Finasteride vs. minoxidil
Two different mechanisms, two different treatment considerations — and why it isn't always either/or.
Comparison guide
Hair loss treatment
Finasteride
Target the hormonal pathway behind pattern hair loss.
Finasteride is a prescription oral treatment that acts on a hormonal pathway involved in male-pattern hair loss. A NORBU MD physician can evaluate your hair loss and discuss whether finasteride may be an appropriate part of your treatment plan.
$29 physician visit · 100% online · Board-certified physicians · Personalized care
Medication cost is separate from the physician visit and is discussed before you decide to proceed.
Finasteride at a glance
- Treatment
- Finasteride
- Primary use on this page
- Male-pattern hair loss
- Form
- Oral
- Prescription status
- Prescription required
- Primary pathway
- DHT / 5-alpha-reductase
- Treatment timeline
- Requires consistency and time to evaluate response.
- Results
- Individual response varies.
No dose, strength or frequency is published here. Any treatment plan, including whether finasteride is appropriate, is determined by a board-certified physician who has evaluated you.
The basics
What is finasteride?
A prescription oral medication
Finasteride is a prescription medication taken by mouth. It is used, among other indications, in the treatment of certain forms of male-pattern hair loss.
It acts on a hormonal pathway
Finasteride works by inhibiting an enzyme called 5-alpha-reductase, which is involved in converting testosterone into dihydrotestosterone (DHT). DHT is a hormone linked to the miniaturization of hair follicles in male-pattern hair loss.
Prescription-only, and physician-decided
Finasteride requires a prescription. Whether it is appropriate for you is a decision made by your physician after reviewing your health history, current medications and goals — not something determined by an online questionnaire alone.
It is not a cure
Finasteride does not cure hair loss and does not reverse hair loss that has already fully progressed to baldness in a given area. It is used to address an ongoing hormonal process.
It does not work for everyone
Individual response varies. Some people notice little or no change, and hair loss can have causes finasteride does not address.
It is not permanent
Benefits associated with finasteride generally depend on continued treatment. Stopping treatment usually means the underlying hormonal process is no longer being addressed.
Important precaution
Finasteride is not for use by women who are or may become pregnant.
Finasteride carries specific handling and use precautions related to pregnancy. Women who are or may become pregnant should not use finasteride and should avoid handling crushed or broken finasteride tablets, because of potential effects on a male fetus.
This is a well-established precaution, not a general statement about who can seek care. If you have any questions about pregnancy, fertility plans or exposure risk, raise them directly with your physician before starting or continuing treatment.
Final safety language for the specific product you are prescribed comes from its current FDA-approved prescribing information. Review it, and discuss it with your physician.
How it works
Addressing the DHT pathway.
01
Testosterone converts to DHT
An enzyme called 5-alpha-reductase converts testosterone into dihydrotestosterone (DHT) in various tissues, including the scalp.
02
DHT affects sensitive follicles
In people genetically predisposed to pattern hair loss, DHT is understood to contribute to the progressive miniaturization of certain scalp hair follicles over time.
03
Finasteride inhibits the enzyme
By inhibiting 5-alpha-reductase, finasteride reduces the conversion of testosterone to DHT, which is the pathway thought to underlie its effect on pattern hair loss.
Finasteride addresses a hormonal pathway. Minoxidil supports hair growth through a different mechanism at the follicle. These are different treatment considerations, and one does not substitute for the other.
- 01
Testosterone
- 02
5-alpha-reductase
- 03
DHT
- 04
Follicle miniaturization
Compare hair treatments
Finasteride or minoxidil?
Finasteride
- Primary pathway
- DHT / 5-alpha-reductase
- General role
- Addresses a major hormonal pathway involved in male-pattern hair loss.
- Prescription
- Required.
Minoxidil
- Primary pathway
- Different from DHT suppression
- General role
- Supports hair growth through a different mechanism.
- Prescription
- Depends on formulation; oral minoxidil requires a prescription.
This isn't always an either/or decision. Because the medications work differently, a physician may consider different treatment approaches based on the individual patient.
Is it right for you?
Finasteride isn't appropriate for everyone.
