Topical Finasteride vs. Oral: Which Is Better? | Jae Pak MD

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

Topical Finasteride vs. Oral: Which Is Better? 

At Jae Pak MD Medical, we understand that navigating the world of hair loss treatments can be overwhelming. Among these treatments, Finasteride has emerged as a pivotal solution for many battling hair loss, particularly male pattern baldness

Available in two distinct forms — topical and oral — Finasteride offers diverse options for those seeking effective hair restoration. However, choosing between these two forms can be challenging without a thorough understanding of their differences and benefits.

It’s also important to understand Finasteride’s potential risks and limitations before beginning use. Finasteride, in either form, is only effective with consistent use, making it a tedious and temporary solution to hair loss. 

Furthermore, Finasteride is not right for everyone, namely women or men considering fatherhood. If you find that Finasteride won’t work for you, we advise looking into alternative treatments and consulting with a hair restoration specialist like Dr. Jae Pak to help you on your hair health journey. 

This article aims to demystify Finasteride, comparing topical and oral applications. Our goal is to provide clear, comprehensive insights to help you determine which form of Finasteride aligns best with your hair restoration journey, lifestyle, and specific needs. 

With a focus on factual information and patient-centric advice, we hope to guide you toward making an informed decision on your path to hair regrowth and overall scalp health.

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What Is Finasteride?

Finasteride’s journey from a medical innovation to a staple in hair loss treatment is a testament to its effectiveness. Originally developed to treat enlarged prostate glands, researchers discovered its potential in addressing hair loss, particularly male pattern baldness, leading to its FDA approval for this use.

The science behind Finasteride’s effectiveness lies in its ability to inhibit the enzyme 5-alpha-reductase. This enzyme converts testosterone into dihydrotestosterone (DHT), a hormone that plays a significant role in male pattern baldness. 

By reducing DHT levels, Finasteride helps slow down hair loss and, in many cases, promotes hair regrowth. Over the years, Finasteride has been extensively studied and validated for its efficacy in treating hair loss. Its ability to improve hair count and thickness has made it a trusted choice for many looking to combat balding. 

However, as with any medication, understanding its applications, benefits, and potential side effects is crucial. This knowledge forms the foundation for choosing between its topical and oral forms, a decision that can significantly impact your hair restoration experience.

What Are the Pros and Cons of Oral Finasteride?

Oral Finasteride, typically prescribed in tablet form, functions by systematically reducing DHT levels throughout the body. This systemic approach has been the traditional and most common method of addressing male pattern baldness.


  • Established Efficacy: Oral Finasteride has a long history of proven effectiveness in combating hair loss, mainly in the crown area, with many users experiencing significant improvements in hair density and a slowing of hair loss progression.
  • Ease of Use: Being an oral medication, it’s convenient to incorporate into daily routines, requiring just a simple, regular dosage.
  • Extensive Research and Data: Numerous clinical trials and studies have established the safety and efficacy of oral Finasteride, providing a wealth of data and user experiences.


  • Potential Systemic Side Effects: As it works systemically, oral Finasteride can affect DHT levels throughout the body, leading to potential side effects, including sexual dysfunction, which has been a concern for some users.
  • Concerns About Sexual Dysfunction: A notable percentage of users report experiencing reduced libido, erectile dysfunction, or other sexual side effects, although these are usually reversible upon discontinuing the medication.
  • Contraindications for Women of Childbearing Age: Oral Finasteride is not recommended for women, especially those who are pregnant or may become pregnant, due to the risk of congenital disabilities.

What Are the Pros and Cons of Topical Finasteride?

Topical Finasteride is a relatively newer application form involving the direct application of the medication to the scalp. This method aims to target DHT levels locally at the site of hair loss.


  • Potential for Reduced Systemic Side Effects: By targeting the scalp directly, topical Finasteride may reduce the likelihood of systemic side effects, including those related to sexual health.
  • Targeted Application: Applying Finasteride directly to the scalp can potentially enhance its effectiveness in the specific areas needing treatment.
  • Growing Popularity: As awareness of topical Finasteride increases, more users are considering it as an alternative to the oral form, particularly those concerned about systemic side effects.


  • Less Extensive Research Compared to Oral Form: Topical Finasteride has not been studied as extensively as the oral form, meaning there’s less empirical data available on its long-term efficacy and safety.
  • Variability in Absorption: The effectiveness of topical Finasteride can vary based on factors like skin type and the formulation of the product, potentially affecting its absorption and efficacy.
  • Convenience Factors: Unlike a simple pill, topical Finasteride requires more effort in the application, which might not fit as easily into some users’ daily routines.

