If you’re a man of a certain age and you’ve noticed hair thinning, bald spots, or a receding hairline, you certainly aren’t alone.
More than 50% of all men over the age of 50 will be affected by male pattern baldness to some extent, according to the U.S. National Library of Medicine (NLM).
If you’ve experienced hair loss for some time, you’ve likely heard of a treatment called Finasteride.
The pill form of this medication is a men-only FDA-approved treatment for hair loss. And now, more and more telehealth brands, like Hims, Keeps, and Roman, are selling topical Finasteride products.
Many of the formulas are mixed with Minoxidil, a synthetic drug said to promote hair growth, and sold via telehealth marketplaces.
They claim to support hair health, stimulate regrowth, and tackle hair thinning when applied to the scalp.
What online companies are claiming about topical Finasteride
According to Hims, a men’s wellness marketplace, their topical Finasteride and Minoxidil spray targets receding hairlines and bald spots by combining “two clinically proven ingredients into a single, no-mess spray — no pills required.”
Men’s telehealth company Roman makes similar claims about its topical Finasteride treatment, stating that with consistent daily treatment, hair loss should have considerably slowed or even stopped completely within six months.
So, how do topical treatments like this work and are they really an effective solution for hair loss?
The difference between oral and topical Finasteride
“Traditionally, Finasteride was taken in oral form, but now it is also used topically in liquid form and applied directly to the scalp,” explains Dr. Furqan Raja, a leading expert hair transplant surgeon at The Private Clinic.
He believes products like these are more accessible for hair loss patients who don’t like taking oral medication. Topical formulations of finasteride may also be a good choice for men who want to avoid some of the side effects associated with the tablet form.
“In a small percentage of patients, oral Finasteride can cause side effects, such as erectile dysfunction,” points out Zoë Passam, consultant trichologist at Philip Kingsley.
For hair loss, Finasteride works by counteracting the effects of DHT, which is a broken-down form of testosterone that plays a major role in hair loss. Too much DHT can cause hair follicles to shrink and ultimately fall out.
“Finasteride can also stimulate regrowth in areas of thinning, and I’ve certainly seen this in my own patient cohort,” says Raja.
As for the benefits of mixing Finasteride with Minoxidil?
“Minoxidil is a medically-approved topical treatment for male pattern hair loss. It dilates the blood vessels, which can aid in the delivery into the scalp of other ingredients applied at the same time,” Passam explains.
In other words, Minoxidil may improve the effectiveness of Finasteride by allowing it to penetrate more deeply.
The effectiveness of topical finasteride
How would both experts rate the effectiveness of topical Finasteride?
“We know that Finasteride has been shown to be clinically effective in 90% of men with male pattern baldness, and approximately two-thirds of men who take Finasteride regularly go on to experience regrowth,” Raja notes.
He says Finasteride is his first-line nonsurgical treatment for patients experiencing hair loss or thinning. If they’re having a hair transplant, he says it can help maintain the existing native hair, which can provide a longer-lasting result.
Or, if they are experiencing early stages of hair loss, he says Finasteride can slow that process down significantly.
However, Raja says it’s premature to comment on whether the topical solution is as effective as the tablet form.
“The topical solution is a relatively novel application, and hence we do not have data as strong as the kind we have for the tablet, which has been available for decades,” he notes.
One study published in the International Journal Of Clinical Pharmacology and Therapeutics in 2014 found that men who applied 1ml of topical finasteride solution to their scalps once a week showed similar results to men who took 1mg of oral finasteride for seven days.
In the study of 24 men with androgenetic alopecia, scalp DHT was reduced by 68 to 75% with topical Finasteride treatment and 62 to 72% with oral Finasteride.
That’s certainly promising.
However, Passam says the stage at which patients are starting treatment is an important factor.
“If the hair loss is very long-standing, there are less likely to be a significant number of viable hair follicles from which new hair can grow,” she points out.
For this reason, topical Finasteride will work best if you start treatment early. While results will likely vary from person to person.
Nevertheless, Passam is hopeful about the effectiveness of these solutions.
“While topical Finasteride does not reduce blood DHT levels as much as the oral form, the benefits to the hair seem to be equal, but with a reduced chance of side effects,” she says.
“Topical Finasteride may help to increase hair density and slow further hair loss by reducing the amount of DHT locally at the hair follicle, which in turn may help to slow the follicle shrinkage that underlies this type of hair thinning,” she notes.
Side effects of topical Finasteride
With most treatments – topical or otherwise – there are side effects to consider. Topical Finasteride is no different.
While Passam says there may be fewer side effects with topical Finasteride compared to the oral form, there are still some risks to consider.
“Males with a female partner who is pregnant or may become pregnant should not use topical Finasteride, as if a pregnant woman comes into contact with this, it can cause abnormal genital development in a male fetus,” Passam warns.
There’s also a risk of itchiness, irritation, and dandruff.
Raja says it’s important to liaise carefully with an experienced surgeon when using non-medical treatment to ensure that it is effective and any side effects are managed accordingly.
So, if you’re considering topical finasteride as a treatment for hair loss, what should you look for?
There are different percentages available, but typically most will be between 0.1 and 0.25%.
If you do choose to use topical Finasteride products, it’s a good idea to manage your expectations.
“As with all treatments for hair loss, it can take up to six months to see a noticeable improvement, and all types of treatment for male pattern hair loss must be used continuously to maintain their effects,” Passam points out.
