Topical Vs Oral Finasteride - Which is Better For Hair Loss?

The Difference Between Topical and Oral Finasteride

While both forms of Finasteride contain the same active ingredient and work towards reducing DHT levels, several differences exist between them.

Application Method

Oral Finasteride is taken as a 1mg tablet daily, providing a straightforward regimen. In contrast, topical Finasteride is administered as a solution or spray that is applied to the affected areas of the scalp, usually twice daily. This method allows for direct treatment of the scalp, potentially increasing the concentration of the drug at the site of action.

Side Effects

One of the significant differences lies in their side effect profiles. Oral Finasteride is associated with systemic side effects in about 1% of patients, as it lowers DHT levels throughout the entire body. These are more typically seen in patients with already low levels of testosterone, and are rare. These can include:

Erectile dysfunction

Decreased libido

Ejaculation disorders

Testicular discomfort

Skin rashes

In contrast, topical Finasteride is less likely to produce systemic side effects. Instead, patients may experience localized issues such as:

Itchy or burning scalp

Skin irritation

Contact dermatitis

Licensing and Clinical Evidence

Oral Finasteride is a licensed medication in the UK, having received approval from the Medicines and Healthcare Products Regulatory Agency (MHRA). It has undergone extensive research and clinical trials, establishing its safety and efficacy for treating AGA. Conversely, topical Finasteride is not yet licensed and lacks the same level of rigorous study. Although recent studies suggest that topical Finasteride can effectively reduce hair loss and promote regrowth, the evidence is still emerging.

Efficacy of Topical vs Oral Finasteride

The effectiveness of Finasteride, whether oral or topical, has been documented in various clinical studies.

Oral Finasteride

Clinical evidence suggests that oral Finasteride can halt hair loss in approximately 90% of men, with significant hair regrowth observed in about 60-66% of patients. It works effectively on both the crown and frontal areas of the scalp, making it a widely recommended treatment option among healthcare professionals. The cumulative results over time indicate that patients can expect to see noticeable improvements after three to six months of consistent use.

Topical Finasteride

While topical Finasteride has been used less frequently, recent studies are shedding light on its efficacy. Research indicates that topical applications can reduce scalp DHT levels by up to 70% and significantly increase hair count and density. In some clinical trials, patients using topical Finasteride alone or in combination with other treatments like Minoxidil exhibited promising results comparable to those using oral Finasteride.

For instance, a study involving a direct comparison between oral and topical Finasteride showed no significant differences in terms of hair count or regrowth effectiveness. This indicates that topical Finasteride can be a valid alternative for patients seeking localized treatment while minimizing systemic exposure.

How to Use Finasteride Effectively

Oral Finasteride

Taking oral Finasteride is straightforward: a single tablet of 1mg should be consumed daily. It’s advisable to maintain a consistent schedule, as regular use enhances the drug's effectiveness. While many patients notice improvements within three months, some may take longer to see visible results.

Topical Finasteride

Applying topical Finasteride requires careful attention to ensure the medication effectively reaches the scalp. Patients should follow these general steps:

Preparation: Ensure your scalp is clean and dry before application.

Application: Hold the spray nozzle or dropper about 2-3 inches from the scalp. Part the hair to expose the areas of thinning or baldness.

Massaging: Apply the prescribed amount, using your fingertips to gently massage it into the scalp for better absorption.

Frequency: This should be done twice daily or as directed by a healthcare professional.

After application, it’s crucial to allow the solution to dry completely, especially before going to bed.

Can You Combine Oral and Topical Finasteride?

Combining oral and topical Finasteride is not typically recommended without medical supervision. Using both forms may lead to excessive levels of Finasteride in the body, increasing the risk of side effects. For most patients, selecting one method of treatment is sufficient, and consulting a doctor is essential if you are considering combining therapies.