 percent of the people who live in the U.S. (04) Vitamin D is metabolized in the skin by cells that process keratin, the protein found in your hair, nails, and skin. When your body has a Vitamin D deficiency, your body has trouble regulating hair growth and shedding.

Thickening Shampoos & Conditioners

Shopping for the right shampoo and conditioner can be overwhelming. Store shelves are packed with different options for every hair type. There are shampoos and conditioners for dry hair, greasy hair, curly hair, straight hair, dandruff, and more. What do you use if your hair is thinning or falling out? Well, there’s a plethora of options for that too. When developing their shampoo and conditioner, Dr. Ben Behnam and Dr. Sean Behnam were very particular about the ingredients they chose. Here are some of the natural ingredients they selected and why:

Argan oil

Research indicates that aragan oil has antioxidant and anti-inflammatory properties. Aragan oil can protect your hair against elements and make it look shinier.

Biotin

Biotin, vitamin B7, is known for stimulating keratin production and increasing follicle growth rate. It was added to help make your hair stronger.

Collagen

Collagen is used to increase your hair’s ability to build protein. It can help make your hair longer and thicker. If you have gray hair, collagen may help improve your hair’s appearance by supporting the hair follicle where your hair’s pigment is produced.

Keratin

Want smoother, shinier hair? Keratin will help. The hair cuticle absorbs keratin, a structural and protective protein which helps keep your hair under control.

Saw Palmetto

Saw palmetto is a member of the palm family. The powder is made from the shrub’s berries. Saw palmetto not only has anti-inflammatory properties, but it also acts as a DHT blocker.

Remember that no shampoo or conditioner alone will prevent hair loss or regrow your hair. The right ones will, however, help keep your hair and scalp healthy and healthy looking.

Hair Supplements

Nutritional deficiencies, hormonal issues, and stress all contribute to hair loss. Daily hair supplements with Vitamin A, Vitamin D, Ashwagandha, probiotics, and other natural ingredients included in our hair supplements help offset the effects to give you stronger, healthier hair.

Researched and Tested Prescription Hair Loss Treatments

Most people are upset when they realize that they’re losing their hair. If that’s you, it’s time to usher in the new year with a fresh approach to managing your hair loss. Thanks to telemedicine, you can quickly, easily, discreetly access the prescription hair loss treatment you need. Our caring, licensed dermatologists are available to help you along the way. There’s even a special edition holiday pack to help you get started.

Remember, it can take six to twelve months to see the full results, so make sure to celebrate your milestones along the way. You may not think that you’re making much progress. After all, you see yourself every day. However, taking photos monthly will make it easier to see new growth. Cheers to new beginnings!

Resources:

(01) https://pubmed.ncbi.nlm.nih.gov/31930807/

(02) https://www.nytimes.com/2022/08/18/health/minoxidil-hair-loss-pills.html

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472914/

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6075634/

(05) https://pubmed.ncbi.nlm.nih.gov/34634163/

What You Need to Know About How to Take Finasteride

If you want finasteride to work its magic and regrow your hair, you’ll need to know how and when to take the medication. Whether you’re taking oral finasteride or the topical version, understanding how to take finasteride will get you the best results.

What is finasteride?

Finasteride is one of only two FDA-approved prescription medications typically used for treating hair loss in males. Originally, finasteride was prescribed to treat benign prostate enlargement and other prostate issues. However, finasteride doctors may also prescribe finasteride to treat hair loss. (01)

How does Finasteride work?

Most cases of hair loss in men occur because of increased amounts of dihydrotestosterone (DHT) in the body. DHT is a hormone that plays a significant role in the development of male sex characteristics and is must more potent than testosterone. DHT is so powerful that it attaches to the same sites as testosterone, like the hair follicles.

An excess of DHT impacts hair follicles and causes them to shrink. In turn, these injured hair follicles become unable to grow hair. By the age of 50 years, over half of the men in the U.S. will probably experience hair loss mediated by DHT. Finasteride works by limiting the action of 5-alpha-reductase, the enzyme used to produce dihydrotestosterone (DHT). The resulting decrease in DHT slows hair loss and can encourage hair regrowth. With regular use, finasteride reduces DHT levels in the body by an average of almost 70 percent. (02, 03)

What types of hair loss can finasteride treat?

The FDA approves Finasteride to treat the most common type of hair loss for men: male-pattern hair loss, also known as androgenetic alopecia. Male-pattern hair loss affects about 50 million adult males in the U.S. With finasteride, men may see an 83% stabilization of hair loss, and 60% of cases may see their hair regrow. Because finasteride prevents DHT from forming, it works on most DHT-related types of hair loss. (01)

What should you tell your doctor before taking finasteride?

Like most medications, finasteride comes with some contraindications. Before taking finasteride, let your doctor know if you’ve ever experienced the following:

Liver disease
Abnormal liver tests
Prostate cancer
An allergy to finasteride

Give your doctor a list of medications, both prescription and nonprescription, that you’re currently taking. This list should include any vitamins, nutraceuticals, and herbal products. Inform your doctor if you smoke, consume alcohol, or use drugs. (01)

Although finasteride shows excellent results in men, children and women in their reproductive years are not typically prescribed finasteride. For both men and women, a doctor may perform laboratory tests and thoroughly assess before prescribing finasteride whether the medication is taken orally or topically. (01)

How should I take oral finasteride?

Oral finasteride is taken daily with a full glass of water, as prescribed. Taking finasteride at the same time each day helps to keep a stable level of finasteride in the body stable at all times. For best results, finasteride should be taken regularly without missing any doses. Because oral finasteride works internally, women are not usually prescribed oral finasteride.

How should I apply topical finasteride?

Topical finasteride is a liquid that is applied using a calibrated dropper. To use a dropper:

Line up the dropper to the scalp area.
Apply the solution by squeezing the dropper.

While finasteride does come in a spray or gel form, a calibrated dropper offers a mess-free application. A dropper, rather than a gel or spray, makes medication application more accurate and reduces medication waste. Rather than trapping medication onto existing hair – where it can’t do its job – a dropper spreads medication directly onto the scalp. Because topical finasteride is applied externally, the medication is safe to use for women over 50. (04)

What if a dose is missed?

When a finasteride dose is missed, avoid the temptation to double up on the next dose. Instead, skip the missed dose. Take the next dose at the regular time instead and resume treatment as prescribed.

People who forget to take their finasteride too often or who skip their treatments frequently may not see successful results. Too many missed doses lower finasteride levels and may produce lackluster results. To see the full advantages of finasteride treatments, it’s crucial to adhere to the prescribed regimen.

What should I do when too much finasteride is taken?