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Side Effects and Safety Profile

Understanding the side effects and safety considerations of both oral and topical Finasteride is key to making an informed choice. For oral Finasteride, the side effects are more systemic and often center around sexual health. While typically reversible, these side effects can be a significant concern for many users. 

As touched on previously, oral Finasteride is also not suitable for women — especially those who are or may become pregnant, and can be a concern for men considering fatherhood.

Topical Finasteride, in contrast, tends to exhibit a milder side effect profile, mainly localized to the application area. The most common issues involve skin irritation or rash at the site of application. 

Though these effects are generally less severe than those associated with the oral form, they can vary based on individual skin sensitivity and the specific formulation used. Making a choice between oral and topical Finasteride should be a collaborative decision with a healthcare professional. 

They will take into account personal health, potential side effects, and individual lifestyle and treatment goals. The decision is not just about efficacy but also how the treatment aligns with the user’s overall health and quality of life.

Patient Considerations and Suitability

When considering Finasteride, whether in oral or topical form, it’s crucial to consider individual factors that can influence its effectiveness and suitability. The choice largely depends on the unique circumstances and needs of each patient.

Key factors to consider include:

  • Severity of Hair Loss: The extent of hair thinning or loss can determine which form of Finasteride might be more effective or appropriate.
  • Lifestyle: Daily routines and personal preferences play a role. For instance, those looking for a straightforward approach may prefer the simplicity of an oral medication, while others might opt for topical application as part of a more extensive hair care regimen.
  • Health History: Past and current medical conditions, especially those related to hormonal health or skin sensitivity, are critical in deciding the form of Finasteride to use.
  • Age and Gender Considerations: While typically prescribed to men, Finasteride’s suitability varies across different age groups and can be contraindicated in women, particularly those of childbearing age or who are pregnant.

Each patient’s situation is unique, requiring a personalized approach to selecting the right form of treatment.

Other Treatment Options and Combination Therapies

In the realm of hair restoration, Finasteride is just one of the many options available. Exploring a range of treatments can sometimes yield the best results, especially when combined strategically. 

Some notable alternatives include:


Another FDA-approved treatment for hair loss, often used in conjunction with Finasteride for synergistic effects. Minoxidil is applied topically and works by stimulating hair follicles to promote growth and slow hair loss. It’s to be noted that Minoxidil is best seen as a short-term solution for those experiencing the early stages of hair thinning. It also comes with its own potential side effects, such as scalp irritation, making it unsuitable for some. 

Platelet-Rich Plasma (PRP) Therapy

PRP involves using a patient’s own blood plasma, enriched with platelets, to stimulate hair growth. This treatment is becoming increasingly popular due to its natural approach and effectiveness in promoting hair regeneration.

Hair Transplant Surgeries

Procedures such as FUT (Follicular Unit Transplantation) and FUE (Follicular Unit Extraction) transplant hair from denser areas to thinning or balding areas, offering a more permanent solution. 

For those experiencing scalp hair loss and thinning eyebrows, an eyebrow transplant can be a complementary procedure. Dr. Jae Pak specializes in these intricate procedures, providing a harmonious restoration of both scalp and facial hair for a natural, balanced look.

Laser Therapy

Low-level laser therapy is non-invasive and promotes hair growth by stimulating the scalp. It can be used in combination with other treatments for enhanced results.

Scalp MicroPigmentation

For those looking for an alternative cosmetic solution, Scalp MicroPigmentation (SMP) creates the illusion of fuller hair through detailed micro-tattoos on the scalp. Dr. Pak was a pioneer in Scalp Micro Pigmentation.

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Schedule a consultation with Dr. Jae Pak today.

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The Bottom Line

At Jae Pak MD Medical, we understand that choosing between Topical and Oral Finasteride for hair loss treatment is a decision that requires careful consideration. Each form has its own set of benefits and potential drawbacks, and what works best can vary greatly depending on individual circumstances and needs. 

Whether it’s the convenience and established track record of Oral Finasteride or the targeted application and reduced systemic side effects of Topical Finasteride, the right choice depends on your unique hair loss situation, health profile, and lifestyle. Even so, Finasteride comes with a list of potential hazards, and it’s only effective so long as you’re taking it consistently, making it a less suitable option for those looking for long-term solutions to hair loss. 

We encourage those exploring hair restoration options to consult with hair restoration specialists like Dr. Jae Pak to tailor a treatment plan that aligns with your specific goals and ensures the best possible outcome for your hair health.


Finasteride: MedlinePlus Drug Information| Medline Plus

Finasteride: a review of its use in male pattern hair loss | PCM 

Finasteride (Oral Route) Description and Brand Names | Mayo Clinic 

Finasteride and sexual side effects | PMC 

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