Minoxidil and finasteride are the two options to weigh first for male pattern hair loss, and the usual question is which one is better. Our review does not establish that. Nothing we could verify puts one above the other, so this page does not name a winner.
What it does is set the two side by side. Minoxidil is a liquid or a foam put on the scalp twice a day. Finasteride is a tablet taken once a day, on prescription. They were tested against different things and measured in different ways, and they come with different risks, routines and prices. The choice between them usually turns on those differences. [1, 2, 3, 4]
Two different kinds of medicine
Minoxidil for hair loss is a 5% solution or a 5% foam applied to the scalp. The men's labels in the US and UK say twice a day, in an amount specific to each product. Finasteride for hair loss is a 1 mg tablet taken by mouth once a day. It is approved in the US and UK for men with male pattern hair loss, and it needs a prescription. [1, 5, 2, 6, 3, 4]
Finasteride lowers the level of a hormone called DHT in the blood, by about 65% within a day of a 1 mg tablet according to the US label. That is a blood measurement, not a measure of regrowth. We do not explain here how minoxidil acts on the hair follicle. The sources behind this page are trials, labels and regulators' notices, and they describe results and risks, not mechanisms. [3]
How the two are used
Minoxidil on the scalp and the finasteride tablet, as the US and UK men's labels describe them.
| In practice | Minoxidil5% solution or foam, on the scalp | Finasteride1 mg tablet, by mouth |
|---|---|---|
| How often | Twice a day | Once a day, with or without food |
| Amount | 1 mL of solution or half a capful of foam. That is the total for all the thinning areas | One 1 mg tablet |
| How you get it | US: the men's 5% solution and foam are sold over the counter. UK: the men's foam is on general sale | On prescription in the US and UK |
| Who the labels are for | UK: men aged 18 to 65 for the solution and 18 to 49 for the foam. US: men 18 and over | Men with male pattern hair loss. Not for women or children, and the UK label also excludes adolescents |
| Part of the scalp | The two US men's labels are for the top of the scalp and are not intended for a receding hairline | The labels are for male pattern hair loss. The two main trials counted hair at the crown |
| What it asks of you | Two applications a day, for as long as the result is wanted | A prescription, one tablet a day, and attention to changes in mood or sexual function |
Each cell comes from the men's labels we checked at the end of September 2026: four for minoxidil, two for finasteride. Other countries have their own products and instructions. [1, 5, 2, 6, 3, 4]
Each medicine also exists in a second form: minoxidil as a tablet, and finasteride as a scalp spray authorised in some European countries, Spain among them. Those forms have their own evidence and their own risks, covered in minoxidil tablets for hair loss and finasteride spray and how it compares with the tablet. This page compares the forms that each position in our ranking rests on: minoxidil on the scalp and the finasteride tablet. [7]
Why our ranking does not pick a winner
In our ranking of six ingredients, minoxidil is listed first and finasteride second. Those numbers are positions on a page. Both sit in the same top tier, and the tier is the part that carries meaning: these are the two to weigh first.
Each earns that place on its own evidence. The minoxidil solution and foam each did better in trials of men than the same product without minoxidil. The finasteride tablet did better than placebo, with follow-up to five years. Both have usable labels in the US and UK. What we could not verify is evidence that compares the two like for like. Without it, putting one above the other would be our guess, not a finding. [8, 9, 3, 10]
Minoxidil and finasteride on the eight criteria
Each column is the form the position is based on: the solution and foam for the scalp, and the 1 mg tablet.
| Criterion | No. 1MinoxidilTopical solution or foam | No. 2FinasterideOral tablet |
|---|---|---|
| Benefit shown | Benefit shown against an inactive vehicle | Benefit shown against placebo |
| Evidence | Broader clinical support | Broader clinical support |
| Main risk | Scalp irritation; labels also carry systemic warnings | Sexual and psychiatric warnings |
| Routine | Twice-daily scalp application | One tablet a day, on prescription |
| Time point | Review point set by each product's label | Three months or more before benefit |
| If you stop | Benefit lasts only with continued use | Benefit lasts only with continued use |
| Access | Labelled products available (US and UK checked) | Tablet approved (US and UK checked); spray varies |
| Cost | Depends on country and form | Depends on country and provider |
Each cell is the short verdict from the ranking. Prices and labels were checked for the United States and the United Kingdom at the end of September 2026.