If a finasteride overdose occurs and the person has trouble breathing, has a seizure, or is unconscious, seek medical attention as soon as possible. The Poison Help line (1-800-222-1222) can also offer assistance if an overdose is suspected.

What finasteride side effects may occur?

Like any other medication, side effects may occur with oral or topical finasteride. There is a higher risk for side effects when taking the oral form of finasteride. Studies on topical finasteride indicate a very low incidence of sexual side effects. Specifically, only one subject out of 268 participants (or 0.37%) showed any sexual side effects when taking finasteride topically. On the other hand, oral finasteride is linked to sexual side effects in 1.8% to 3.8% of users. (05)

Other rare side effects that may occur with finasteride are:

Depression
Changes in breast or nipple shape and size
Rash
Hives
Nipple discharge
Itching
Facial swelling
Difficulty breathing
Problems swallowing

In most cases, doctors prescribe the lowest dose and titrate the medication up to reduce side effects and ensure safety. Many people who do experience mild side effects find that the effects disappear after their bodies adjust to the medication.

What should I know about the storage and disposal of this medication?

Appropriate storage and disposal of finasteride keeps the medication safe and in good condition. Finasteride should be kept tightly closed when not in use and kept in the container it came in. Store the medication out of reach of children and away from moisture and extreme temperatures. Discarded medication and containers should be disposed of in such a way to ensure pets and children can not obtain them. We encourage our users to read our blog titled “Side Effects of Topical Finasteride: Review of Current Medical Literature.”

What other information should I know?

Your doctor will monitor your progress on finasteride to ensure efficacy and safety. Monitoring may include a short assessment or laboratory tests. Because finasteride isn’t for everyone and requires a prescription, don’t let anyone else use your finasteride.

How long does finasteride take to work?

Every person sees results from finasteride at a different pace. Some individuals may not see results until three months into regular medication use. However, finasteride starts working and lowers DHT from the very first dose.

Finasteride has a short half-life, which means it doesn’t last long in the body. Because of its short half-life, it’s essential to stick to your doctor’s prescribed schedule to keep enough medication in the body for peak effectiveness. Taking finasteride for hair loss takes patience. So, remember, a finasteride regimen is not a sprint – it is a marathon with a worthwhile prize in the end! (04)

Finasteride and Then Some!

Happy Head uses a proprietary formula of topical Finasteride and a 40% higher concentration of Minoxidil with Retinoic Acid. Each product is crafted individually for each client, offering the best results and the lowest risk for side effects. Every hair growth formula is customized, factoring every client’s age, sex, and medical history. At Happy Head, you’ll have the attention of board-certified dermatologists specializing in hair growth every step of the way. If you are interested in a science-based satisfaction-guaranteed hair growth formula, visit Happy Head today.

Resources:

(01) https://www.pdr.net/drug-summary/Propecia-finasteride-378.609

(02) https://www.webmd.com/skin-problems-and-treatments/hair-loss/hair-loss-treatments-men#1

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3262531/

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6609098/

(05) https://reference.medscape.com/drug/propecia-proscar-finasteride-342824#4

Everything You Need To Know About Finasteride Interactions

If you have aging parents or grandparents and have seen their overflowing pill boxes, you know that it’s important to track their medications. One prescription can easily interact with another, and boom, you’re at the doctor’s office figuring out which drug is the culprit.

Dermatologists and hair specialists often recommend prescription hair loss medications because they are safe and effective. However, if you are taking other drugs or supplements at the same time, you should be aware of potential unintended interactions. Since Finasteride, also sold under the brand names Propecia and Proscar, is FDA-approved to treat hair loss, it’s the one most often prescribed. So, for that reason, we’ll tell you everything you need to know about what mixes well with Finasteride and what might not be the best combination.

Finasteride is a Leading Treatment for Male and Female Pattern Baldness

Research continually demonstrates that Finasteride, a medication originally developed to treat Benign Prostatic Hyperplasia (BPH), is one of the most effective ways to treat androgenetic alopecia. The statistics tell the story. After two years on Finasteride, 83 percent of men included in Merck’s research study did not experience further hair loss. More than 70 percent showed increased hair growth. (01) Finasteride works just as effectively for women. (02) That’s why Finasteride is often dermatologists’ drug of choice when it comes to stopping further hair loss and stimulating new growth.

Finasteride Increases the Testosterone Levels in Your Body

So, how does Finasteride help stop your hair from shedding? It blocks an enzyme called 5-alpha-reductase (5-AR). When 5-AR isn’t produced, testosterone can no longer be converted to an androgen called Dihydrotestosterone (DHT), which is what causes your hair follicles to miniaturize. Finasteride also increases testosterone levels in your body. More testosterone shrinks prostate size and helps your hair grow. The only catch is that when you stop taking Finasteride, any new growth will be lost.

Finasteride Interactions are Uncommon

Complications stemming from Finasteride use are rare. That’s not to say that it doesn’t or can’t happen. Certain medications can either increase or reduce the amount of Finasteride in your bloodstream. Carbamezepine, Rifampin, and St. John’s Wart may reduce Finasteride’s efficacy by metabolizing the Finasteride faster in your liver. Other medications such as Itraconazole and erythromycin may actually increase the levels of Finasteride in your blood. Checking with your doctor is the best way to know if other medications you are already taking will contradict Finasteride.

Avoid Interactions with Other Medications by Using Topical Finasteride Versus Oral

If you have androgenetic alopecia and are worried about Finasteride interacting with the other medications you are taking, ask your doctor about using topical Finasteride. Research indicates that topical Finasteride is equally as effective as oral. (03) Think of topical Finasteride as a spot treatment. It works directly on the areas where your hair is thinning to prevent further hair loss and stimulate growth. Oral Finasteride, on the other hand, is systemic since it is metabolized in your stomach. Topical Finasteride is the ideal solution for men and women who want the benefits of the medication without any potential drug interactions.

Some Medications Make Finasteride Work More Effectively

Some medications have been found to increase the efficacy of Finasteride. Because some medicines work synergistically, dermatologists and hair specialists often recommend that patients use multiple hair loss treatments simultaneously to maximize results.

Minoxidil, also marketed under the brand Rogaine, is a topical hair loss solution that has proven to complement Finasteride. (04) While Finasteride blocks the testosterone from converting to DHT, Minoxidil enlarges the hair follicles, preventing hair loss, and allowing new growth to break through. Minoxidil is available in both oral and topical formulas.

Retinol is also a medication that is often prescribed with Finasteride. Retinol, a derivative of Vitamin A, is often prescribed to reduce wrinkles and improve skin texture. The medication increases collagen production and stimulates the production of new blood vessels bringing oxygen to the skin. In addition, retinol has been proven to improve the absorption of topical Finasteride. (05)

When patients with hair loss experience inflammation, topical or injected cortisone is often prescribed in conjunction with Finasteride as well.

