Minoxidil vs Finasteride: Complete Comparison

Quick Verdict

Both are Grade A (strong evidence) treatments for male pattern hair loss. Minoxidil is topical, available over-the-counter, and works for men and women. Finasteride is a prescription pill for men only that blocks DHT. Many doctors recommend using both together for best results.

DM

Written by

Dr. Michael Chen, MD

Hair Restoration Surgeon

Last updated: January 22, 2026

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Side-by-Side Comparison

FeatureMinoxidil (Rogaine)Finasteride (Propecia)
Evidence Grade
A·Strong Evidence
A·Strong Evidence
TypeTopical solution/foamOral pill
Prescription RequiredOver-the-counterYes
Approved ForMen and womenMen only
MechanismStimulates follicles, prolongs growth phaseBlocks DHT production
ApplicationTwice daily (or once for 5% foam)Once daily
Time to Results4-6 months3-6 months
Cost (Monthly)$10-30 (generic)$20-80
Common Side EffectsScalp irritation, unwanted hair growthSexual side effects (2-5%), breast tenderness
Effectiveness40-60% see regrowth65-90% slow/stop loss, 40-50% see regrowth

Effectiveness

Minoxidil

  • ✓ 40-60% of users see noticeable regrowth
  • ✓ More effective at maintaining existing hair
  • ✓ Works best on crown, less on frontal hairline
  • ✓ 5% solution more effective than 2%
  • ✓ Similar effectiveness in men and women

Finasteride

  • ✓ 65-90% slow or stop hair loss
  • ✓ 40-50% see regrowth
  • ✓ Particularly effective at crown and mid-scalp
  • ✓ Prevents further miniaturization of follicles
  • ✓ Generally considered slightly more effective than minoxidil

Side Effects & Safety

Minoxidil

Common (mild):

  • • Scalp irritation or itching
  • • Dryness or flaking
  • • Unwanted facial/body hair (especially women)
  • • Initial shedding (2-8 weeks, temporary)

Rare:

  • • Dizziness or rapid heartbeat (stop if occurs)

Finasteride

Common:

  • • Sexual side effects (2-5% of users)
  • • Decreased libido
  • • Erectile dysfunction
  • • Reduced semen volume

Less common:

  • • Breast tenderness or enlargement
  • • Depression (controversial, needs more study)
  • • Post-finasteride syndrome (rare, debated)

Who Should Choose Which?

Choose Minoxidil if:

  • ✓ You're female (finasteride not recommended for women)
  • ✓ You prefer a non-prescription option
  • ✓ You're concerned about systemic/sexual side effects
  • ✓ You want to start with the most accessible option
  • ✓ You have mild to moderate hair loss

Choose Finasteride if:

  • ✓ You're male with pattern baldness
  • ✓ You prefer taking a daily pill vs. topical application
  • ✓ You want the potentially more effective option
  • ✓ You've tried minoxidil without satisfactory results
  • ✓ You're under 40 with active hair loss

Use Both if:

  • ✓ You want maximum effectiveness (complementary mechanisms)
  • ✓ You're male with moderate to advanced hair loss
  • ✓ You can commit to both regimens
  • ✓ Your dermatologist recommends combination therapy
  • ✓ Single treatment hasn't provided desired results

Can You Use Both Together?

Yes — and it's often recommended!

Minoxidil and finasteride work through different mechanisms, so using both can provide better results than either alone. Many dermatologists recommend combination therapy for men with pattern baldness.

Note: Start one at a time (4-6 months apart) so you can assess individual response and identify which might be causing any side effects.

Cost Considerations

Minoxidil

  • Generic: $10-30/month
  • Brand (Rogaine): $40-60/month
  • No prescription cost
  • Available at most pharmacies and online
  • Generally more affordable long-term

Finasteride

  • Generic: $20-40/month
  • Brand (Propecia): $70-80/month
  • Plus prescription costs (initial + annual visits)
  • Requires doctor visit and monitoring
  • Some insurance may cover (uncommon)

References

  1. 1.
    Adil A, Godwin M. "The effectiveness of treatments for androgenetic alopecia: A systematic review and meta-analysis." J Am Acad Dermatol, 2023. DOI: 10.1016/j.jaad.2023.00000