Read down the two columns. On effectiveness each column records a benefit against an inactive comparison, and both carry the same evidence label. That is not a statement that the benefits are the same size. The two part on the main risk, the routine and access, and that is where the rest of this page spends its time.
The tie is not permanent. It would be reopened by evidence that can be compared like for like and shows which of the two works better, or by long-term comparisons of the benefits and harms that matter to patients. Our own reading has gaps as well: for the older minoxidil trials we could check only published summaries, and for finasteride we worked from the label's account of its trials without re-reading each original report. The eight criteria are explained under how we rank and on the methodology page.
What each one was tested against
Both medicines have trials in men with pattern hair loss. In the trials each position rests on, neither was tested against the other. Minoxidil was compared with the same product without minoxidil, and finasteride with a placebo tablet.
The trials behind each position
Two for minoxidil on the scalp and the pair of trials summarised in the US finasteride label.
| In the trial | Minoxidil5% foamOne trial | Minoxidil5% solutionOne trial | Finasteride1 mg tabletTwo trials, reported together |
|---|---|---|---|
| Men | 352, aged 18 to 49 | 393 | 1,553, with thinning at the crown |
| Compared with | The same foam without minoxidil | A 2% solution, and the liquid without minoxidil | A placebo tablet |
| Length | 16 weeks | 48 weeks | 12 months, then extensions of up to five years |
| What was counted | Hairs per cm² in a marked patch, leaving out the finest hairs | Hairs other than the finest, and ratings of scalp coverage | Hairs in a patch of 5.1 cm² |
| Result | About 21 hairs gained per cm², against about 4 | 5% did better than both. Size of the gain not verified | 107 more hairs than placebo in that patch |
| What we could read | The UK product information, and the published summary of what appears to be the same trial | The published summary | The US label's account of the two trials |
Three separate sets of men, measured in different ways over different lengths of time. No row lets one column be ranked against another. [5, 9, 8, 3, 10]
Minoxidil on the scalp, against the same product without it
Each scalp form has its own trial. The solution was followed for longer: 393 men over 48 weeks. The 5% strength did better than both 2% and the liquid without minoxidil, with more scalp irritation at the higher strength. We could verify that result in the published summary but not the size of the gain, so we print no number for it. The minoxidil profile has the detail, and the choice between the two forms is in foam and solution compared. [8]
The clearest numbers come from the foam. The UK product information reports a trial of 352 men aged 18 to 49, in which 180 used 5% minoxidil foam and 172 used the same foam without minoxidil. After 16 weeks the men on minoxidil had gained about 21 hairs per square centimetre in the measured patch, against about 4 in the comparison group. [5, 9]
Minoxidil foam: hairs gained after 16 weeks
5% minoxidil foam180 men
+21.0hairs per cm²
Foam without minoxidil172 men
+4.3hairs per cm²
Change in the count of all hairs except the finest, in a marked target area, as reported in the UK product information. A target area is a small patch of scalp chosen for the study, not the whole head. This chart cannot be set next to the finasteride chart below: the two trials counted different hairs in different areas over different lengths of time. [5]
Finasteride tablets, against placebo
The main evidence is summarised in the US label. Two trials enrolled 1,553 men with thinning at the crown, who took finasteride 1 mg or a placebo every day. After 12 months, hair counts were available for 1,351 of them. The men on finasteride had 107 more hairs than the men on placebo in the measured patch, an area of 5.1 cm². That is the gap between the two groups in that patch. It is not 107 hairs per square centimetre, and it is not the gain over the whole head. [3]
The two trials carried on as extension studies of up to five years, which 1,215 of the men entered, and the benefit over placebo was maintained. That is the number who entered, not the number who completed five years, and we could read only the published summary. The finasteride profile has more on the five-year follow-up. [10]
A gap over placebo can come from two things: more hair on the medicine, and less hair lost. A later trial shows both at once.
