By Dr. Cole, FUE Hair Transplant Pioneer

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


In the battle against thinning hair, Finasteride has become a leading contender. Available in both topical and oral forms, this treatment is a game-changer. However, understanding the nuances of these two forms is critical in making an informed decision best suited to your needs.

This article will provide a comprehensive look at both topical and oral Finasteride. We’ll delve into how each work, its benefits, potential side effects, and even the cost considerations.

Moreover, we will compare the two forms head-to-head, discussing their effectiveness and suitability for different types of hair loss. You’ll also get insights from expert opinions and a brief review of the latest research findings on this topic.

The journey to managing hair loss can be daunting, but you can make informed decisions with the correct information. Read this blog as it empowers you to choose the best course of action for your hair health.

Understanding Finasteride

Finasteride is a medication that plays a pivotal role in treating baldness. It’s a synthetic compound designed to combat male pattern hair loss or baldness (androgenetic alopecia). Still, it is also used, in some instances, to treat hair loss in women.

You must first know about Dihydrotestosterone (DHT) to understand how it works. DHT is a hormone that contributes to the problem by shrinking hair follicles, leading to thinner hair and, eventually, baldness.

This medication’s primary purpose is to inhibit the conversion of androgen testosterone to DHT, thus slowing down or even reversing the effects of hair loss.

Low testosterone means high DHT and less hair
Low testosterone means high DHT and less hair

This medication is in two forms: oral and topical. The oral form is a daily pill, while the topical form is a solution or a gel applied directly to the scalp. Both forms aim to decrease DHT levels in the scalp, preserving your hair and potentially promoting regrowth.

However, while it is a potent tool, it’s essential to understand that everyone’s body responds differently to medications. Therefore, individual results may vary, and it’s crucial to consult a healthcare provider before starting any treatment.

What is Oral Finasteride?

Oral Finasteride, often recognized under Propecia, is a prescription for losing hair. Available in tablet form, it’s orally consumed and classified as a 5-alpha reductase inhibitor. It blocks the enzyme responsible for testosterone to DHT conversion – the hormone primarily responsible for male pattern hair loss.

How is Oral Finasteride Taken, and What’s the Dosage?

Taking this medicine orally is relatively straightforward. Typically, it is a once-daily tablet, with or without food. The standard dosage for treatment is 1mg per day. However, it’s crucial to note that you should always follow the dosage instructions provided by your healthcare provider.

Even if you miss a dose, it’s advised not to take a double dose to make up for it but rather continue with your regular schedule.

Benefits of Oral Finasteride

It’s is highly effective in treating male pattern hair loss. Clinical studies indicate that over 80% of men using it orally experienced improvement, and more than 60% saw some hair regrowth. It is a long-term solution, with most men seeing significant results after continued use for three to six months.

Oral finasteride prevents the conversion of testosterone to DHT, allowing hair regrowth.
Oral finasteride prevents the conversion of testosterone to DHT, allowing hair regrowth

Another advantage of is its convenience. The once-a-day pill fits easily into most daily routines, making it a practical choice for many male patients struggling with thinning hair.

Side Effects and Considerations

Despite its effectiveness, it isn’t without its potential side effects. Some men have reported experiencing post finasteride syndrome, sexual side effects, such as reduced libido and loss of sexual desire, ejaculation disorder or decreased ejaculatory volume, erectile or sexual dysfunction, or decreased semen volume.

However, side effects are relatively rare, and the syndrome is usually reversible upon discontinuing the medication or may be associated with other issues, such as an enlarged prostate gland, symptomatic benign prostatic hyperplasia, or high grade prostate cancer.

Regarding benign prostate hyperplasia, some doctors actually administer to treat it and decrease prostate size.

Less common but more severe side effects include breast tenderness or enlargement, nipple discharge, or testicular pain. If you experience any of these side effects, seek immediate medical attention.

Moreover, pregnant women planning to become pregnant should not handle crushed or broken tablets due to the risk of a specific congenital disability.

Discussing these potential side effects with your healthcare provider before starting the treatment is essential. They can provide a more comprehensive understanding of the risks and benefits, helping you make an informed decision.

