Topical finasteride is a novel therapy that has been studied since the late 1990s and has recently shown more promise in the treatment of male pattern hair loss. Its active ingredient, finasteride, is offered in a 1mg oral tablet form as a clinically proven and licensed treatment for hair loss. Oral finasteride stabilises hair loss or increases hair density in 90% of men that use it with a less than 2% likelihood of side effects which are usually mild and normally disappear when treatment is stopped.
There is evidence that topical finasteride can also be effective for hair loss prevention and regrowth, but with a lower rate of systemic side effects.
How Effective is Topical Finasteride?
Topical finasteride is applied on the scalp and research has shown significant decrease in scalp DHT levels, resulting in reduced hair loss and improved hair count. Numerous studies have been conducted to understand the efficacy of topical finasteride. A literature review from 2020 summarised published research on topical finasteride from 1992 to 2020 and demonstrated significant improvement in hair count and subsequently, improved quality of life. Some studies used combined therapies where topical finasteride was used in combination with topical minoxidil for synergistic effect. A 2018 study from Chaudhary Charan Singh University explored the efficacy of topical finasteride 0.1% + minoxidil 5% over a period of 12 months. Findings suggested 83% clinical improvement after a year of using this therapy and no significant report of systemic side effects.
What are the side effects?
Whilst topical finasteride is not yet a licensed treatment, studies show that it has better tolerance than the licensed tablet. The full list of potential side effects for 1mg oral finasteride can be found on the Propecia patient information leaflet here. Localised reactions not associated with oral finasteride including contact dermatitis, itching, scaling, and redness of the scalp are possible but are usually mild and manageable. Some studies suggest less than 1% likelihood of systemic side effects; however, more long-term studies are needed in future.
What’s right for you?
Results of both oral and topical finasteride have been monitored with standardised digital photography and trichoscopy. Overall, available research shows excellent efficacy from both therapies so it is up to the individual to decide on which treatment they feel suits them best.
For more information on the treatments offered by The Belgravia Centre, please contact us for a consultation at one of our clinics or arrange a Zoom consultation by first completing our online consultation.
Lee MD, S. W., Juhasz MD, M., Mobasher MD, P., et al. (2018). A Systematic Review of Topical Finasteride in the Treatment of Androgenetic Alopecia in Men and Women. Journal of Drugs in Dermatology. 17(4): 457–463
Rai, P. B., Khushwaha, P., Jain, N. and Gupta, S. (2018). Comparing the therapeutic efficacy of topical minoxidil and finasteride with topical minoxidil and oral finasteride in androgenetic alopecia: a randomized trial. International Journal of Research in Dermatology. 4(3):386-390
Sheikh, S., Ahmad, A., Ali, A.M., et al. (2015). A New Topical Formulation of Minoxidil and Finasteride Improves Hair Growth in Men with Androgenetic Alopecia. Journal of Clinical & Experimental Dermatology Research. 6(1). 1-6
Suchonwanit, P., Iamsumang, W. and Leerunyakul, K. (2020). Topical finasteride for the treatment of male androgenetic alopecia and female pattern hair loss: a review of the current literature. Journal of Dermatological Treatment. Jun 26;1-6
Suchonwanit,P., Srisuwanwattana,P., Chalermroj, N. and Khunkhet S. (2018). A randomized, double‐blind controlled study of the efficacy and safety of topical solution of 0.25% finasteride admixed with 3% minoxidil vs. 3% minoxidil solution in the treatment of male androgenetic alopecia. Journal of The European Academy of Dermatology and Venerology.32 (12). 2257-2263