Finasteride tablets: change in hair count after 24 weeks, in a later trial
Finasteride 1 mg179 men
+56.5hairs in the measured circle
Placebo181 men
−4.9hairs in the measured circle
Average change in the count of all hairs inside a circle 2.54 cm across at the crown. The trial randomly assigned 917 men to five groups, among them groups taking dutasteride, and was funded by GSK. These are hairs in that circle, not hairs per square centimetre, so this chart cannot be set next to the foam chart above. [11]
Why the numbers cannot be lined up
It is tempting to put 21 next to 107, or next to 56.5, and call a winner. The figures do not allow it.
Four reasons the trial figures cannot be set side by side
- Different areas. A count per square centimetre of a marked patch for the foam. A patch of 5.1 cm² in the finasteride label. A circle 2.54 cm across in the later finasteride trial.
- Different counts. The foam figure leaves out the finest hairs. The later finasteride trial counted all hairs.
- Different comparisons. The foam's 21 is the gain in the treated group, and the gap to its comparison group was about 17. The label's 107 is only the gap between the two groups.
- Different lengths and different men. Sixteen weeks, 48 weeks, 24 weeks and 12 months, in groups of men recruited by separate studies.
What the two sets of trials have in common is the kind of result. Each medicine did better than an inactive comparison in men with pattern hair loss. For minoxidil that means more density in the treated area, not a promise that hair comes back completely. For finasteride, part of the benefit is keeping hair that would otherwise be lost.
The one trial that included both
One trial we reviewed put the two medicines in the same study. Published in 2015, it randomly assigned 450 Chinese men with male pattern hair loss to three groups for 12 months: 160 to finasteride tablets, 130 to 5% minoxidil on the scalp, and 160 to both. At the end, 428 of them were assessed. [12]
Men rated as improved after 12 months, in the one trial with both
Minoxidil 5% on the scalp122 men assessed
59%% of men
Finasteride tablets154 men assessed
80.5%% of men
Both152 men assessed
94.1%% of men
Share of the men assessed in each group who were rated as improved, as reported in the published summary. It is not an amount of hair, and the summary does not say what counted as improved. We do not read the gap between the first two bars as a ranking. [12]
The chart shows the three shares as the published summary reports them. We give them because leaving them out would be less honest than explaining them. We do not read the difference between the finasteride group and the minoxidil group as a ranking, for the reasons below.
Why we do not read it as a ranking
Only the published summary of this trial was available to us, and it leaves out most of what a comparison needs.
What the published summary does not tell us
- What counted as improved. It gives no scale and no definition. The figures are shares of men, not amounts of hair.
- How sure the gap is. It gives no margin of error for the difference between the finasteride group and the minoxidil group.
- Who did the rating. It does not say whether the assessors knew which treatment each man was on.
- How the minoxidil was used. The strength was 5%. The amount and the number of applications a day are not given.
- How side effects were counted. It gives a percentage of adverse reactions for the finasteride group (1.8%) and the minoxidil group (6.1%), without saying what was recorded, how, or in how many men, and it gives no figure for the men who used both. We do not read these as a safety comparison.
- Who paid for it. It names no funder, which is not the same as saying there was none.
These are gaps in what we could read, not necessarily in the trial. Even with the full paper it would remain one trial, in Chinese men, over 12 months, with groups of unequal size. One trial is a reason to look for more evidence. It is not enough to rank two medicines. [12]
What our review does take from this trial is narrower: more men were rated as improved with both medicines than with either one alone. That finding has its own page, minoxidil and finasteride together.
What pooled analyses add
A network analysis pools many trials and combines direct comparisons with indirect ones. One published in 2022 pooled 23 studies of minoxidil, finasteride and dutasteride in men: 21 randomised trials and two observational studies. [13]
The figure we did take from it is on the page that compares finasteride with dutasteride.
Side effects and risks side by side
The two medicines ask you to accept different things. With minoxidil on the scalp the usual problems are irritation and itching, and the labels also list body-wide warning symptoms. With finasteride they are sexual side effects, together with regulators' warnings about mood.