Whether finasteride may be appropriate depends on your pattern of hair loss, sex, medical history and other clinical factors. A physician reviews these before any prescribing decision.
What a physician may consider
- Pattern and duration of hair loss
- Sex and reproductive plans
- Medical history
- Liver health
- Current medications and supplements
- Previous hair-loss treatments and response
What else gets reviewed
- Whether you are, or may become, pregnant, or could be exposed to crushed or broken tablets while pregnant
- History of mood changes, depression or sexual side effects with prior medications
- Family and personal medical history relevant to hormonal treatment
- Your tolerance for potential side effects and your treatment preferences
- Whether evaluation beyond an online visit is appropriate
Expectations
Hair doesn't change overnight.
- 01
Start
Treatment begins only after a physician has evaluated your hair loss and determined finasteride may be appropriate for you.
- 02
Consistent treatment
Benefits associated with finasteride depend on continued, consistent use exactly as directed. Missed or inconsistent use makes response difficult to evaluate.
- 03
Hair cycles progress
Because hair grows in cycles, changes are assessed over months rather than weeks. There is no guaranteed milestone at a particular week or month.
- 04
Reassess response
Your physician reviews how treatment is going, discusses any side effects, and can adjust the plan when clinically appropriate.
Individual results and timelines vary. No specific outcome is promised, and no visible result is guaranteed by any particular point in treatment.
Long-term treatment
Finasteride treatment usually requires consistency.
Treatment-related benefits from finasteride generally depend on continued treatment. If treatment is discontinued, the underlying hormonal process it was addressing is no longer being treated, and hair-loss progression may continue.
This is a property of how the treatment works — it is not dependence, addiction or withdrawal. It simply means hair-loss care with finasteride is usually ongoing rather than a one-time course.
If you're considering stopping, talk with your physician first so you understand what to expect and whether another approach makes sense.
Prescription treatment
What should I know about finasteride?
Finasteride is a prescription medication with known risks, warnings and contraindications. Review the current FDA-approved prescribing information for the specific product prescribed to you and discuss your full medical history with your physician.
Reported considerations with finasteride
- Decreased libido
- Erectile difficulties
- Changes in ejaculation or ejaculate volume
- Breast tenderness or enlargement
- Mood changes
- Skin rash
Finasteride is not for use by women who are or may become pregnant, including through handling crushed or broken tablets, because of potential effects on a male fetus. Finasteride can also affect PSA (prostate-specific antigen) test results, which is relevant if you undergo prostate-cancer screening — tell any clinician ordering that test that you take finasteride. Tell your physician about all medications, supplements and health conditions, including liver conditions, before starting finasteride. Contact your physician promptly if you experience breast changes, mood changes or other concerning symptoms during treatment.
Important Safety Information
Every prescription medication has risks, warnings, contraindications and possible interactions. Review the full prescribing information for any product prescribed to you, and tell your NORBU MD physician about all medications, supplements and health conditions before starting or changing treatment. Seek medical care promptly for any symptom that concerns you.
Reported side effects
Some patients report sexual side effects with finasteride.
Sexual side effects — including decreased libido, erectile difficulties and changes in ejaculation — have been reported by some patients taking finasteride. This is discussed openly here because minimizing it would not be honest or useful to you.
Reports vary in frequency, severity and whether they resolve after stopping treatment; the evidence on persistence after discontinuation is an active area of clinical and scientific discussion. This is exactly the kind of consideration to weigh with your physician before starting treatment, and to report promptly if it occurs.
Mood changes, including reports of depression, have also been described by some patients. Tell your physician about any new or worsening mood symptoms during treatment.
Talk about it before you start
Ask your physician what is currently known and unknown about these effects so you can make an informed decision.
Report it if it happens
Don't assume side effects are something to push through silently. Tell your physician so your plan can be reevaluated.
It doesn't affect everyone
Many patients do not experience these effects. Individual response varies, and no outcome — positive or negative — is guaranteed.
