Daily Health

Finasteride vs. Minoxidil

Hair loss isn’t a serious medical condition (most of the time), but it can feel serious when it’s happening to you. You don’t know what you have until it’s gone — and when you lose your hair, you realize how much of your confidence goes down the drain at the same rate. 

In Canada, 30% of cisgender men experience male pattern baldness by age 30, and 50% of them will experience it by the time they’re 50. Most of the time, it’s caused by factors we can’t control, like genetics and hormone changes.  

But hair loss treatments have come a long way since the 80s’ era of bad toupees. Most notably, finasteride (Propecia) and minoxidil (Rogaine) are two treatments that can be used at the same time to treat hair loss. Keep reading to find out how.

Want to understand more about your hair loss before you seek treatment? Check out our Hair Loss 101 resource.

What is finasteride?

Finasteride is the generic version of Propecia, one of the most popular and effective medications for the treatment of hair loss. People take it as a pill once per day.

Finasteride is a 5-alpha-reductase inhibitor, which prevents testosterone from turning into dihydrotestosterone (DHT) — the compound responsible for shrinking your hair follicles and stopping hair growth.

Read more about how to get the best results with finasteride.

What is minoxidil?

Minoxidil, otherwise known as Rogaine, is a topical foam or solution applied to the scalp twice per day. 

Minoxidil acts as a vasodilator, which increases blood flow to your hair follicles by widening the blood vessels. More blood flow means more oxygen and nutrients, and for some people that can mean more hair growth — or at least preventing further hair loss.

Three key differences between finasteride vs. minoxidil

Finasteride and minoxidil can be used together for the most effective treatment strategy against hair loss, but it’s important to understand some key differences before you do. 

1. Finasteride can stop hair loss. Minoxidil promotes hair growth.

Finasteride stops hair loss by blocking DHT. Minoxidil promotes hair growth by improving blood flow to your hair follicles. 

While some people can see hair regrowth with finasteride, it takes a long time. One study showed hair growth improvements in 48% of study participants after one year of taking finasteride, and 66% of people saw improvements after two years (compared to 7% of placebo recipients). 

Finasteride really shines when it comes to preventing more hair loss. One study found that 83% of people who took finasteride didn’t see any more hair loss after two years. 

Minoxidil, on the other hand, doesn’t stop hair loss like finasteride — instead it promotes growth of new hair. In a one-year observational study, 48% of people said minoxidil was effective for hair regrowth. 

2. Finasteride may be easier than minoxidil to work into your routine.

Finasteride is a pill you take once per day. Minoxidil comes in two forms: a foam or a dropper solution you apply to your scalp twice per day.

It’s easier to take a pill than apply a solution to your scalp.

3. Minoxidil is available over the counter. You need a prescription for finasteride.

In Canada, you can get minoxidil over the counter in concentrations of 5% or lower. 

Finasteride, on the other hand, requires a prescription from a healthcare practitioner.

What are the side effects of finasteride vs. minoxidil?

Both minoxidil and finasteride are well-tolerated, but they each come with their own possible side effects you should know about.

Minoxidil side effects

Skin irritation and rashes at or near the application site are the most common side effects of minoxidil. When you use the solution, you may feel a burning sensation — this is normal.

Less common side effects of minoxidil include:

  • Acne
  • Facial hair growth
  • Inflammation around the hair roots
  • Facial swelling
  • Increased hair loss – which is normal at first as the solution starts to work

Pay attention to the recommended dose when using minoxidil. You can use too much, which may cause more serious side effects:

  • Dizziness and feeling light-headed
  • Fainting
  • Irregular heartbeat
  • Chest pain
  • Headaches
  • Flushing
  • Blurred vision
  • Numbness and/or swelling of the face, hands, and feet
  • Rapid weight gain

If you see any of these side effects, reduce your dose immediately and consult a healthcare practitioner. 

Finasteride side effects

Did you know: High doses of finasteride are prescribed to shrink an enlarged prostate. When taken this way, high-grade cancers were more common in the finasteride group compared to placebo. 

But when you’re taking finasteride for hair loss, you’re unlikely to see this side effect because you’re taking the medication at a lower dose.

Other rare finasteride side effects include:

  • Depression and anxiety
  • Erectile dysfunction
  • Decreased sex drive
  • Rashes
  • Breast enlargement and tenderness

Most people who experience these side effects get used to the medication and don’t experience them after a few days or weeks.

If you see any of the following side effects on finasteride, see a healthcare practitioner immediately:

  • Suicidal ideation
  • Nipple discharge
  • Swelling of the lips, tongue, throat, or face
  • Lumps or pain in the chest area

Women who are pregnant or trying to conceive shouldn’t even touch finasteride — literally. The medication can pass through the skin and potentially cause birth defects in babies.

If you’re looking for hair loss treatment options in Canada, talk to a healthcare practitioner today.

Felix Team
Updated on:
February 19, 2023
Medically reviewed by
Dr. Sarah Lasuta
Family Physician, MD, CCFP

The views expressed here are those of the author and, as with the rest of the content on Health Guide, are not a substitute for professional medical advice, diagnosis, or treatment. If you have any medical questions or concerns, please talk to your healthcare practitioner.

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