Male pattern baldness is the most common type of hair loss in men. It is thought that over 50% of men over 50 years old have some degree of male pattern baldness. Genetics has a strong influence on male pattern baldness, but lifestyle factors can also have an effect. If you believe that you are starting to experience hair loss, finasteride or minoxidil may be effective treatment options for you. 

What is Finasteride?

Finasteride, also known as Propecia, is a medication used to treat male pattern hair loss. Finasteride is a type of drug known as a 5-alpha reductase inhibitor. Finasteride works by preventing testosterone from converting into a hormone called DHT (dihydrotestosterone). DHT is the hormone responsible for hair loss. 

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What is Minoxidil?

Minoxidil, also known as Rogaine, is another hair loss treatment. Unlike finasteride, it can also be used by some women experiencing hair loss. 

Hair grows from hair follicles. When hair loss occurs, some of these follicles may die and some may be lying dormant. Minoxidil works by stimulating these dormant follicles to grow more hair. 

How Long do They Take to Work?

Hair can take a long time to grow, therefore, it can take around 3-6 months before you notice any effect from finasteride. Hair regrowth should start to be noticeable after about 8 weeks of using minoxidil. 

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What are the Side Effects of Minoxidil and Finasteride?

The most common side effect of finasteride is sexual dysfunction. This can include a number of different symptoms such as a low sex drive, inability to achieve orgasm or erectile dysfunction. This is because finasteride has an effect on your hormone levels. These hormonal changes can also lead to the development of breast tissue in men, male infertility, or testicular pain. 

Other potential side effects of finasteride include skin reactions, swelling and depression. 

Side effects from minoxidil foams or lotions are unusual. In rare cases, people have experienced a decrease in blood pressure. 

What Forms are Available?

Finasteride is available in 1mg tablets to treat male pattern baldness. Minoxidil is a topical solution/spray or foam. A minoxidil tablet is available, but this is only used to reduce blood pressure, not to treat hair loss. 

How Effective is Minoxidil vs Finasteride?

The effectiveness of minoxidil and finasteride has been compared in a study of 65 men from 2004. The men were split into two groups: one was treated with finasteride and the other with minoxidil. After 12 months, finasteride had effectively treated male pattern baldness in 80% of the men, whereas minoxidil was effective in only 52%.  

The participants only experienced mild side effects. Only 4% of the men taking minoxidil experienced any side effects, but 17.5% of men experienced mild side effects when using finasteride. 

How Safe are Finasteride and Minoxidil?

Like all medications, both finasteride and minoxidil do carry a risk of side effects. As a topical treatment, minoxidil has fewer side effects than finasteride. 

Both finasteride and topical minoxidil are considered safe for use in male pattern baldness for most men. However, having certain medical conditions may increase your risk. 

Finasteride may not be suitable for you if you experience any obstructions when passing urine (obstructive uropathy). You should also be aware that finasteride can be found in your semen. Therefore, you should use a condom if your partner is pregnant or likely to become pregnant. 

Minoxidil must not be used by people who suffer from a tumour of the adrenal gland known as phaeochromocytoma. You should avoid using minoxidil on any areas of skin which are broken, inflamed, infected or shaven. Avoid any contact between minoxidil and your eyes or mouth. Avoid inhaling any mist from minoxidil spray. 

Finasteride must not be used by women. If you are using minoxidil as a woman, you should avoid using it during pregnancy as it may affect your baby.

Both finasteride and minoxidil can interact with other medications. Therefore, you should always let the prescribing doctor know about any other medication you are taking.  

Can You Take Finasteride with Minoxidil?

Finasteride and minoxidil can be used together. They work in different ways, so they should not interact with each other. 

Should You Take Finasteride or Minoxidil After a Hair Transplant?

Both finasteride and minoxidil can be used to improve your results following a hair transplant. To maximise hair growth, it is recommended that you use finasteride for four weeks preceding your hair transplant and for 48 weeks afterwards. Minoxidil can be used up to one week before surgery and you can start reusing it two weeks afterwards. 

Can Women Take Finasteride or Minoxidil?

As finasteride acts of testosterone, women cannot take it. However, women experiencing hair loss may be able to use minoxidil. You should not use minoxidil if you are pregnant. 

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Both finasteride and minoxidil are effective hair loss treatments for men. They can be used together to maximise the effects. Minoxidil can produce effects more quickly and finasteride has more associated side effects. However, finasteride is also thought to be the more effective of the two treatments. Exactly which medications you want to use is a personal decision. You can speak to your doctor for advice and try both finasteride and minoxidil to find out which works best for you. 

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