Taking Finasteride, Minoxidil, Retinol, and Cortisone all at the same time can seem like a lot of medications to remember. Fortunately, topical formulas are now available that combine all into one convenient bottle.

Alternatives to Finasteride

Other options exist if you are experiencing male or female pattern baldness and oral or topical Finasteride aren’t suitable for you.

Dutasteride

Finasteride is effective for most people. However, an alternative medication is Dutasteride. Dutasteride works similarly to Finasteride by blocking the conversion of testosterone into DHT. The difference between the two medications is that Finasteride inhibits the Type 2 5AR isoenzyme,while Dutasteride inhibits both Type 1 and Type 2. In addition, Dutasteride’s prescribed dosages are typically lower than Finasteride’s because the medication is a bit stronger.

Spironolactone

Spironolactone, also known as Aldactone, is used off-label to treat female pattern hair loss. It was originally marketed to treat fluid retention caused by liver and kidney disease. The medication is only prescribed for women because it can cause feminizing features when used over time. Research has not yet been conducted on a large sample size, but four women included in a study, saw reduced hair loss and experienced some growth. (06)

PRP

PRP, an abbreviation for Platelet Rich Plasma, is a three-step process designed to trigger hair growth by increasing the amount of oxygen available to the hair follicles. First, blood is drawn. Then, blood is then separated into three groups using a centrifuge. Lastly, the platelet rich plasma is injected into the scalp. PRP is often used in conjunction with other treatments to maximize results.

Hair Transplant Surgery

If you are concerned about drug interactions, hair transplant surgery may be an option and a long-term hair loss solution. During the past few years, many advances have been made in how the procedure is performed. Rather than taking strips of hair to transplant, surgeons are now able to move individual hairs giving a more natural look.

Low-light Laser Therapy (LLLT)

You may have seen ads recently for laser caps marketed for hair growth. Most use light in the red or infrared range to penetrate the scalp and target the hair follicles. Early studies show promise for the technology, but more research needs to be conducted on the efficacy. One study found that LLT works better when used with Minoxidil or Finasteride. The study also indicated that more data is needed to determine the optical laser power and wavelength. (07)

Be Honest About Your Medical History

If your dermatologist recommends Finasteride or any other prescription hair loss treatment, the best thing you can do is be honest about your medical history. In addition to telling your doctor about any other hormone, heart, or other medications you’re taking, remember to list any supplements. Also, although sharing information about smoking, drinking, or recreational marijuana use may seem embarrassing, remember that your dermatologist has seen and heard it all. He or she is more concerned with giving you the best hair regrowth options and keeping you safe than passing judgment on your behavior.

Is Finasteride Right For You?

If you have questions about whether Finasteride is right for you or could potentially interact with other medications you’re taking, let us know. Our board-certified dermatologists have full medical degrees from accredited universities. They are available and happy to review your medical history and suggest solutions based on the type of hair loss you are experiencing.

Resources:

(01) https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020788s020s021s023lbl.pdf

(02) Note: Recommended doses differ for men and women

(03) https://pubmed.ncbi.nlm.nih.gov/34634163/#:~:text=Conclusion%3A%20Topical%20finasteride%20significantly%20improves,impact%20on%20serum%20DHT%20concentrations.

(04) https://onlinelibrary.wiley.com/doi/10.1111/dth.12246#:~:text=Efficacy%20assessment,combination%20therapy%20showed%20improvement%2C%20respectively.

(05) https://jamanetwork.com/journals/jamadermatology/article-abstract/557305

(06) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3769411/#:~:text=In%20a%20case%20study%20of,total%20number%20of%20anagen%20hairs.

(07) https://pubmed.ncbi.nlm.nih.gov/29270707/

How to Avoid Side Effects from Finasteride

If you’ve seen television ads for any medication, you know that almost all of them have potential side effects. By the time the announcer gets to the end of the (sometimes very long) list, you’re probably wondering why doctors even prescribe the medication in the first place. But, of course, some medications have more side effects than others. And, some medications get a bad rap just because one or two out of thousands had unusual reactions.

Fast forward to Finasteride. Finasteride, also known as Propecia or Proscar, is often prescribed to treat hair loss due to various conditions. Finasteride was originally marketed to treat men with enlarged prostates. During drug trials, doctors noticed that men who took Finasteride as a prostate treatment experienced hair growth. Finasteride was then FDA-approved to treat hair loss too. In this case, the side effect was a good one. However, some male Finasteride users have reported some undesirable sexual side effects. Should you be concerned? Not really. The side effects aren’t typical. Plus, there are ways to avoid the side effects if that’s a concern. We’re here to share why you shouldn’t worry if your doctor has prescribed Finasteride to treat your hair loss.

Why is Finasteride Prescribed for Hair Loss?

Finasteride is what’s called a DHT blocker. DHT is an acronym for dihydrotestosterone, which is an androgen, a male sex hormone. When men and women experience androgenetic alopecia, an enzyme called 5-alpha-reductase converts testosterone to DHT. When this happens, DHT can bind to the receptors on your hair follicles, shrinking the follicles during a process called miniaturization. Over time, the anagen phase of the hair growth cycle is reduced. The result is hair that is shorter and thinner. Eventually, new hairs become so small that they can’t penetrate the hair follicle. As a DHT blocker, Finasteride prevents this process from happening, so you maintain your existing hair and continue to grow healthy new hair.

What Hair Loss Conditions Does Finasteride Treat?

Oral Finasteride is FDA approved to treat androgenetic alopecia, male and female pattern hair loss. Male and female pattern hair loss is the most prevalent type of alopecia worldwide. There isn’t a way to predict who will experience pattern hair loss. The condition is genetic and can be inherited from either the maternal or paternal sides of the family. There isn’t a specific test to diagnose androgenetic alopecia. Dermatologists and hair specialists can make the diagnosis by evaluating a patient’s hair loss pattern.

Finasteride is also used to treat other types of alopecia, including alopecia areata and lichen planopilaris, which are caused by autoimmune conditions. However, the prescription is considered off label when prescribed to treat hair loss other than androgenetic alopecia.

Is Finasteride Effective in Preventing Hair Loss and Stimulating Growth

If you’re wondering whether Finasteride is worth the risk of whatever side effects could occur, that’s a valid question. Although deciding whether to use Finasteride is highly personal, research indicates that Finasteride is highly effective in promoting growth and preventing further hair loss. Over 80 percent of men who use Finasteride see improvement, and over 65 percent see new hair growth. Not only that, the results are long-term. A study of 1879 men indicates that hair count present after one year was maintained during the second year of treatment.

