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
View author profileSide-by-Side Comparison
| Feature | Minoxidil (Rogaine) | Finasteride (Propecia) |
|---|---|---|
| Evidence Grade | A·Strong Evidence | A·Strong Evidence |
| Type | Topical solution/foam | Oral pill |
| Prescription Required | Over-the-counter | Yes |
| Approved For | Men and women | Men only |
| Mechanism | Stimulates follicles, prolongs growth phase | Blocks DHT production |
| Application | Twice daily (or once for 5% foam) | Once daily |
| Time to Results | 4-6 months | 3-6 months |
| Cost (Monthly) | $10-30 (generic) | $20-80 |
| Common Side Effects | Scalp irritation, unwanted hair growth | Sexual side effects (2-5%), breast tenderness |
| Effectiveness | 40-60% see regrowth | 65-90% 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)
Ready to make a decision?
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