Note: Throughout this article (and my other hair loss articles), I use the terms “androgenetic alopecia,” “androgenic alopecia,” “hair loss,” and “male pattern baldness” interchangeably. They all mean the same thing. You’re going bald. You have a receding hairline or a thinning crown. A man’s worse nightmare, by any other name, is still a man’s worse nightmare.”
There are only two FDA-approved measures for treating the most common type of hair loss, Androgenetic Alopecia (male pattern baldness): Minoxidil (Rogaine) and Finasteride (Propecia).
Though I’ve written about other powerful remedies you can use and effective measures you can take to regrow hair (read about them here—>How to stop hair loss), these are the only medications that have produced enough evidence of efficacy in stopping or reversing hair loss to be approved by the Food and Drug Administration.
However, there are three big problems:
- Oral finasteride works by manipulating a man’s hormone profile. This sometimes has devastating, irreversible consequences and sexual side effects.
Oral finasteride, by itself, has a much better success rate than Minoxidil, but it comes it can often come at a steep price. You have to decide when evil is worse: androgenetic alopecia or not being able to get it up.
- Topical minoxidil and finasteride are excellent at stopping your hair from falling out, but they aren’t particularly great at hair regrowth. Part of this is just bad luck. Some men are “hard responders” who don’t have a potent reaction to either drug.
The other part of this issue is that after a certain amount of hair follicle miniaturization, there isn’t much that you can do to regrow the hair outside of getting an FUE hair transplant or using a low-level light therapy laser cap.
- This last one isn’t so much of a problem as it is a general annoyance. To be effective, Rogaine must be applied 2x per day. It also starts with a relatively intense shedding phase, where it seems like your rate of hair loss has accelerated.
Also, some guys complain that the Rogaine foam is greasy. I personally don’t have this complaint, but I’m a black dude who grew up putting Murray’s hair pomade in his hair.
However, there’s a new player in the game to combat hair loss that has produced much better results than finasteride or minoxidil on their own. It doesn’t have *any* of the common side effects that have been reported by those who use Propecia. It’s also a once-daily application instead of two.
I’m talking about Topical Finasteride+Minoxidil. This is one of the best options for treating androgenetic alopecia that you can find.
The rest of this article will talk about my experiences, show some pictures, and break down the science behind one of the most promising (and extremely affordable) effective treatments for hair loss.
First, let’s look at how finasteride and minoxidil work on their own.
How finasteride fights against androgenic alopecia (male pattern baldness)
Finasteride is a type of drug referred to as “5α-reductase inhibitors.” These drugs work by inhibiting 5α-reductase, the hormone responsible for converting about 10% of your testosterone to dihydrotestosterone. Drugs in this category are primarily used to treat benign prostatic hyperplasia by stopping the conversion of testosterone to DHT, as DHT is the main culprit behind the disease.
DHT can also bind to your hair shaft hair follicles and cause them to shrink. While these are obviously undesirable outcomes, DHT is a vital hormone for masculinity.
DHT contributes to male secondary sex characteristics such as:
- a deep voice
- body hair and muscle growth
- growth of the penis, scrotum, and testicles
- Male fat storage patterns
If we lower DHT blood levels with the oral administration of finasteride, we essentially erase a vital chemical component of what makes a man a man. Proof of this is what happens when you lower DHT levels. The potential side effects include:
- Loss of body hair
- Lower sperm count
- Decreased libido
- Erectile dysfunction
- Increased weight gain
Based on how the drug works, it should be no surprise that these are the common finasteride side effects. These adverse effects are why I’m against taking oral Propecia (1 mg finasteride) or Proscar (5 mg finasteride) to slow down hair loss.
I like a nice full of head of hair as much as the next guy, but I’m not willing to suffer through that sexual dysfunction hell to get my hair back. The cost of finasteride greatly exceeds its value.
How minoxidil works to attack androgenic alopecia
Topical minoxidil increases hair growth by stimulating hair follicle activity. It belongs to a class of drugs known as vasodilators. These drugs work by opening the blood vessels. In fact, minoxidil was originally developed to treat high blood pressure (source).