What are Finasteride’s Side Effects?

Side effects caused by oral Finasteride are usually mild and disappear after you stop taking the medicine. Here are a few signs to watch:

Anxiety
Depression
Dizziness
Weakness
Headache
Inability to urinate
Testicular pain
Runny nose
Rash, itching, swelling of the face, lips, or tongue, or other signs of an allergic reaction
Swelling of your hands or feet

Although these side effects aren’t exactly desirable, they aren’t most mens’ biggest fear. Most are more concerned about potential sexual side effects such as:

Decreased libido
Erectile dysfunction
Decreased semen volume
Breast enlargement & tenderness
Premature ejaculation

The good news is that these side effects aren’t common. Some men who do experience the sexual side effects find that their symptoms disappear over time as their bodies acclimate to the medication. If not, discontinuing the use of Finasteride usually resolves the issue.

How Common are Side Effects from Finasteride?

As mentioned previously, side effects from Finasteride aren’t common. The main reason is that the dosage typically prescribed to treat alopecia is usually very low, much lower than the dosage prescribed for prostate treatment. As a matter of fact, only 3.8 percent of men who took Finasteride experienced side effects during the drug’s clinical trials. That’s compared to 2.1 percent of men who took a placebo.

Want to Avoid Finasteride Side Effects? Use Topical Finasteride Instead

If you’re still a little worried about using Finasteride, even though the risk of side effects is low, there’s a simple solution. Use topical Finasteride instead of oral Finasteride. The topical solution has been proven to be just as effective in treating male and female pattern baldness without the same risk of side effects. Whereas oral Finasteride is metabolized in your stomach, topical Finasteride is not systemic. Even better, topical Finasteride has less impact on serum DHT concentrations. Think of it as a highly effective spot treatment for your hair.

Research also indicates that combining Minoxidil with Finasteride yields even better results than using either medication alone. Adverse reactions among patients were rare, indicating that the combined medication is not only a good choice, but a preferable one.

Are You a Good Candidate for Finasteride?

Finasteride is often prescribed to both men and women to treat androgenetic alopecia. The medication is generally safe for most people. There are some exceptions though. Finasteride is not recommended if you have kidney problems, prostate cancer, liver disease, or any other liver-related issues. The medication is also not recommended to women who are pregnant, trying to get pregnant, or are breastfeeding.

What Should You Do if you Experience sexual or Other Side Effects from Finasteride?

If you think Finasteride is causing side effects, stop taking the medication and contact your dermatologist. The side effects usually go away after the medication is out of your system. However, you’ll want to work with your dermatologist to identify a substitute.

When considering a new medication, it’s important to do your research and feel confident about your choice. Finasteride is no exception. If you have questions and are looking for answers, we’re here to help. Our board-certified dermatologists and hair specialists look forward to giving you the information you need, when you need it, to get the healthiest, most effective hair loss treatment.

Resources:

(01) https://pubmed.ncbi.nlm.nih.gov/9951956/

(02) https://pubmed.ncbi.nlm.nih.gov/9951956/

(03) https://pubmed.ncbi.nlm.nih.gov/34634163/#:~:text=Conclusion%3A%20Topical%20finasteride%20significantly%20improves,impact%20on%20serum%20DHT%20concentrations.

(04) https://pubmed.ncbi.nlm.nih.gov/32166351/

What Is Topical Finasteride?

If you’re searching for hair loss treatments, finasteride is a name you’ll need to familiarize yourself with. Why? Only two hair loss products have received the FDA’s seal of approval — minoxidil is one of them. The other product is finasteride.

What is finasteride?

Although there are many different types of hair loss, the most common type is androgenetic or androgenic alopecia, also known as male pattern baldness or MPB. As part of a class of medications called 5-alpha reductase inhibitors, finasteride treats male pattern baldness by blocking testosterone’s ability to develop into dihydrotestosterone (DHT). DHT is a hormone that causes hair loss in adults, especially men. By blocking the production of DHT, finasteride reduces the amount of DHT within the scalp. (01)

Isn’t finasteride used for prostate issues?

Yes, finasteride is also prescribed for symptoms of benign prostatic hypertrophy (BPH) — an enlargement of the prostate gland. When used for BPH, finasteride reduces urinary frequency and urinary retention. However, the doses used in the treatment of BPH are much higher than the doses used to treat hair loss. As a treatment for BPH, finasteride is sold under the name Proscar.

What is finasteride’s history?

During finasteride’s use as an FDA-approved treatment for BPH under the name Proscar, researchers noticed its effectiveness against hair loss. Several years afterward, lower-dose finasteride was approved for hair loss under the name Propecia.

How does finasteride work against hair loss?

Finasteride works by inhibiting the action of the 5 alpha-reductase enzymes. Concentrated in the oil glands of hair follicles, 5 alpha-reductase, which helps convert testosterone into DHT, another hormone. For people who have the genes for hair loss, DHT binds to hair follicle receptors and diminishes the follicle’s size. If the follicle becomes too small, gradual hair loss occurs.

Finasteride inhibits 5 alpha-reductase, thus reducing serum DHT (the DHT in the blood). Without DHT to constrict hair follicles, hair loss slows and — for many people — hair regrows. With less DHT in the blood, some people see their hair loss stop completely. In short, finasteride protects hair follicles from DHT damage and stops hair loss.

Which Types of Hair Loss Does Finasteride Treat?

The average person loses 100 hairs each day, even with no hair loss issues. Hair falls away as part of each strand’s natural growth cycle, and the loss is negligible. Each strand of hair grows until its fullest length, then rests and eventually falls away. Afterwards, another strand grows to take its place. (02)

Excessive hair loss is more than a normal part of a hair’s growth cycle. Hair loss can become a problem when more than the average amount of hair is lost over time or if hair fails to regrow. For many people — about an estimated 80 million US adults — a balding scalp or thinning hair is the result of hereditary factors. (02)

If a person’s hair loss stems from DHT’s damage to hair follicles, then finasteride can help.

Is oral finasteride better than topical finasteride?

Finasteride requires a physician’s prescription. A physician can determine the cause of hair loss and prescribe the most appropriate treatment. Getting to the root of the problem determines what works and what doesn’t — like oral finasteride versus topical finasteride.

Oral finasteride, though effective, comes with a myriad of side effects. Many of the side effects of oral finasteride are life-altering, for example:

Decreased sex drive
Pain or tenderness in the testicles
Numbness in the testicles
A reduction in sperm count
Difficulty obtaining or maintaining an erection (erectile dysfunction)
Reduced ejaculatory volume
Severe mood changes
Breast enlargement

In rare cases, oral finasteride may cause permanent side effects.