The oral form offers a promising solution to hair loss. However, its usage must fit individual needs and medical history. Always seek professional advice when considering this form of treatment.

What is Topical Finasteride?

Topical Finasteride is an alternative formulation of the traditional oral medication used to treat the problem.

You apply it directly to the area, limiting side effects.
You apply it directly to the area, limiting side effects

 It’s typically available as a solution or gel directly applied to the scalp where thinning or balding occurs. This method aims to maximize the medication’s impact on the scalp while minimizing systemic absorption, thereby reducing potential side effects.

How is Topical Finasteride Applied, and What’s the Dosage?

Applying topical is a straightforward process, usually applied to the affected areas of the scalp once daily. Dosage can vary, but a 0.1% solution is a typical concentration. However, a healthcare provider should always determine the specific dosage and application frequency based on individual needs and circumstances.

It’s important to remember that topical Finasteride must be applied consistently for several months before noticeable results are likely to be seen. Patience and routine are vital to the success of this treatment.

Benefits of Topical Finasteride

One of the main benefits of topical finasteride is its targeted action. Because it’s applied directly to the scalp, it delivers a concentrated dose of the medication to the areas that need it most. That may enhance its effectiveness in promoting hair growth and preventing further hair loss.

Moreover, topical finasteride is often combined with other treatments like minoxidil, potentially boosting its efficacy. Such combinations are usually well-tolerated and can provide a more comprehensive approach to managing hair loss.

Side Effects and Considerations

While topical Finasteride minimizes systemic absorption and reduces side effects, some systemic absorption still occurs. It means side effects similar to oral Finasteride can still happen, although they may be less common or severe. These can include sexual side effects like reduced libido or erectile and ejaculatory dysfunction.

You can talk to your doctor about male hormone stimulation and address side effects.
You can talk to your doctor about male hormone stimulation and address side effects

Skin irritation at the application site is another potential side effect specific to topical Finasteride. If you notice redness, itching, or swelling, it’s advisable to consult with your healthcare provider.

Just like oral Finasteride, pregnant women or those planning to become pregnant should avoid handling topical Finasteride, as it can potentially lead to congenital disabilities.

While topical Finasteride minimizes systemic absorption and reduces side effects some systemic absorption still occurs. It means side effects similar to oral Finasteride can still happen, although they may be less common or severe. These can include sexual side effects like reduced libido or erectile and ejaculatory dysfunction.

Oral Finasteride vs. Topical Finasteride


Regarding effectiveness, oral and topical Finasteride successfully treats male pattern hair loss. Taking Finasteride once daily is widely recognized for slowing the problem and promoting new hair growth.

Clinical studies have found that about 80% of men taking oral Finasteride experienced hair regrowth, and even higher percentages reported a halt in hair loss.

Topical Finasteride, on the other hand, is a newer approach to hair loss treatment. Early studies suggest that it is as effective as its oral counterpart, though more research is needed to confirm these findings. A potential advantage is that the topical form can be combined with other hair growth stimulants like minoxidil, possibly enhancing results.

Side Effects

While both forms of Finasteride can be effective, they also have potential side effects. Taking Finasteride orally may lead to sexual side effects in some men, including decreased libido and erectile dysfunction.

Though rare, a potential side effect could be prostate cancer.
Though rare, a potential side effect could be prostate cancer.

Some men also report changes in mood. However, it’s important to remember that everyone does not experience these side effects, and they usually disappear once male patients stop taking Finasteride.

Topical finasteride aims to reduce these systemic side effects by limiting absorption into the bloodstream. The risk of side effects may be lower, but they can still occur. Additionally, topical finasteride may cause local irritation at the application site, a side effect not associated with the oral form.

Suitability for Different Types of Hair Loss

Oral and topical Finasteride is primarily used to treat male pattern hair loss, also known as androgenetic alopecia. It is a condition when one loses hair at the temples and crown of the head—both forms of finasteride work by reducing levels of DHT, the hormone responsible for androgenic alopecia.

For other types of hair issues, such as alopecia areata or telogen effluvium, Finasteride may not be the best treatment option. These conditions have different underlying causes not solved by reducing DHT levels.


