Medically reviewed by Jill Johnson, FNP
Written by Our Editorial Team
Last updated 6/21/2022
Search for information about treating and preventing male pattern baldness and you’ll see two medications mentioned often: minoxidil (the active ingredient in Rogaine®) and finasteride (the active ingredient in Propecia®).
Both of these medications have been around for decades, and both are commonly used to treat male pattern hair loss, or androgenetic alopecia.
But do either of them really work? If so, which of them is the most effective choice for preventing hair loss and regrowing hair?
Below, we’ve explained how minoxidil and finasteride work, as well as how effective each option is for treating male pattern baldness and stimulating hair regrowth.
We’ve also talked about how you can use minoxidil and finasteride, either on their own or at the same time, to stop hair loss and grow a fuller, thicker head of hair.
Before we get into the specific details of how minoxidil and finasteride work, let’s quickly go over the main differences between these two medications.
Minoxidil and finasteride are both approved by the FDA to treat male pattern baldness. Both are supported by a significant amount of research, although there are a few major differences in the ways that they work to stop hair loss and promote hair growth.
The main difference between minoxidil and finasteride is the dosage form that each medication takes.
Minoxidil is a topical medication that comes in liquid or foam form. It’s formulated for use directly on your scalp (more specifically, areas of your scalp with visible hair loss) and works primarily by promoting local hair growth.
Finasteride, on the other hand, comes as a tablet for oral use. Instead of working locally to help your hair grow, it has a systemic effect throughout your body by reducing levels of the hormone that’s responsible for male pattern baldness.
You can think of minoxidil and finasteride as treating hair loss from different angles. Minoxidil is a topical treatment that works like a fertilizer, giving your hair the nutrients it needs to grow to its full potential.
Finasteride, on the other hand, is more like a shield that protects your hair follicles from damage from certain hormones.
We’ve gone into more detail about each medication below, as well as how you can use minoxidil and finasteride together for optimal results.
Minoxidil is a type of medication called a hair growth stimulator. It works by widening the blood vessels inside your scalp, which may help to promote blood flow to your hair follicles -- the tiny organs throughout your scalp from which your hair grows.
In addition to increasing blood flow, experts believe that minoxidil lengthens the anagen phase of your hair’s natural growth cycle.
So, what does this mean exactly? Each and every hair on your scalp and body grows as part of a multi-phase cycle referred to as the hair growth cycle. This cycle consists of three to four main phases: anagen, catagen, telogen and exogen.
During the anagen phase, your hair follicle works to produce a hair fiber. This fiber slowly grows to its full length over the course of several years, resulting in the steady hair growth that most of us see on a regular basis.
After it stops growing, the hair enters a transitional state called the catagen phase, during which it shrinks in diameter. The hair then passes into the telogen phase of the growth cycle, in which it rests and is replaced by a new hair, which grows from the same follicle.
Eventually, the old hair detaches and the new hair replaces it -- a stage that’s referred to as the exogen phase.
Minoxidil works by extending the duration of the anagen phase, allowing your hair to grow for a longer period of time before shedding. It also shifts dormant hairs, such as those in the telogen phase, into the anagen phase to stimulate hair growth.
This can result in increased hair growth, including in areas of your scalp that may be affected by male pattern baldness.
Because minoxidil interrupts your hair growth cycle, it may cause you to shed slightly more hairs during the first few months of use.
This is a normal side effect that usually passes with time. As the telogen hairs are replaced with new anagen hairs, your hair will generally start to take on a thicker, denser appearance.
So, does minoxidil work? Since it first came onto the market in the 1990s, several studies have looked at the efficacy of minoxidil, with most producing very positive results.
For example, one double-blind, randomized, placebo-controlled trial published in the Journal of the American Academy of Dermatology in 2002 found that both 2% and 5% minoxidil produced improvements in hair growth in men with androgenetic hair loss.
A separate study, which was published in the journal Dermatologic Therapy in 2015, found that 59 percent of men with pattern hair loss showed improvements after one year of treatment with minoxidil.
One important thing to understand is that minoxidil doesn’t have any impact on your production of androgen hormones, meaning it won’t actually prevent hair loss at the follicular level.
We’ve explained this in more detail below. In general, it’s best to think of minoxidil as a tool for stimulating hair growth and maximizing the hair that you already have, not as a medication for shielding your hair from the long-term effects of male pattern baldness.
Finasteride works by stopping your body from producing dihydrotestosterone (DHT), a hormone that causes male pattern baldness.