Fortunately, taking finasteride topically reduces many of the more problematic side effects caused by taking finasteride orally. However, topical finasteride isn’t without precautions and still necessitates professional oversight to monitor and prevent side effects. Though not as severe as oral finasteride, some topical finasteride side-effects include:

Decreased sex drive
Inability to urinate
Swelling of hands and feet
Increased liver enzymes
Headaches
Testicular tenderness
Scalp irritation
Contact dermatitis
Depression or anxiety
Dizziness or weakness

Can you buy finasteride over the counter?

Because finasteride works best for people with an inherited tendency for hair loss, it’s safest to have a physician determine its use. Therefore, finasteride is not a product that anyone can purchase at a pharmacy without a prescription. Finasteride is not an over-the-counter medication and requires a physician’s approval.

Is topical finasteride effective for hair loss?

Topical finasteride works excellently against hair loss. What’s more, topical finasteride avoids many of the adverse side effects that may deter others from completing treatment. The following are studies highlighting the effectiveness of oral finasteride.

A 2016 article published in the journal Dermatology Clinics and Research of 107 people found that:
- Both topical and oral finasteride are equally effective.
- However, participants on topical finasteride were more likely to complete treatment because there were less side effects. (03)
A 2019 literature review published in the Journal of Drugs and Dermatology found that topical finasteride delivered: (04)
- A significant decrease in the rate of hair loss.
- An increase in hair counts.
- A reduction in DHT levels within the scalp and plasma.
A 2021 study published in the Journal of European Academy of Dermatology and Venereology utilized 458 study participants found: (05)
- No serious adverse side effects in participants.
- Fewer complaints of sexual side effects when using topical finasteride.
- Topical finasteride improves overall hair count while producing fewer adverse side effects.

To summarize, the topical application of finasteride is as effective as taking the drug orally. However, adverse side effects are less common with the topical application of finasteride when compared to oral treatment.

When taken orally, finasteride goes through the digestive system and into the bloodstream. Applied as a topical, it bypasses the digestive tract and goes straight to its target with little to no side effects. This aspect makes topical use much more desirable, making users more likely to stick with the treatment!

How do you balance the effectiveness of finasteride versus the side effects?

Getting the most benefits from finasteride with minimal side effects is achieved through:

Combining both finasteride and minoxidil, the two only FDA-approved medications for hair loss.
Customizing hair loss treatment to the needs of each individual, making every formula unique to each person’s needs.

Because each person is different, it’s essential to make every finasteride treatment as specific to the person as possible. By catering the therapy to each person, adverse side effects are less likely to occur. And because side effects like the loss of libido and a reduction in sperm count can lead to non-adherence with treatment, catering each treatment to the patient makes it more likely that customers finish their treatment and see successful results.

Making That First Step Towards Finasteride Hair Treatments

Happy Head requires a physician assessment to begin treatment. Happy Head, in collaboration with the physician and the customer, determines the most effective hair loss treatment with the least amount of side effects. The involvement of a licensed professional helps to improve safety, provides valuable feedback, and determines the most successful path toward stopping hair loss.
With the help of board-certified dermatologists, you can find the right balance of finasteride treatments to suit your hair loss needs. Happy Head understands that hair loss can hurt. Losing your hair can be a traumatic event, even if it occurs slowly over time. Add the fact that hair loss treatments often come with side effects, and it can make anyone feel overwhelmed when searching for treatments. With Happy Head, help is just around the corner!

Resources:

(01) https://medlineplus.gov/druginfo/meds/a698016.html

(02) https://www.aad.org/media/stats-numbers

(03) https://www.scitcentral.com/article.php?journal=19&article=60&article_title=Randomized%20Comparative%20Research%20Study%20of%20Topical%20and%20Oral%20Finasteride%20with%20Minoxidil%20for%20Male%20Pattern%20Androgenetic%20Alopecia%20in%20Indian%20Patients

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6609098/(05) https://pubmed.ncbi.nlm.nih.gov/34634163/

What Are the Results of Finasteride?

Male pattern baldness is something that exists commonly and everywhere. It is something that many men experience in their lifetime. This is backed by the fact that at least 85% of men are affected by this when they are about to turn 50. These findings were recorded by the American Hair Loss Association. Finasteride is something that can help. We’ll take a look at the results of Finasteride.

This is a cause of concern for many men because they don’t want to turn bald. However, there is not much that can be done to stop this from happening except hair loss treatments. One of these treatments is known as Finasteride, whether it’s oral Finasteride or topical Finasteride.

What Is Finasteride?

What is it and what are the results of results of Finasteride? This is a small pill that one has to take daily. It is used to treat male pattern baldness and is used by many men around the globe. However, one thing to remember here is that it is not a magic pill that will solve your problems overnight. Instead, you have to take it daily and you have to be consistent. In many cases, you will start seeing results after at least 4 – 6 months of taking this pill daily. If you don’t see any results even after a year of taking this then it is time you prepare a visit to your doctor because this medicine is highly effective.

Get Customized Topical Finasteride Just for You

How Does It Work?

Are the results of Finasteride worth the taking? The Finasteride medication interacts with the testosterone in the body. It is responsible for converting testosterone into DHT (dihydrotestosterone) that is responsible for the male pattern baldness. When your body is producing more DHT your hair follicles will reduce and this will cause your hair to become thin and fall out. However, what Finasteride does is that it reduces the production of this hormone. In the long run, your follicles will stop shrinking and your hair will not thin or fall. Do remember that this medication is only suitable for men as it interacts differently with female hormones and so they are not advised to take it.
In many cases, this medication has worked towards reducing the production of DHT in the scalp by at least sixty-percent! This is a significant number and any male experiencing hair loss or hair thinning problems can make the use of this medication. From this process, you will start seeing the results of Finasteride.

Is It Effective?

Is Finasteride effective and when will I be able to see the results of Finasteride? One study was done on men who took Finasteride daily for two years. These were the results that were found in this study:

Sixty-six percent of men showed a boost in the growth of their hair
Five percent of men showed an even greater increase
Thirty-one percent of men had a fairly moderate increase in hair growth
Thirty percent of men exhibited a slight increase
Eighty-three percent of men did not experience any more hair loss after taking the pill

This shows that if you are consistent with taking the pill, it will fix your hair loss problems by a significant amount. It does three things to men with problems of male pattern baldness and hair loss:

Increases growth of hair
Halts male pattern baldness
Halts hair loss

Of course, these results vary individually as some may experience one of these and some may experience all. This is because individuals have different reactions to the same medicine. And this is the way the results of Finasteride are described as. For some people, this pill may not even work. However, this is something that happens rarely but it does happen. One thing to remember here is that this medication is only extremely effective when it comes to hair loss and thinning. If you have an area on your head that has completely lost hair then Finasteride may not work as effectively. This is because this medication does not reverse hair loss.