The cost of treatment can also factor into the decision between oral and topical Finasteride. Generic oral Finasteride is typically more affordable and covered by insurance, and topical Finasteride is usually more expensive and may not be covered by insurance since compounding pharmacies formulate them.

Therefore, cost considerations may be necessary for long-term treatment.

Speed of Results

Both oral and topical finasteride requires patience, as the results are not immediate. Typically, it may take anywhere from three to six months to observe noticeable changes with either form. Some studies indicate that oral finasteride may show results slightly quicker, although this can vary from person to person.

The effects will be noticeable with continued use.
The effects will be noticeable with continued use

Convenience and Ease of Use

Taking Finasteride is pretty straightforward – a pill is taken once daily, with or without food, and a missed dose should not occur. It’s easy to incorporate into a daily routine, which may increase adherence to the treatment plan.

Topical Finasteride, however, requires a bit more effort and must be applied to the scalp once or twice daily, depending on the formulation. It can be time-consuming and unsuitable for those with a busy lifestyle or who travel frequently.

Lifestyle Considerations

Personal lifestyle can also play a part in choosing between oral and topical finasteride. For example, if you spend a lot of time outdoors, you should know that sunlight can degrade topical finasteride, reducing its effectiveness. In this case, oral finasteride might be a better option.

On the other hand, if you have a sensitive stomach, dislike taking pills, or are wary of drug interactions and using other drugs, topical finasteride could be a better choice. The use of other drugs with oral finasteride might cause adverse effects. Topical finasteride allows for direct application to the scalp without the need for ingestion.

Flexibility in Combining Treatments

Another consideration is combination therapy. You can apply topical Finasteride with minoxidil, another proven hair loss treatment that could offer enhanced results.

One can take Oral Finasteride and apply minoxidil. Still, given that minoxidil is a topical treatment, some people may find applying one topical treatment more straightforward to manage than applying one and taking another.

A combination therapy that is both topical is simpler.
A combination therapy that is both topical is simpler

In summary, oral and topical Finasteride offer viable pathways to managing hair loss, each with unique advantages and potential downsides.

 The best choice depends on individual factors such as your comfort, the severity of your hair loss, tolerance for potential side effects, and financial considerations. Always consult a healthcare provider to determine the best action for your situation.

Factors to Consider When Choosing Finasteride Formulation

When it comes to selecting between oral and topical Finasteride, you should take factors into account.

Personal Comfort and Convenience

Choosing between a pill and a topical application can hinge on your lifestyle and preferences. Oral Finasteride might suit those who prefer a quick, no-fuss approach, while topical Finasteride may appeal to those who enjoy a more hands-on, ritualistic aspect of care.

Severity and Type of Hair Loss

Your specific type and stage of hair loss can also influence the choice. Both forms are effective for male pattern baldness, but if your hair loss is more advanced, you should discuss which option could provide optimal results with a healthcare provider.

Individual Health Conditions and Potential Side Effects

Your overall health and potential side effects are paramount considerations. If you have a history of hormonal imbalances, liver disease, or a serious allergic reaction, or you’re planning to conceive, ensure to discuss these factors with your healthcare provider to determine the most suitable and safe form of Finasteride for you.

Final Thoughts

In understanding Finasteride, we’ve navigated through the characteristics, benefits, and potential side effects of both oral and topical formulations. The effectiveness, comfort of use, costs, and individual health considerations all play significant roles in determining which route may be more suitable for you.

Effectivity plus comfort at less cost is ideal
Effectivity plus comfort at less cost is ideal

Remember, hair loss is a deeply personal experience, and the approach to its treatment should be just as personalized. Expert guidance is key in this process. Whether it’s the well-established oral Finasteride or the newer topical option, You should decide in consultation with professionals well-versed in this field.

As we close, it’s important to emphasize that while this guide provides a comprehensive overview, it cannot replace the value of personalized medical advice. Contact healthcare professionals or hair loss experts who can provide tailored advice based on your unique situation.

They can help guide you to the most effective treatment strategy for your hair health. The right choice of Finasteride is the one that fits your needs and lifestyle best.


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