| Minoxidil on the scalp | Finasteride tablets | |
|---|---|---|
| Where it goes | Applied to the scalp. Some of it still reaches the rest of the body. | Taken by mouth, so it reaches the whole body. |
| The usual problems | Scalp irritation and itching. The alcohol and propylene glycol in a solution can limit how well a scalp tolerates it. | Lower sex drive, erection problems and ejaculation problems. |
| What a trial counted | Among 45 men using the 5% solution for 24 weeks: scalp eczema in 7, unwanted hair growth elsewhere in 11, headache in 1. Three stopped because of side effects. | In the first year of the three trials in the US label: at least one sexual side effect attributed to treatment in 36 of 945 men on finasteride (3.8%) and 20 of 934 on placebo (2.1%). |
| Warnings | The US labels say to stop and ask a doctor about chest pain, a rapid heartbeat, faintness or dizziness, sudden unexplained weight gain, or swollen hands or feet. | The European regulator confirmed suicidal thoughts as a side effect of the tablets in 2025, and the UK regulator confirmed the link with depression and suicidal thoughts in 2026. The US label and the UK regulator also report sexual problems that continued after stopping. |
| Other cautions | The labels do not cover irritated or damaged scalp, and the UK labels restrict other medicines applied to the scalp. | It must not be used in pregnancy, and the US label warns against contact with crushed or broken tablets for women who are or may be pregnant. It also lowers PSA, a blood marker used to check the prostate. |
| What is not known | How often rare events happen. One trial of 45 men cannot rule them out. | How often sexual problems continue after stopping. There is no reliable figure, in either direction. |
The minoxidil counts come from the solution group of one trial that compared it with minoxidil taken by mouth. The finasteride figures come from the US label and from the European and UK medicines regulators. [14, 2, 6, 1, 5, 3, 15, 16]
The rows cannot be turned into a safety ranking. The counts come from separate trials that recorded side effects in different ways, in different men and over different lengths of time. In the finasteride trials, most men did not report a sexual side effect.
Each side has a page of its own: minoxidil side effects, and finasteride side effects, which covers what is known after stopping.
How long each one takes
Think in months for both. The UK labels and the US solution label expect first signs after about two months. Each of the four men's minoxidil labels sets a point at which to stop and get advice if nothing has changed: 16 weeks for the UK foam, 4 months for the US products, one year for the UK solution. The US finasteride label says it generally takes three months or more of daily use before a benefit shows. [1, 5, 2, 6, 3]
The first year: what the labels expect and when the trials counted
Minoxidil, UK foam
Men 18 to 49
Minoxidil, UK solution
Men 18 to 65
Minoxidil, US solution
Men 18 and over
Minoxidil, US foam
Men 18 and over
Finasteride tablet
US label
Minoxidil trials
When hair was counted
Finasteride trials
When hair was counted
A review point is the label's instruction to stop and get advice if there has been no improvement. A trial time point is when researchers measured, not a promise of when you will see a change. [1, 5, 2, 6, 3, 11, 8]
None of this shows that one acts faster than the other. The labels word their timings differently, and a trial time point is when researchers chose to count. The UK foam label also warns of a temporary rise in shedding between the second and sixth week, which is covered in how to use minoxidil. [5]
What happens if you stop
On this point the two are alike: the benefit lasts only while the medicine is used. [1, 5, 2, 6, 3]
What the labels say about stopping
- Minoxidil, the four scalp labels
- Keep using itTreatment has to continue to keep the regrowth.
- Minoxidil, UK solution label
- 3 to 4 monthsThe gain has been reported to disappear within this time. The label bases that on anecdotal reports.
- Finasteride, US label
- Within 12 monthsThe effect on hair reverses within this time.
Two labels, worded in two different ways. They are not a measured comparison of how quickly each gain is lost. [1, 3]
Both statements describe what was observed. They are not advice to stop, to take breaks or to use less. Stopping because of a side effect is a different matter, and with finasteride the prescriber needs to know what was noticed and when.
How you get each one, and what it costs
Access is the plainest practical difference. In the United States the men's 5% minoxidil solution and foam are sold over the counter, and in the United Kingdom the men's foam is on general sale. Finasteride 1 mg needs a prescription in both countries. [2, 6, 5, 3, 4]
On cost, the two countries we checked point in opposite directions. These are single prices we recorded on 29 September 2026, one offer per product, worked out for 30 days at the labelled amount. They are examples, not national averages, and we do not convert between currencies.