Topical Finasteride Made for You

How Effective Is It In Growing Back Hair?

The main function of Finasteride is to reduce the thinning and falling out of hair. However, in many cases, it has been observed that it also encourages the growth of hair. So what is the results of Finasteride, or even Propecia, and how can it help? This depends on the individual, however, studies done have shown that the medication has the potential to aid regrowth of hair. It is said to grow hair again faster and in many cases thicker as well. One note to take here is that it will not magically change the quality of your hair neither the texture. This is because the main function of this medicine is to halt hair loss and thinning. It may only grow back faster and thicker but there will no dramatic changes in the way your hair feels or appears. It is important that you do your research first and read reviews from other people before deciding to take this medication. The best course of action is to first talk to your doctor and if they approve then you can start this daily pill to fix your hair problems.

How You Can Use It Effectively for Amazing Results

This is something many people wonder as they want the medication to be as effective as possible on their hair. The only way it will be effective for you is if you consult your doctor first.
Once you do, you have to follow the instructions they have given to you. You need to remember that this is a process that takes time and consistency. In the first few months, you may not even see any noticeable changes. However, if you keep at it then by 6 – 7 months you will start seeing the results of finasteride and changes that will just keep on increasing. Another thing to keep in mind is that you should also be consistent in the time you take the medication. For example, if you take it in the morning then that is the time you should take it daily. This is because having a gap between doses that is too wide may impact the Finasteride you have in your body i.e. it may reduce. Once it reduces it will not be as effective. This is why it is essential to take the dose at the same time every day so the level of Finasteride in your body can stay consistent.

Results of Finasteride Compared to Other Treatments for Hair Loss

Firstly, this is an effective treatment because it directly tackles the hair loss issue and it is not too heavy on the pocket either unlike other treatments. There are many other treatments that you can get at pharmacies. These can take other forms as well such as creams, lotions, and capsules. Some are prescription based and some you can get over the counter. It entirely depends on what you want and what your doctor has recommended. One other effective treatment is a capsule that has shown promising results of Finasteride over time known as Avodart. However, this is the only prescription based so you need to talk to your doctor first. There are also other options available such as hair supplements. These are not as effective as other methods. If you want something effective, safe, and cheap then Finasteride is your best bet. You will just have to wait and be consistent so if you are willing to do that then this will prove to be the most effective treatment for your hair loss problems. The results of this treatment are extremely positive from almost all its users.

Prescribed Finasteride

Can You Speed Up the Results from Finasteride?

When we take medication, we always want the results to be apparent fast. How fast can I see the results of Finasteride? This is something many people wonder because no one wants to wait a long time for their hair problems to go away. Here are some effective ways you can speed up the results from Finasteride. Do remember that these may not work for everyone.

Diet

Be mindful of what you eat. Did you know that more than 20% of men who have male pattern baldness also have an iron deficiency? Another reason is that your body may be lacking the fatty acids it needs for hair growth. This is why it is important to fulfill your nutritional needs so that your hair can also do better.

Rest

Getting enough sleep and rest is important for maintaining and healthy lifestyle. If you’re are experiencing stress in your life, try ways to control and reduce stress. Just like with many of the other medications we use, getting enough rest is important and can affect the results of Finasteride on your head.

Stress

Hair loss and stress can be related. There are three types of hair loss that is associated with stress. These three are telogen effluvium, trichotillomania, and alopecia areata.

Telogen effluvium

Telogen effluvium is when a notable amount of stress pushes large numbers of hair follicles into a resting phase which causes the the hair growth process to stop.

Trichotillomania

Trichotillomania is when you constantly have the urge to pull out hair from your scalp. This may be a problem to take care which will not have the results of Finasteride.

Alopecia areata

This is when your immune system attacks the hair follicles, which in result will cause hair loss. If you do use topical Finasteride, you may see the results of Finasteride.

Scalp Massage

This is already known to be effective when it comes to stimulating your hair growth. This is because blood circulation is increased which encourages the growth of hair. Relax and help your hair grow faster with a daily scalp massage.

Take Finasteride With Minoxidil

Minoxidil usually comes in a liquid form and it is supposed to be rubbed on the scalp two times a day. It has shown promising results because more than 40% of men have re-growth once they start using this. This is why both of them combined can be an extremely effective treatment for hair loss prevention and in seeing results of Finasteride. This is probably by far the most effective treatment out there for males who are dealing with hair loss problems or male pattern baldness. It takes time but it is also safe.

Conclusion

This is why if you want to treat your male pattern baldness then you can opt for Finasteride. However, you must consult your doctor first before taking any kind of medication. Using or taking finasteride may be worth the results of Finasteride. They will advise you the best and also give you a set of instructions that you need to follow while taking this medication. Once you start taking it all you have to do is be patient and consistent and the amazing results will automatically come!

Disclaimer: The information in this article does not constitute medical advice and should only be used for informational purposes only. The information in this article is not a substitute for professional medical advice and please do not rely on this information to make medical decisions. Please make sure to discuss the risks and benefits of any treatment with your medical doctor before beginning treatment.

Get custom made topical Finasteride just for you by a Happy Head board-certified dermatologist.

Side Effects of Topical Finasteride: Review of Current Medical Literature

Oral Finasteride, also known as Propecia, is an oral medication that has been prescribed by physicians for decades for hair loss. It works in the majority of patients by reducing hair loss and stimulating hair growth, however there can be side effects. One of the most concerning side effects are the sexual side effects, which occur only in 1.8% to 3.8% of patients who take it. As a result, many physicians have been switching to topical Finasteride as an alternative. In recent years, there have been many studies on the efficacy and side effects of topical Finasteride. In this article, we will review the clinical trials and scientific data to evaluate the side effect profile of topical Finasteride.

In one of the first single-blind, placebo-controlled clinical trials of topical finasteride, Mazarella et al.¹ (1997) published a study of 52 subjects ranging from 19 to 28 years of age. The patients were treated with topical finasteride 0.005% vs placebo for 16 months. These were the results:

There was a significant reduction in the rate of hair loss after 6 months of treatment.
There were no reports of local or systemic side effects in the patients who received topical Finasteride for treatment.

In another double blind, randomized clinical trial study conducted with 45 male patients, Hajheydari et al.² (2009), compared oral Finasteride 1mg vs topical Finasteride 1% for a total of 6 months.

