When you start looking for potential treatments against your thinning hair or receding hairline you will likely come across Finasteride and Minoxidil.
Both are better know under their brand names Propecia (Finasteride) and Regain (Minoxidil) and are the only licensed and approved medications to treat male pattern baldness in the UK. But do they actually work? What is the science behind them? Which one is more effective?
We will take a closer look at both Finasteride and Minoxidil and how they compare to each other and what you can expect from a treatment.
What is the Difference Between Finasteride and Minoxidil?
Generally speaking, Finasteride stops hair loss, while Minoxidil promotes new hair growth. Hence they are often advised to be used together as the most effective hair loss treatment.
How Does Finasteride Work?
Finasteride forms part of medications called 5α-reductase inhibitors and works by inhibiting (or blocking) testosterone to be converted into Dihydrotestosterone (DHT). DHT is an androgen, or male sex hormone, which is predominately responsible for hair loss.
How DHT causes hair loss may not seem straightforward, that’s why we have compiled an extensive Guide to DHT and Male Pattern Baldness. It goes into more detail of how DHT makes your hair fall out.
In essence, Finasteride blocks the conversion of testosterone into DHT and is, therefore, more commonly referred to as a DHT-blocker. This stops DHT from binding to the hair follicles and prevents miniaturising, a process where the hair follicles shrink and eventually stop producing hair altogether
The conversion of DHT is blocked only for as long as Finasteride is active in your body, therefore the medication must be taken on a daily basis. If the treatment is discontinued, you will start to convert testosterone to DHT again and as a result, your hair loss will continue.
How Does Minoxidil Work?
Minoxidil is a topical solution which is applied 1-2 times daily directly onto the scalp where you are experiencing thinning hair.
We need to understand the hair growth cycle, in order to fully understand how Minoxidil works:
- Anagen (Growing Phase): Lasts on average 3-5 years, during which a healthy hair grows about half an inch a month.
- Catagen (Transition Phase): A short transitional phase that lasts on average 10 days.
- Telogen (Resting Phase): The follicle remains inactive for 3 months. While the old hair is resting a new hair begins the growth phase.
- Exogen (New Hair Phase): The old hair falls out, a new hair continues to grow and the hair growth cycle is repeated.
While researchers are not entirely sure how Minoxidil works, it is believed to work by widening blood vessels and allowing more oxygen, blood and nutrients to the hair follicles. This, in turn, is believed to start an early anagen phase, meaning it can make hair follicles go prematurely through the entire hair cycle process before starting again.
As a result, you may experience some hair to fall out, in a process called shedding. This is a common side effect at the beginning of the Minoxidil treatment as hair in the Telogen phase are replaced by new hairs in the Anagen phase. The side effect is not a reason to be concerned and actually shows that Minoxidil is working.
So, while Finasteride is effective in stopping hair loss, Minoxidil is stimulating the growth of new hair in the areas it is applied in.
Do Finasteride and Minoxidil Work?
An overwhelming number of different online sellers and self-proclaimed hair loss experts are fighting for your attention and claiming to have found the cure for hair loss. But do any of them actually work?
When assessing the effectiveness of medication like Finasteride and Minoxidil, it is always recommended to look at actual research which has been published in reputable academic journals.
Finasteride is widely considered to be the most effective treatment against hair loss. An extensive study from 2003 found that 90% of patients on a Finasteride treatment either maintained (no further visible hair loss), or sustained visible improvement in hair growth over a five year period. The same study found that 65% of men experienced an increase in hair count after taking 1mg finasteride daily over a five year period.
An earlier study from 1999 found that daily use of 1mg of Finasteride was effective in reducing scalp skin DHT levels by 64%, which is sufficient to effectively stop hair loss and in some cases weakened hair follicles can start producing hairs again.
For Minoxidil, several academic studies using a 5% solution were conducted. In 2012, a twelve-month study of about 1,000 men with male pattern baldness found Minoxidil to be effective in over 65% of patients for stimulating hair growth.
Another study tested a 5% solution of Minoxidil on 743 men with male pattern baldness over the course of 4 months. It was found to be either very effective or effective in stimulating hair growth for 62.5% of the men. 74% of men also reported that Minoxidil had noticeably increased the thickness of the hair.
Can Finasteride and Minoxidil Be Taken Together?
Both Finasteride and Minoxidil have found to be effective as a hair loss treatment, but can they be taken together?
A Study from 2002 published in the Journal of Dermatology, assessed the effectiveness of different hair loss treatments. The study divided men into four different groups, which underwent distinct treatment plans.
Group I: Finasteride
Group: II: Finasteride + Minoxidil
Group III: Minoxidil
Group: IV: Finasteride + Ketoconazole
At the end of one year, hair growth was observed in all the groups with best results recorded in group II with a combination of Finasteride and Minoxidil followed by groups IV, I and III.
To answer the question, given Finasteride and Minoxidil stop hair loss and promote hair growth in different ways, they can be safely used in conjunction as the drugs do not interact with each other. However, before you start a treatment you should check with your GP to see if you are eligible.
Do a free online consultation with one of our experts to see if you are eligible for either for one of our hair loss treatments.