Sources & medical references
- Drugs@FDA: FDA-Approved Drug Products (prescribing information) — U.S. Food and Drug Administration
- Understanding Unapproved Use of Approved Drugs 'Off Label' — U.S. Food and Drug Administration
- Hair Loss (Alopecia) — Health Topics — National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIH)
- Minoxidil — peer-reviewed dermatology literature index — National Library of Medicine (PubMed)
- MedlinePlus Drug Information: Minoxidil — National Library of Medicine (MedlinePlus)
The NORBU standard
Hair treatment should start with the right question.
Not “Which hair product should I buy?” But: “Why am I losing hair, and which treatment approach makes sense for me?”
- Real physicians
- Every plan starts with a board-certified physician reviewing your history — not a checkout page.
- Personalized options
- Finasteride, minoxidil, a different approach or further evaluation — the approach follows the patient, not the product.
- Ongoing care
- Hair care is long-term. Your physician can review how treatment is going and adjust when clinically appropriate.
Start with a physician
$29Physician visit
Is finasteride right for you? Let's find out together.
For $29, meet online with a licensed NORBU MD physician to discuss your hair loss, health history and available treatment options.
$29 physician visit
Start my $29 visit →The $29 fee covers the physician visit. Medication, laboratory testing or other services, if applicable, are separate. Prescription treatment is provided only when a board-certified physician determines it is clinically appropriate.
Questions
Finasteride, answered.
What is finasteride?
Finasteride is a prescription oral medication used, among other indications, in the treatment of certain forms of male-pattern hair loss.
How does finasteride work?
Finasteride inhibits an enzyme called 5-alpha-reductase, which converts testosterone into dihydrotestosterone (DHT). DHT is linked to the miniaturization of hair follicles in male-pattern hair loss.
Is finasteride prescription-only?
Yes. Finasteride requires a prescription from a licensed physician.
Who should not take finasteride?
Finasteride is not for use by women who are or may become pregnant, including exposure through handling crushed or broken tablets, because of potential effects on a male fetus. Whether finasteride is appropriate for anyone else is a decision made by a physician based on medical history.
How long does finasteride take to work?
Hair grows in cycles, so response is evaluated over months rather than weeks. No specific timeline is guaranteed, and results vary from person to person.
Does finasteride have sexual side effects?
Some patients report sexual side effects, including decreased libido, erectile difficulties and changes in ejaculation. These effects do not occur in everyone, and reports vary in frequency and severity. Discuss this with your physician before starting treatment and report any side effects promptly.
Can finasteride affect mood?
Mood changes, including reports of depression, have been described by some patients taking finasteride. Tell your physician about any new or worsening mood symptoms during treatment.
What happens if I stop taking finasteride?
Treatment-related benefits generally depend on continued treatment. If you stop, the underlying hormonal process finasteride was addressing is no longer being treated, and hair-loss progression may continue. This is not dependence or withdrawal.
Does finasteride affect PSA test results?
Finasteride can affect PSA (prostate-specific antigen) levels used in prostate-cancer screening. Tell any clinician ordering that test that you take finasteride.
What's the difference between finasteride and minoxidil?
Finasteride targets the conversion of testosterone to DHT through 5-alpha-reductase inhibition. Minoxidil supports hair growth through a different mechanism at the follicle. They are different treatment considerations, and the appropriate approach depends on the individual patient.
Can finasteride and minoxidil be used together?
Because they work differently, clinicians may consider them together for certain appropriate patients. Whether a combination is right for you is a clinical decision made by your physician.
How much does the NORBU MD physician visit cost?
The physician visit is $29. It's paid directly and does not require insurance.
Does the $29 include medication?
No. The $29 fee covers the physician visit. Medication, pharmacy and laboratory costs, if applicable, are separate.
Learn more about finasteride and hair loss
View all articles →What does DHT have to do with hair loss?
The hormonal pathway finasteride addresses, explained plainly.
How it works
What should I know before starting finasteride?
Candidacy, precautions and what a physician reviews before prescribing.
Before you start
Finasteride side effects, honestly explained
Sexual side effects, mood changes and what to report to your physician.
Safety
Don't just pick a hair treatment. Find the right approach.
Meet online with a NORBU MD physician and discuss whether finasteride or another hair-loss treatment option may be appropriate for you.