Authors concluded that “the therapeutic effects of both Finasteride gel and Finasteride tablet/oral were relatively similar to each other.”
One person had erythema of the scalp after application of the topical Finasteride.

In a prospective pilot study conducted in 15 patients for 9 months by Rafi and Katz³ (2011), patients applied a topical solution called NuH Hair, which is a novel topical combination of Finasteride, Dutasteride, and Minoxidil, with the option to add oral Finasteride, Minoxidil and/or Ketoconazole shampoo for 9 months.

Significant growth was demonstrated after 3 months of use of the topical solution.
There were no reports of sexual side effects or irritation or redness reported.

In a randomized clinical study by Tanglertsampan C.⁴ (2012), 33 male patients ranging between 27 to 49 years old were enrolled to compare the efficacy and safety of a 24 weeks application of Minoxidil 3% lotion versus Minoxidil 3% combined with 0.1% Finasteride lotion.

This study showed that Finasteride combined with Minoxidil is superior to minoxidil alone by itself.
Contact dermatitis and redness was observed in 4 patients (24%) using the Finasteride + Minoxidil combination. No sexual side effects were observed.

Caserini et al. conducted two pharmacokinetic studies on topical finasteride. In a randomized clinical study of 23 males, Caserini et al.⁵ (2014) compared topical Finasteride 0.25% twice daily vs oral Finasteride 1mg once daily for seven days. They measured Dihydrotestosterone (DHT) and Testosterone levels in the serum (systemic DHT levels).

Similar reduction in serum DHT was observed by the use of topical 0.25% Finasteride twice daily (68-75% ) and oral Finasteride 1mg (62-72%).
No sexual side effects were observed.

In another randomized clinical trial, Caserini et al.⁶ (2015) did another study involving 50 male patients studying DHT in both the serum and the scalp.

This pharmacokinetic study confirmed that topical Finasteride 0.25% (1ml application twice daily) and oral Finasteride 1mg (once daily) both have similar reduction in scalp (47-51%) and serum DHT levels (74-76%). No changes in testosterone were observed.
In the portion of the study where patients used 1ml of topical finasteride 0.25% twice daily, there were 2 patients (11%) that had the following side effects. Elevated ALT levels, pollakiuria and testicular pain.
About 37-54% when 0.1ml, 0.2ml, 0.3ml and 0.4ml of topical 0.25% Finasteride was used, showing relatively similar results to 1ml twice a day application of topical 0.25% Finasteride. Serum DHT was reduced by 24% with the use of 0.1ml, 26% with 0.2ml, 44% with 0.3ml and 48% with use of 0.4ml of 0.25% topical Finasteride. This testing suggests that lower dosage of topical Finasteride may lead to lower reduction of serum DHT levels and thus lower sexual side effects (assuming that serum DHT is solely responsible for the sexual side effects).

	Scalp DHT	Serum DHT
Oral FInasteride 1mg	51%	76%
1ml (twice daily) of 0.25% Topical Finasteride	47%	74%
1ml (once daily) of 0.25% Topical Finasteride	71%	76%
0.1ml (once daily) of 0.25% Topical Finasteride	52%	24%
0.2ml (once daily) of 0.25% Topical Finasteride	47%	26%
0.3ml (once daily) of 0.25% Topical Finasteride	37%	44%
0.4ml (once daily) of 0.25% Topical Finasteride	54%	47%

Oral vs Topical Finasteride

In a retrospective assessment and prospective crossover cohort study of 50 male between 20 to 40 years old by Chandrashekar et al.⁷ (2017), all 50 patients used Minoxidil 5% and oral 1mg Finasteride for 2 years.They then stopped and their treatment differed.

Results showed that 80% to 84.4% of these patients maintained good hair density while on the topical combination of Minoxidil 5% + Finasteride 0.1% treatment for 1 year.
No sexual side effects were reported.

The studies⁸ above demonstrate that topical finasteride has clinically proven, evidence-based, scientific data to show its efficacy in growing hair and that it has a lower side effect profile compared to oral finasteride. Out of the 7 clinical studies reported above, only one study showed one event with sexual side effects (testicular pain). This is 1 out of 268 subjects in all of the studies, which equates to a rate of 0.37%. In contrast, oral finasteride is associated with sexual side effects in 1.8% to 3.8% of patients, which means that in the above 268 subjects, there should have been about 5 to 10 subjects experiencing some form of sexual side effects. However, this was not the case. Only 1 person had sexual side effects as opposed to 5 to 10 individuals.

Pharmacokinetic studies by Caserini et al. suggest that lower doses of topical finasteride result in lower reduction of serum DHT compared to oral finasteride and thus lower sexual side effects. No study has conclusively shown the reason of how finasteride can cause sexual side effects. Certainly serum DHT is a contributing factor but may not be the only factor. The reason for this conclusion is because there are studies that patients were on high dosage of topical finasteride and still had no sexual side effects.

In conclusion, the majority of studies on topical finasteride show no to only a few sexual side effects. However, this does not mean that sexual side effects can not happen. It just suggests that risk of sexual side effects are lower due to the fact that the finasteride is not taken orally. Additional larger clinical studies are needed to address the sexual side effects of topical finasteride.

References:

1. Topical finasteride in the treatment of androgenic alopecia. Preliminary evaluations after a 16-month therapy course. GF Mazzarella, GF Loconsole, GA Cammisa, GM Mastrolonardo & Ga Vena; Pages 189-192 | Received 23 Aug 1996, Accepted 18 Mar 1997, Published online: 12 Jul 2009

2. Comparing the therapeutic effects of finasteride gel and tablet in treatment of the androgenetic alopecia. Hajheydari Z1, Akbari J, Saeedi M, Shokoohi L. .Indian J Dermatol Venereol Leprol. 2009 Jan-Feb;75(1):47-51.

3. Pilot Study of 15 Patients Receiving a New Treatment Regimen for Androgenic Alopecia: The Effects of Atopy on AGA. Rafi and Katz. SRN Dermatol. 2011;2011:241953. doi: 10.5402/2011/241953. Epub 2011 Apr 11.

4. Efficacy and safety of 3% minoxidil versus combined 3% minoxidil / 0.1% finasteride in male pattern hair loss: a randomized, double-blind, comparative study. Tanglertsampan C1. J Med Assoc Thai. 2012 Oct;95(10):1312-6.

5. A novel finasteride 0.25% topical solution for androgenetic alopecia: pharmacokinetics and effects on plasma androgen levels in healthy male volunteers. Caserini M, Radicioni M, Leuratti C, Annoni O, Palmieri R. Int J Clin Pharmacol Ther. 2014 Oct;52(10):842-9. doi: 10.5414/CP202119.

