Topical Finasteride vs. Oral Finasteride Tablets: Which Is Better?
Finasteride is one of the most popular and well-studied treatments for hair loss. It’s available in two forms: a topical solution and an oral medication.
Both topical finasteride and oral finasteride tablets are effective treatments for male pattern hair loss. But there are some key differences between the two.
So, what’s the difference between topical vs. oral finasteride? Let’s explore the advantages and disadvantages of both hair loss treatments.
What Is Finasteride?
Finasteride is the active ingredient in Propecia®. This prescription medication is used to treat androgenetic alopecia, also known as male pattern baldness or male pattern hair loss.
Before we discuss how finasteride works, let’s first cover the basics of androgenetic alopecia.
Your body converts testosterone into dihydrotestosterone (DHT) using an enzyme called 5-alpha-reductase. DHT attaches to receptors in the scalp and shrinks hair follicles. This results in male pattern hair loss, such as a receding hairline or thinning hair at the crown.
This is where finasteride comes in. Finasteride is a 5-alpha-reductase inhibitor, which means it stops the enzyme that converts testosterone to DHT. Thus, finasteride reduces your DHT levels.
With lower levels of DHT, your hair follicles get the chance to recover, allowing them to shift into a new hair growth cycle. Over time, this slows down hair loss.
When it comes to finasteride’s results, both oral and topical finasteride require consistent use in order to see and maintain the benefits. Most men can expect to see some improvement in their hair after about three to six months, with peak benefits after a year or two. If you stop using either product, the benefits may reverse within about a year.
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Topical vs. Oral Finasteride: The Key Differences
While both forms aim to reduce scalp DHT and slow hair loss, they differ in a few important ways:
1. Delivery Method
Let’s start with the most obvious difference, the delivery method.
Oral finasteride is taken as a tablet by mouth.
Topical finasteride is applied directly to the scalp as a solution, serum, or spray.
Both topical and oral finasteride need to be used consistently, typically once a day. For this reason, it’s important to choose a delivery method you’re able to stick with — the convenience can make a significant difference.
2. Side Effects
While oral tablets affect DHT levels throughout the body, topical finasteride treatment works by reducing DHT directly at the scalp, with minimal absorption into the bloodstream.
This means oral finasteride may cause systemic side effects. “Systemic side effects” are side effects that affect the whole body rather than just the area where a medication is applied.
The potential systemic side effects of oral finasteride include:
Decreased libido
Ejaculation disorder
Dizziness
Cold sweats
Mood changes
These side effects are uncommon, occurring in approximately 2 percent of men taking oral finasteride. Most men tolerate the medication well.
However, the Medicines and Healthcare products Regulatory Agency (MHRA) has issued a patient alert card with the aim of increasing awareness among men taking oral finasteride about its potential psychiatric and sexual side effects. Men taking finasteride who develop depression or suicidal thoughts should stop taking the medication and contact their provider straight away. Men who experience problems with sexual function should talk to their provider about their symptoms and be aware that some cases of sexual dysfunction have persisted even after stopping finasteride.
Topical finasteride has a lower risk of systemic side effects, but it may cause scalp irritation (including redness, dryness, and discomfort) where it’s applied.
3. Clinical Evidence
Oral finasteride is supported by decades of research. Topical finasteride isn’t as well-studied, but early research is promising.
A 2020 review of studies, spanning 33 articles, concluded that topical finasteride is a promising treatment for men with androgenetic alopecia. It also found that the topical formulation is a safe option. However, it emphasized that we need more research on the long-term effects.
The available research shows that both topical and oral finasteride are effective treatments for male pattern hair loss: Both can slow down hair loss, increase hair count, and improve hair density. But oral finasteride has a longer track record than topical finasteride, so we know more about its safety and efficacy.
The MHRA has licensed oral finasteride 1 mg (Propecia) for the treatment of male pattern hair loss in the UK. While topical finasteride isn’t licensed by the MHRA, it may be prescribed off-label by a licensed provider. Off-label prescribing is a common and legal practice in UK medicine when a healthcare professional believes it's in the patient's best interest.
Pros and Cons of Topical vs. Oral Finasteride
Feature | Oral Finasteride | Topical Finasteride |
MHRA Approval | Yes (for hair loss in men) | No (used off-label) |
Application | Daily tablet | Daily scalp application |
Typical Time to Results | 3-6 months for initial results; 12-24 months for peak results | 3-6 months for initial results; 12-24 months for peak results |
Side Effects | Small risk of systemic effects | Lower systemic risks; possible scalp irritation |
Evidence Base | Extensive clinical research | Promising but less long-term data |
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Before/after images shared by customers who have purchased varying products, including prescription-based products. Customers were compensated for their testimonials. These customers’ results have not been independently verified. Individual results will vary.
Should I Use Oral or Topical Finasteride?
There’s no one-size-fits-all answer here. The choice between topical and oral finasteride depends on your medical history, lifestyle, and tolerance for potential side effects.
You might prefer oral finasteride if you:
Want a more well-proven hair loss treatment
Have a sensitive scalp and are worried about scalp irritation
Value the convenience of taking a daily tablet
You might prefer topical finasteride if you:
Are concerned about potential systemic side effects
Have had side effects with oral finasteride
Don’t mind applying the solution to your scalp every day
Both oral and topical finasteride are prescription-only hair loss treatments. A healthcare professional can help determine which form is more suitable for you based on your medical history and goals.
Keep in mind that some people should not use finasteride. It’s generally not recommended for women or children, and it may not be safe for people with liver problems or severe bladder problems, people who have had depression or self-harm thoughts, or those who may be allergic to the medication. A provider can help determine if finasteride is right for you.
If finasteride isn’t appropriate, they can help you explore other treatment options — for example, topical minoxidil. You might also benefit from reading about our science-backed tips for hair regrowth.
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Final Thoughts on Topical Finasteride vs. Oral Finasteride
Finasteride is the active ingredient in Propecia® and works by reducing levels of DHT. This slows down male pattern hair loss. Both oral and topical finasteride are effective, they just use different delivery methods and come with different potential side effects.
Here’s what to keep in mind about topical vs. oral finasteride:
Topical finasteride may be a gentler alternative with fewer systemic side effects. The topical version has a lower risk of side effects, but it can potentially cause scalp irritation.
There is more research on oral finasteride. While promising research suggests topical finasteride is effective, oral finasteride has a longer track record of efficacy.
Convenience is also worth considering. Taking finasteride in tablet form can be easier than applying a topical treatment every day.
So is topical finasteride better than oral? That depends entirely on your preferences, medical history, and lifestyle.
Both oral and topical finasteride are prescription-only hair loss treatments, so accessing either one starts with speaking to an expert. If you’re ready to take that step, book an online hair loss consultation today to get expert medical advice from a registered clinician.
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your GP about the risks and benefits of any treatment.