Minoxidil and finasteride are the two best-evidenced medicines for pattern hair loss. Minoxidil, applied to the scalp, keeps follicles growing longer and works for men and women. Finasteride, a 1 mg daily tablet for men, lowers the hormone DHT that causes the loss. Both take months to work, and the benefit lasts only while you keep using them.
Medically reviewed by Prof. Irakli Bebiashvili, MD, PhD · Updated 2026-10-14
| Minoxidil | Finasteride | |
|---|---|---|
| What it does | Keeps follicles in the growth phase longer and thickens hairs that are thinning | Lowers DHT, the hormone that drives pattern hair loss |
| Form | Solution or foam on the scalp (2% or 5%); low-dose tablets off-label | 1 mg tablet once a day; topical sprays in some countries |
| Who it suits | Men and women | Men |
| First results | 3–6 months | 6–12 months |
| If you stop | New hair is lost within a few months | Hair loss resumes as DHT rises again |
| Main side effects | Scalp irritation, early shedding, unwanted facial hair | Lower libido or erectile problems in a small minority |
| Prescription | Not usually required | Required |
Minoxidil keeps hair follicles in their growth phase for longer and enlarges follicles that are shrinking, so thinning hairs grow back thicker. It does not act on the hormone behind pattern hair loss, and it cannot revive a follicle that has stopped producing hair altogether.
It comes as a solution or a foam in 2% and 5% strengths. The solution is usually applied to a dry scalp twice a day; the foam often once. Using more, or more often, does not speed up results.
Plan on at least 4 months; first results usually appear at 3–6 months and the full effect at around a year. Extra shedding in the first weeks is common and temporary: resting follicles restart their cycle and push out old hairs.
The most common are scalp itching, dryness or flaking, and unwanted hair on the forehead or face, especially in women. Stop and see a doctor if you feel dizzy, notice a fast heartbeat or swelling.
Some doctors prescribe minoxidil tablets at low doses, off-label, for patients who cannot use the scalp form. It can work well but can also cause excess body hair, fluid retention and changes in heart rate or blood pressure, so it is only for use under medical supervision.
Finasteride blocks the enzyme that turns testosterone into DHT. It lowers DHT by up to about 70% in the blood and 60% in the scalp, which slows or stops pattern hair loss and lets some miniaturised hairs recover.
The usual dose for hair loss is 1 mg once a day, with or without food.
Some men notice a change after about 3 months of daily use; most need 6–12 months to see the result. Its first effect is often that the loss stops, which is easy to overlook.
In trials, reduced libido affected 1.8% of men on finasteride versus 1.3% on placebo, and erectile problems 1.3% versus 0.7%. These usually resolve after stopping. Depression has been reported rarely. Finasteride also roughly halves PSA, a prostate test, so tell your doctor you take it before any prostate check.
Finasteride is not licensed for women. Anyone who is pregnant or may become pregnant must not take it or handle crushed or broken tablets, because it can affect the development of a male foetus.
Finasteride sprays applied to the scalp are available in some countries. They aim to act on the scalp with less effect on the rest of the body; the evidence is newer than for tablets.
Because they work in different ways, minoxidil and finasteride are often used together, and for male pattern hair loss the combination is the best-evidenced medical treatment. A hair transplant adds hair where it has already been lost; it does not stop the loss of the native hair around it. That is why medication often continues after surgery: it protects the hair the transplant was designed to sit alongside.
They do different jobs. Finasteride acts on the cause of male pattern hair loss by lowering DHT; minoxidil supports the follicles that are still producing hair. For men, using both together is the best-evidenced medical treatment. For women, minoxidil is the main option.
Minoxidil usually needs at least 4 months, and first results typically appear at 3–6 months. Finasteride can show a change after about 3 months of daily use, but most men need 6–12 months to see the full effect. Judge either treatment after a year, not after a few weeks.
The benefit stops with the treatment. Hair grown with minoxidil is usually lost within a few months of stopping, and after stopping finasteride DHT rises again and hair loss resumes. Both are long-term treatments.
In a small minority of men. In trials, reduced libido was reported by 1.8% of men on finasteride versus 1.3% on placebo, and erectile problems by 1.3% versus 0.7%. These usually resolve after stopping. Mood changes have been reported rarely; tell your doctor if you notice them.
Women can use topical minoxidil, which is the main medical treatment for female pattern hair loss. Finasteride is not licensed for women, and anyone who is pregnant or may become pregnant must not take or handle it, because it can affect a male foetus.
Early shedding in the first weeks is common and temporary. Minoxidil pushes resting follicles into a new growth phase, so old hairs fall out to make way for new ones. It is a sign the treatment is acting, not failing.
Often, yes. Transplanted hair comes from the donor area and is resistant to DHT, but the native hair around it is not. Medication helps keep that native hair, so the transplant does not end up surrounded by new thinning a few years later.
Both are sold in pharmacies in Georgia. Before you buy, have your hair loss assessed: not all thinning is pattern hair loss, finasteride requires a prescription, and the right choice depends on your diagnosis, age, sex and health.