DHT is a hormone that’s produced as a byproduct of testosterone. It’s important in your early life and adolescence, where it plays a major role in the development of your genitals and secondary sex characteristics, such as your facial and body hair.
As an adult, DHT can attach to receptors in your scalp and cause your hair follicles to gradually miniaturize. Over time, this can affect your hair’s natural growth cycle and eventually stop hairs from growing at all.
DHT normally affects the hair follicles near your hairline and crown first, resulting in the classic receding hairline that often develops in the early stages of male pattern baldness.
Our guide to DHT and male hair loss goes into more detail about the effects of DHT, as well as the steps that you can take to prevent it from affecting your hair follicles.
Finasteride works by inhibiting the action of the enzyme 5-alpha-reductase, which is involved in converting testosterone into DHT.
By preventing testosterone from being converted into DHT, finasteride significantly lowers DHT levels throughout your body. Research shows that a typical dose of finasteride can eliminate as much as 70 percent of serum DHT.
This reduction in DHT levels helps to shield your hair follicles from damage, preventing hair loss from becoming worse. For many men, it also results in regrowth of hair in the parts of your scalp that have already been affected by male pattern baldness.
Like minoxidil, finasteride is supported by numerous large-scale studies showing improvements in men with male pattern baldness.
For example, one study involving more than 1,500 men published in the Journal of the American Academy of Dermatology found that treatment with finasteride produced a significant increase in hair count in the vertex scalp (an area often affected by pattern hair loss) over two years.
A different study published in the journal Dermatologic Therapy, which compared finasteride and minoxidil, also found that 94.1 percent of men who used finasteride over the course of one year showed improvements.
We offer finasteride online, following an online consultation with a physician who will determine if a prescription is appropriate.
Put simply, yes. Minoxidil and finasteride are both supported by a large quantity of research that shows real benefits to using them, especially if you’re just beginning to notice hair loss.
In fact, minoxidil and finasteride are often viewed as the gold standard of hair loss treatments for men, both by dermatologists and by the general public.
Both short-term and long-term studies show the efficacy of minoxidil and finasteride, with longer term use generally associated with more significant benefits.
For example, a five-year study of finasteride published in the European Journal of Dermatology found that men with pattern hair loss who took finasteride showed improvements in hair growth, as well as reduced progression of hair loss.
An even longer 10-year study conducted in Japan found that daily use of finasteride prevented male pattern hair loss from becoming more severe in more than 99 percent of men and caused improvements in hair growth in more than 91 percent of study participants.
There are also several reputable studies showing that topical minoxidil is effective at preventing hair loss and promoting hair growth.
In a 12-month study carried out in Germany, researchers found that 97.1 percent of balding men who used minoxidil either experienced an improvement in hair growth or no further worsening of their hair loss.
Of the more than 900 men that took part in the study, 84.3 percent rated minoxidil as either “very effective,” “effective” or “moderately effective” as a hair loss treatment.
A review of minoxidil published in the journal Drug Design, Development and Therapy analyzed several studies of minoxidil and concluded that it offers “remarkable benefits” to people affected by hair disorders.
In short, like finasteride, minoxidil is backed up by real, reputable scientific studies that show it’s effective.
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Minoxidil and finasteride are generally safe and effective medications when used on their own to treat hair loss. Research also shows that they’re safe to use together.
In fact, many studies have looked at the potential benefits of using both minoxidil and finasteride to treat hair loss, often with some very promising results.
A 2015 study published in the Indian Dermatology Online Journal found that regular use of both finasteride and minoxidil together helped to maintain a good hair density level.
Interestingly, this study used a topical version of finasteride, rather than the more common oral finasteride tablets.
A larger study published in the journal Dermatologic Therapy looked at the effects of finasteride and minoxidil used at the same time to treat male pattern baldness.
After 12 months of treatment, 94.1 percent of the men who used finasteride and minoxidil at the same time showed improvements, compared to 80.5 percent and 59 percent of the men treated with finasteride or minoxidil alone, respectively.
Finasteride and minoxidil work through distinct mechanisms to treat pattern hair loss -- minoxidil by moving hairs into the anagen phase of the growth cycle and stimulating local blood flow, and finasteride by reducing DHT levels throughout the body.
Because they work in different parts of the body, there’s no risk in taking them together. In fact, as the study above shows, you’ll likely get better results by using both finasteride and minoxidil together than by only taking one medication to treat hair loss.
With this said, although minoxidil and finasteride don’t interact with each other, it’s important to check for potential drug interactions before you start any type of hair loss medication, including minoxidil or finasteride.
