A Survey of Finasteride, Minoxidil, and Other Medications for Hair Loss

- Reviewed by: Dr. Jae Pak, M.D.

There have been countless hair loss medications and supplements sold over the years, with hit-and-miss results and mixed reviews from the masses.

While some hair loss cases are due to autoimmune disorders, traumatic events, or complications from surgery or other medication, the majority of instances fall under the umbrella of Androgenetic Alopecia.

In both men and women, genetics and hormones are the main determiners of whether hair loss will occur, to what degree it happens, and what the pattern of loss looks like on the scalp. Therefore, medications that address these factors are more desirable and effective.

Nowadays, two major medications are by far the most widely prescribed: Finasteride and Minoxidil. Each has its own pros and cons, side effects and considerations, and used for slightly different purposes.

This article will be an overview of these two main medications and will touch on all the key information that hair loss patients should know before moving forward. It will also address some other medications that are a tier below but still might deserve a closer look.

Finasteride Overview

Despite its unusual origins, Finasteride is arguably the most popular hair loss drug for men on the market today.

The discovery of the drug can be traced back to the 1970s, originally formulated to address the prostate’s issues such as enlargement and inflammation. While performing tests and trials throughout the 1980s, scientists discovered that subjects were experiencing unexpected hair growth on the arms, head, and other parts of the body.

Researchers soon realized that the drug may be a golden ticket for hair restoration and changed the direction of their studies to focus on that.

After many tests and changes, the makers of Finasteride achieved FDA approval in 1997, making it the only established and safe drug for hair loss in men (the status it maintains today). Since then, it has been marketed and sold in many forms, most commonly as Propecia.

Finasteride aims to target and block androgenetic compounds in the scalp, which are thought to contribute to hair loss in men. The drug is a member of a class called 5a-reductase inhibitors, specifically focusing on blocking DHT and promoting strong, healthy hair when men need it most.

DHT is a byproduct of the male sex hormone testosterone and appears in high concentrations in areas such as the hairline, vertex, and along the temples, where male pattern baldness tends to occur. While the exact mechanism of Finasteride is not certain, the correlation is strong enough to determine effectiveness, with plenty of anecdotal evidence to support it.

Because the drug interacts with male hormones, it should not be taken by women or males under the age of 18.

Minoxidil Overview

While doctors may more widely prescribe Finasteride, Minoxidil is certainly the more popular of the two medications overall, available over the counter and online in the form of products like Rogaine.

Minoxidil is different in appearance and effect from Finasteride, so the two are often prescribed concurrently for men who seek better hair restoration results.

Rather than targeting compounds like DHT, Minoxidil is a vasodilator, meant to treat issues relating to hypertension. The idea is to increase the flow of blood in areas of the scalp where the hair is thinning or falling out, reinvigorating the roots of the hair and allowing it to grow back stronger.

Since it doesn’t interact with male hormones, women are safe to take Minoxidil as well.

The story of Minoxidil is not unlike the journey of Finasteride, beginning in the late 1950s with the discovery of a drug that proved effective in lowering blood pressure with an oral tablet.

Researchers observed and reported hair developments on patients using the drug in patch form, suggesting that Minoxidil may have hair restoration properties when applied directly to the skin. From there, patents were filed for topical Minoxidil, and the drug as we know it today obtained FDA approval for hair loss in men in 1988.

Three years later, a comparable direct-application Minoxidil product was made available for women experiencing thinning and patchiness on the scalp. Shortly thereafter, the drug was approved for over-the-counter sale, solidifying its reputation as an ultra-popular treatment.

Now, Minoxidil can be ordered from the internet, prescribed by doctors, or just picked up at any chain retail store. Nevertheless, it’s wise to discuss any medical treatment with a hair restoration specialist before trying anything new.

Clinical Trials and Results

Finasteride has shown promising results in clinical trials and positive feedback from everyday men using the drug.

In one trial, 83 percent of men who took Finasteride for a 48-week period reported that their hair loss slowed or stopped completely, specifically along the temples and the crown of the head.

Another trial found that more than two-thirds of men reported hair growing back after a two-year period of taking Finasteride, showing that the drug might actually be able to turn back the clock for some men who stick with the program.

In terms of precise metrics, the same 48-week study showed that hair regrowth occurred at a rate of 18 hairs per square centimeter in a single cycle. That was twice the amount of regrowth compared to the placebo group.

While men have more success slowing or stopping balding with Finasteride than they do with regrowing hair from the source, these trials are convincing enough to get many patients on board.

Minoxidil has a longer history of clinical trials with more information to draw from. A study from 1987 (the year of FDA approval) showed that 40 percent of test subjects saw moderate to dense hair growth on the crown of the head after several months of use.

Another year-long study found that nearly two-thirds of men reported a decrease in hair loss rate with the use of 5% Minoxidil. Reports of hair regrowth were also notable, with almost 50% of respondents stating that the drug was “effective” at restoring lost hair. However, only 16% of men said the drug was “very effective” while the remaining men said it was only “moderately effective” or “ineffective”.

Upkeep and Side Effects

In terms of ease of use, Finasteride has the edge as a single tablet taken once a day. Minoxidil, on the other hand, comes in the form of a liquid solution or foam that is typically administered twice a day – morning and night.

Minoxidil isn’t necessarily difficult to administer, but it does take some extra attention and time that some people are unwilling or able to facilitate. Also, the substance itself may stain or harm fabrics or skin if not immediately washed away.

As far as dosage and duration are concerned, both drugs must be continually taken for as long as results are desired. The moment a patient comes off either Finasteride or Minoxidil, they can expect their hair to return to normal rates of thinning or balding as before.

For this reason, the majority of people who decide to take these drugs stay on them for years at a time so as not to risk losing any hair they might have gained back.

Since the medications take some time to work, patients using either drug are recommended to use them daily for two to four months before deciding whether to continue.

Side effects are rare for both drugs, although some men report issues with sexual dysfunction after taking Finasteride for a prolonged duration. Men with a history of high blood pressure should also consult a physician when considering Finasteride.

Minoxidil is also considered safe for most people, but patients should be acutely aware of any negative interactions when administering the solution to the scalp. While some tingling in the area is normal, excessive burning, stinging, or inflammation is a sign to stop.

Working with a Specialist

Hair loss medications are widely available to the public, and many people choose to self-treat with over-the-counter or online purchases. While this can lead to decent results, it’s always better to speak directly with a hair restoration specialist who has experience and insight in the field.

The best hair loss doctors will help patients make the best series of choices for hair restoration and ensure they stay ahead of the curve with medications, treatments, and procedures.

How Dr. Jae Pak Can Help

Still, you have so many questions about hair loss: What are my options? What kind of results can I expect? Are my expectations realistic? Hair loss is not a common topic of discussion. So, who do you turn to?

A successful hair restoration or transplant process starts with a consultation with an expert who truly wants to understand your personal goals. Dr. Jae Pak of Jae Pak, M.D. Medical is a board-certified physician and a hair transplant artist with 15 years experience. With a complementary background in engineering, Dr. Pak uses precision-like skill to bring his patients a natural and balanced hair line they can be proud of.

Schedule a consultation with Dr. Pak today and discover what hair transplants can do for you.





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