Topical Finasteride

Topical finasteride is a relatively new liquid version of a medication called finasteride. Finasteride has been used for a long time as a tablet which is taken to treat a type of hair loss caused by male pattern baldness. Studies have shown topical finasteride to be just as effective as the tablet but with fewer and less severe side effects. If you’ve been considering starting hair loss treatment but have been concerned about side effects or taking a tablet, topical finasteride may be a more suitable treatment for you.

Topical finasteride is a liquid solution applied to the scalp daily to treat a type of hair loss known as male pattern baldness.

Finasteride treats hair loss by stopping your body from producing dihydrotestosterone (DHT). High levels of DHT often cause hair loss, so if your system has less DHT, this should result in reduced hair loss.

• Oral finasteride is taken in tablet form, whereas topical finasteride is a gel or lotion applied to the scalp.
• There are fewer side effects from using topical finasteride.
• Women cannot take oral finasteride, but they can use topical finasteride.
• Studies indicate that oral and topical finasteride are similar in how effective they are at preventing hair loss.
• The UK Medicines & Healthcare Regulatory Agency (MHRA) has not yet licensed topical finasteride for use in the UK because there is not enough medical evidence yet.

The sooner you notice hair loss and start treating it, the better the results you will see from treatment. Recognising the early signs of hair loss can help you to take appropriate steps to deal with it. Some common early signs of hair loss include:

• a receding hairline
• thinning hair
• increased hair shedding
• widening part
• slow hair growth

Always follow the instructions on how to use topical finasteride:

• apply to the scalp once a day
• only apply to the areas affected by the hair loss
• make sure it is evenly applied

If you stop using topical finasteride, hair loss is likely to continue, so it’s important to apply topical finasteride every day.

A 2019 review of medical studies found that topical finasteride was generally effective at treating hair loss with fewer side effects than finasteride tablets. However, doctors need more evidence to understand its effectiveness and side effects fully.

There have been far more extensive studies into the use of oral finasteride. One study found that oral finasteride led to a 48% improvement in hair loss in one year.

A 2014 study that compared topical finasteride treatment and oral finasteride treatment found that both treatments reduced scalp DHT by similar amounts: 68 to 75% reduction with topical finasteride and 62 to 72% with oral finasteride.

It can take up to four months of applying topical finasteride before you see hair growth and up to a year before you see a complete improvement.

One study in 2015 found that topical finasteride works best after an initial course of oral finasteride. A 2019 systematic review of studies into topical finasteride stated that the evidence was limited but showed that topical finasteride was a “safe and promising” way to treat hair loss.

Evidence currently indicates that topical finasteride causes fewer side effects than taking finasteride tablets. However, it is essential to remember that studies are still limited, and medication affects everyone differently, so you may still experience side effects.

Common side effects of topical finasteride include:

• itching
• burning
• irritation

These symptoms only affect the area where there is hair loss and have generally been found to be mild and to clear up relatively quickly.

One 2018 study found that taking topical finasteride caused levels of DHT to decrease in the body. While topical finasteride mainly works on the scalp, this study proved that it also impacts the rest of the body. As DHT plays an essential role in male sexual development, reducing its levels in the body can also affect:

• sex drive
• erectile dysfunction
• how you ejaculate
• tenderness in male breasts

These side effects are the same as those from oral finasteride, affecting around 1 in 100 men. The limited studies available indicate that these side effects from topical finasteride are generally less severe than when taking oral finasteride.

If you have the following symptoms, you may be experiencing an allergic reaction to the ingredients in topical finasteride. Seek medical attention immediately.

• difficulty breathing
• rash, hives or itching
• swelling of the lips, tongue, throat and face

Topical finasteride is suitable for both men and women.

You should not use topical finasteride if you:

• are allergic to any of the ingredients
• have bladder or liver problems
• are pregnant or breastfeeding

Finasteride can get into semen, so you should use a condom while having sex if your partner is pregnant.

As well as prescription medications, there are over the counter treatments available to prevent or stem further hair loss. These include:

• shampoos such as Alpecin
• vitamin supplements such as Nourkrin and Biotin

Alternative treatments for hair loss available on Superdrug Online Doctor include:

• finasteride tablets
• minoxidil foam

There are several other options for dealing with hair loss. Not all of these are available on the NHS.

• steroid injections or cream
• topical immunotherapy (applying chemicals to stimulate a reaction)
• ultraviolet light
• transplant of hair or artificial hair
• scalp reduction surgery
• tattoos resembling short hair

Can topical finasteride regrow hair?

Used consistently and as directed, topical finasteride can help hair growth when applied for a year.

Can I use topical finasteride if I have alopecia areata?

Finasteride does not work to treat alopecia areata because the condition is not caused by high DHT levels. Finasteride works for male pattern baldness by reducing DHT levels.

Can I take both topical and oral finasteride at the same time?

No – to avoid overdosing, you must stop taking the tablets if you start using topical finasteride.

What is the difference between topical finasteride and topical minoxidil?

Topical minoxidil is available without a prescription and has fewer known side effects than finasteride.

Minoxidil works to promote hair growth, whereas finasteride works to stop hair loss.