Before starting either medication, let your healthcare provider know about any medications you currently use or have recently used, as well as any dietary supplements that you take.
They’ll be able to let you know if you need to make any changes to safely use minoxidil and/or finasteride to treat your hair loss.
Minoxidil and finasteride come in very different dosage forms, with one a topical medication and the other an oral tablet.
To get the best results from minoxidil or finasteride (or both medications together), it’s important to use your medication at the correct dosage.
A normal dosage of minoxidil is 1ml of liquid solution applied directly to the scalp two times per day, typically in the morning and at night. Our guide to applying minoxidil explains how you can use minoxidil for optimal results.
A normal dosage of finasteride for male pattern baldness is 1mg per day, either with or without food. You can take finasteride at any time of day, although it’s important to take it at around the same time on a daily basis.
If you forget to take finasteride, skip the missed dose and continue to take your medication as normal. You should not take a double dose of finasteride to make up for a missed dose.
Minoxidil and finasteride are both safe, effective medications for most people. Both drugs have been studied extensively, with clinical trials showing that side effects are usually mild, transient and rarely severe.
However, like other medications, both minoxidil and finasteride can both potentially cause side effects, including some that may be bothersome.
Common side effects of minoxidil include:
Exacerbation of seborrheic dermatitis
Hypertrichosis (excessive hair growth)
Isolated pruritus (dry, itchy skin)
Allergic contact dermatitis
Minoxidil can also cause a form of temporary hair loss called telogen effluvium, in which hairs prematurely exit the telogen phase of the hair growth cycle.
Although the idea of a hair loss treatment causing hair shedding might seem unusual, this is a common issue for people who use minoxidil. It occurs because minoxidil can affect the natural growth cycle of hair when it shifts follicles into the anagen phase.
In the short term, this can cause a shortening of the telogen phase, resulting in some degree of hair shedding.
This hair shedding is only temporary. Over the course of several months, minoxidil produces a noticeable improvement in hair growth and hair thickness in most men.
Although uncommon, finasteride can cause side effects, including sexual side effects that may affect your sexual function or enjoyment.
Potential side effects of finasteride include:
Erectile dysfunction (ED)
Changes in ejaculatory volume
Gynecomastia (increased breast gland tissue)
While these forms of sexual dysfunction may sound concerning, they aren’t very common, and research suggests that they almost always stop upon cessation of treatment.
For example, clinical trial data from the FDA claims that 1.3 percent of men who take finasteride at a dosage of 1mg per day (the normal dosage used to treat male pattern baldness) experience erectile dysfunction, versus 0.7 percent of men in a placebo group.
In other words, although these side effects can potentially happen, they only affect a very small percentage of men who use finasteride.
Our guide to the side effects of finasteride explains these issues and their prevalence amongst finasteride users in more detail.
If you start to develop side effects from minoxidil, finasteride or both medications, it’s important to inform your healthcare provider. They may suggest making changes to the way you use your medication to reduce the severity of side effects.
Minoxidil and finasteride are both for anyone starting to notice thinning hair, a receding hairline or other signs of male pattern baldness.
You don’t need to have a minimum level of hair loss to use minoxidil or finasteride. However, it’s important to understand that if you already have advanced hair loss, you may not be able to get back all of your hair by starting treatment with either of these medications.
Put simply, it’s important to have realistic expectations about what minoxidil and finasteride can do for you.
Most men who use minoxidil, finasteride or both medications notice improvements. However, it can take several months before you may notice that your hair loss has slowed, or that you have a more dense and complete hairline than before.
Not sure if you need finasteride? If you only have mild hair loss, you may want to start by trying minoxidil before using other medications. As an over-the-counter drug, minoxidil is easy to add to your hair loss prevention routine without any need for a doctor’s visit.
Minoxidil and finasteride are different medications designed for very different purposes. One is a topical vasodilator that works by increasing blood flow to your scalp and shifting hair follicles into the anagen phase of the hair growth cycle.
The other is a DHT blocker that works by protecting your hair follicles from damage that causes male pattern baldness in the first place.
As research shows, minoxidil and finasteride work best when they’re used together to treat hair loss from multiple angles. As such, it’s best to think of these medications as partners instead of competitors.
We offer both minoxidil and finasteride as part of our full range of men’s hair loss treatments, as well as both medications together in our Hair Power Pack. We also offer a Topical Finasteride & Minoxidil Spray that you can use to easily apply both medications at the same time.
Interested in learning more about treating hair loss? Our guide to the most effective treatments for thinning hair goes into detail about your options, from medications to changes that you can make for thicker, healthier hair.