6. Effects of a novel finasteride 0.25% topical solution on scalp and serum dihydrotestosterone in healthy men with androgenetic alopecia. Caserini M, Radicioni M, Leuratti C, Terragni E, Iorizzo M, Palmieri R. Int J Clin Pharmacol Ther. 2016 Jan;54(1):19-27. doi: 10.5414/CP202467.

7. Topical minoxidil fortified with finasteride: An account of maintenance of hair density after replacing oral finasteride. B. S. Chandrashekar, T. Nandhini, Vani Vasanth, Rashmi Sriram, and Shreya Navale. Indian Dermatol Online J. 2015 Jan-Feb; 6(1): 17–20. Doi: 10.4103/2229-5178.148925

8. A Systematic Review of Topical Finasteride in the Treatment of Androgenetic Alopecia in Men and Women. Sung Won Lee, MD,1 Margit Juhasz, MD,1 Pezhman Mobasher, MD,1 Chloe Ekelem, MD,1 and Natasha Atanaskova Mesinkovska, MD, PhD1. J Drugs Dermatol. 2018 Apr 1; 17(4): 457–463.

The information in this article does not constitute medical advice and should only be used for informational purposes only. The information in this article is not a substitute for professional medical advice and please do not rely on this information to make medical decisions. Please make sure to discuss the risks and benefits of any treatment with your medical doctor before beginning treatment.

Efficacy of Topical Finasteride: Review of Current Medical Literature

In one of the first single-blind, placebo-controlled clinical trials of topical finasteride, Mazarella et al.¹ (1997) published a study of 52 subjects ranging from 19 to 28 years of age. The patients were treated with topical finasteride 0.005% vs placebo for 16 months. Here were the results.

There was a significant reduction in the rate of hair loss after 6 months of treatment.
There was slight to marked reduction of the balding areas in the patients using the topical finasteride.
73% of the patients using the topical finasteride reported moderate effectiveness.

In another double blind, randomized clinical trial study of 45 male patients, Hajheydari et al.² (2009) compared oral finasteride 1mg vs topical finasteride 1% for a total of 6 months.

Both the oral finasteride 1mg and the topical finasteride 1% showed statistically significant increase in total and terminal hair count after 4 months.
There was no significant difference between the two groups in hair thickness, total hair counts and the size of bald area.
Authors concluded that “the therapeutic effects of both finasteride gel and finasteride tablet were relatively similar to each other.”

In a prospective pilot study conducted in 15 patients for 9 months by Rafi and Katz³ (2011), patients applied a topical solution called NuH Hair, which is a novel topical combination of finasteride, dutasteride, and minoxidil, with the option to add oral finasteride, minoxidil and/or ketoconazole shampoo for 9 months.

Significant growth was demonstrated after 3 months of use of the topical solution.
In those patients who utilized the NuH Hair along with either Rogaine foam, Propecia, and ketoconazole shampoo saw significant growth was achieved in as little as 30 days.

In a randomized clinical study by Tanglertsampan C.⁴ (2012), 33 male patients ranging between 27 to 49 years old were enrolled to compare the efficacy and safety of a 24 weeks application of minoxidil 3% lotion versus minoxidil 3% combined with 0.1% finasteride lotion.

Hair count increased in both groups but was only significant in the finasteride + minoxidil group.
This study showed that finasteride combined with minoxidil is superior to minoxidil alone by itself.
Finasteride combined with minoxidil showed significantly higher efficacy by global photographic assessment compared to the minoxidil group.

Caserini et al. conducted two pharmacokinetic studies on topical finasteride. In a randomized clinical study of 23 males, Caserini et al.⁵ (2014) compared topical finasteride 0.25% twice daily vs oral finasteride 1mg once daily for 7 days. They measured DHT and testosterone levels in the serum (systemic DHT levels).

Similar reduction in serum DHT was observed by the use of topical 0.25% finasteride twice daily (68-75% ) and oral finasteride 1mg (62-72%).
No relevant changes occurred for serum testosterone.

In another randomized clinical trial, Caserini et al.⁶ (2015) did another study involving 50 male patients studying DHT in both the serum and the scalp.

Scalp DHT was reduced by 71% with the use of 1ml topical finasteride 0.25% once daily application vs 51% reduction in scalp DHT with the use of oral finasteride 1mg once daily.
Interestingly, once a day application of the 1ml topical finasteride 0.25% lead to a higher reduction of scalp DHT (71%) vs twice a day application of 1ml topical finasteride 0.25% (47%).
Serum DHT decreased by 60 – 70% with the use of both 1ml topical finasteride and 1mg of oral finasteride.
This pharmacokinetic study confirmed that topical finasteride 0.25% (1ml application twice daily) and oral finasteride 1mg (once daily) both have similar reduction in scalp (47-51%) and serum DHT levels (74-76%). No changes in testosterone were observed.

In a retrospective assessment and prospective crossover cohort study of 50 male between 20 to 40 years old by Chandrashekar et al.⁷ (2017), all 50 patients used minoxidil 5% and oral 1mg finasteride for 2 years.They then stopped and their treatment differed.

45 of the patients that stopped the above treatment immediately started topical minoxidil 5% + finasteride 0.1% treatment for 1 year.
Results showed that 84.4% of these patients maintained good hair density while on the topical combination.
5 of the patients stopped all treatments for 8-12 months and then started the topical minoxidil 5% + finasteride 0.1% for 1 year.
Results showed that 80% of these patients maintained good hair density.

The studies⁸ above demonstrate that topical finasteride has clinically proven, evidence-based, scientific data to show its efficacy in growing hair. Firstly, pharmacokinetic studies suggest that topical finasteride results in a similar reduction in scalp DHT as oral finasteride. Studies also suggest that topical finasteride causes a statistically significant increase in total and terminal hair count. Additionally, when topical finasteride was compared to oral finasteride, both the oral finasteride 1mg and the topical finasteride 1% showed statistically significant increase in total and terminal hair count and that no significant difference was observed with respect to hairthicknes and hair counts. Authors concluded that “the therapeutic effects of both finasteride gel and finasteride tablet were relatively similar to each other.” When topical finasteride was combined with topical minoxidil, the combination of finasteride with minoxidil was superior to minoxidil alone by itself. Finally, 84.4% of patients who were on oral finasteride for about 2 years and then switched over to topical finasteride with minoxidil maintained good hair density. Thus far, these studies with a total patient count of 268 show that topical finasteride can cause hair growth and have similar efficacy as oral finasteride. Additional large cohort studies are still needed to better evaluate the efficacy of topical finasteride vs oral finasteride.