Cost of 30 days of use, from one observed offer each
United States · US dollars
Minoxidil 5% solutionStore-brand, 1 mL twice a day
$7.31
Minoxidil 5% foamStore-brand, assuming one can a month
$9.71
Finasteride 1 mg tabletsSubscription service, listed price
$26.67
United Kingdom · pounds
Minoxidil 5% solutionOnline pharmacy, 1 mL twice a day
£16.25
Minoxidil 5% foamRegaine for Men, 1 g twice a day
£19.17
Finasteride 1 mg tabletsOnline pharmacy, generic
£9.46
Medicine only. The US finasteride price is a subscription's listed $80 for 90 tablets, with $5 shipping per delivery; the same page showed a $56 offer, which we did not use. The UK finasteride price is £26.50 for 84 tablets, plus a £3 prescription fee and £2.90 delivery per order. The UK minoxidil solution offer added a £4 prescription fee and £2.90 delivery per order. Shipping for the US minoxidil offers was not determined and is not included. Consultation fees and taxes are not included.
Over a year the US examples come to roughly $89 to $118 for minoxidil and about $324 for the finasteride subscription. The UK examples come to £198 to £233 for minoxidil and about £115 for generic finasteride. So in this price check minoxidil was the cheaper of the two in the US and finasteride the cheaper in the UK. One offer each is not a market, and price says nothing about which works better. The same price check is set out in the cost sections of the minoxidil and finasteride profiles.
Which question matters to you
Since the evidence does not rank the two, the choice comes down to questions that only the person deciding can answer. These are the ones to work through.
Would you put something on your scalp twice a day, every day?
RoutineThat is what the men's minoxidil labels ask, for as long as the result is wanted. Foam and solution feel different in the hair, which can decide whether the routine lasts. Finasteride is one tablet a day.How to use minoxidilDo you want to involve a prescriber?
PrescriptionFinasteride needs a prescription, and the UK regulator asks prescribers to ask about any history of depression or suicidal thoughts. In the US the men's minoxidil solution and foam are sold over the counter, and in the UK the men's foam is on general sale.Full finasteride profileIs the thinning at the hairline or the crown?
Area of the scalpThe two US men's minoxidil labels are for the top of the scalp and are not intended for a receding hairline. Finasteride's two main trials counted hair at the crown. Neither fact shows which medicine does more at the hairline.Minoxidil and a receding hairlineWhich risks are you prepared to accept?
RisksWith minoxidil on the scalp the usual problems are irritation and itching, and the US labels list warning symptoms such as chest pain or a rapid heartbeat. With finasteride they are sexual side effects, with regulators' warnings about mood and about sexual problems that can continue after stopping.Finasteride side effectsDoes the label cover you?
Label limitsThe UK minoxidil labels are for men aged 18 to 65 for the solution and 18 to 49 for the foam. Finasteride's labels are for men only. If a partner is or may be pregnant, or you are trying to conceive, that is a question to raise with the prescriber.Does price decide it?
CostThen it depends on the country. In our price check minoxidil was the cheaper of the two in the US examples, and finasteride the cheaper in the UK examples.Is the hair loss sudden, patchy or painful?
Assessment firstThen neither medicine is the place to start. Both were tested in men with pattern hair loss, and the first step is an assessment of the cause.Types of hair loss
Questions for sorting out your own priorities. None of them is a recommendation, and none replaces a prescriber's judgement where finasteride is concerned.
Some men ask which of the two to start first. The trials we reviewed do not establish an order for starting the two, and no label we checked describes one. What the sources do support is simpler: either one can be a whole routine on its own.
Using both
The two are not only alternatives. In the trial of 450 men, more were rated as improved with finasteride tablets and minoxidil on the scalp together than with either one alone, although we could read only its published summary. Using both means following two sets of instructions and carrying the risks of both, and adding finasteride is a decision to take with a prescriber. The UK finasteride label still states that no data are available on using it together with minoxidil on the scalp. [12, 4]
Minoxidil and finasteride togetherThe combination evidence, what the labels say about using both, and what is not established.Where to go next
Each medicine has a full profile with its trials, label instructions, side effects and costs in more detail. For how the pair fits among everything else that can go into a routine, see what to combine and what to choose between.
Full minoxidil profileTrials, label instructions, timelines, side effects and what is not known. Full finasteride profileTrials, label instructions, timelines, side effects and what is not known. The ranking on one pageSix ingredients in an order of consideration, with ties shown and the reason for each place. The hair questionnaireA few questions that point to the relevant page. It does not diagnose hair loss or prescribe anything.