When it’s applied to the scalp, an enzyme called sulfotransferase converts minoxidil into minoxidil sulfate, the pro-drug’s active form. Lack of this enzyme sulfotransferase in certain people may actually hold the key to why some people don’t experience success using Minoxidil.
However, some people experience unwanted side effects such as itching, burning, redness, swelling, or irritation. minoxidil sulfate. It works by shortening the telogen, or resting phase of the hair, and causes the hair to enter the anagen or growing phase. There is also some evidence that minoxidil can increase the thickness of the hair (source).
The drug is generally well tolerated, though some people have complained of itching, burning, redness, swelling, or irritation.
Finasteride in a topical solution: The solution to oral finasteride
In the neverending hunt for ways to battle back male pattern baldness, scientists figured they may as well try applying finasteride in a gel or spray solution. Clinical studies show that topical finasteride (in gel and solution form) not only decreased the rate of hair loss but increased the total amount of hair present. In other words, it seems to regrow hair.
The best part about the topical finasteride solution is that it works locally as opposed to systematically. This means there are WAY fewer side effects compared to oral finasteride.
The topical formulation and application of finasteride have been shown to work just as well as—if not better—than taking an oral tablet of Finasteride. A clinical study comparing oral finasteride to topical finasteride in 24 men demonstrated the following: decreased DHT levels by 67-74% with daily application of topically applied finasteride (in the form of a gel, cream, or spray) for seven days and by 61-71% with oral version taken for the same time period (source).
As an added bonus, topical finasteride gel shows tenfold less systemic absorption than oral finasteride. This means that topical treatments of finasteride will result in way few systemic effects and reactions.
But it gets even better.
It turns out that topical finasteride works even better to halt or reverse androgenetic alopecia when it’s paired with topical minoxidil solutions.
Topical Finasteride Mixed with Minoxidil Is a Game Changer
Combining topical finasteride treatment with minoxidil is probably the most powerful agent we have to battle male pattern hair loss. I remember when I first got into dealing with my hair loss, I wished there was something like this.
Actually, I just wished for a topical application of finasteride since the key behind dealing with hair loss seems to manage hair loss seems to be reducing DHT via 5-alpha reductase inhibitors. But like I said before and thousands have echoed on forums, that comes with ridiculous sexual side effects.
So it works like this:
Minoxidil is a powerful vasodilator (it opens up veins and arteries to increase blood flood). Finasteride is one of the most 5-alpha reductase inhibitors and DHT blockers. The efficacy of finasteride as an oral medication, fine-mist spray, or gel is unquestioned. When the two are combined as a topical medication, incredible results occur.
Consider this study in which 40 men who were from androgenic alopecia were treated with a topical finasteride and minoxidil solution for 12 months. Hair count analysis was performed at baseline and every 3 months during the follow-up period. The average increase in hair count was 30%, while 10 of them showed an increase of >50% (source).
This combination of treatments has made a big difference in my life. Especially in post-fue maintenance. When I got my transplant, this hair loss treatment wasn’t available but if it was, perhaps I would have preserved my hair longer.
[Read about my FUE transplant here—>My experience getting an FUE hair transplant]
Either way, now I have a look to maintain (and hopefully enhance), and this 2-in-1 spray gives me the best of both worlds because it works by only affecting the scalp, without any system effects.
My experience with the combination topical mixture
First, it’s easy as hell. I wake up and spray. Then I spray again before I go to sleep.
Technically, you only have to do it once, but I have my old rogaine habits are still there. Plus, I figure an extra application couldn’t hurt. I’ve been doing it this way for over a year and I have yet to run out of combination topical solution before my next shipment arrives.
I’ve mentioned that I started using this after my hair transplant so I could maintain the hair that hasn’t fallen out yet and also, potentially, regrow hair and reactivate follicles that were thinning but weren’t replaced during my FUE. The FUE looks great in the first few months, but it will start to look bad if other hair that wasn’t transplanted starts to fall out.
That started to happen to me. If I let my hair grow out, I could see my hair thinning in areas where the donor hair follicles weren’t placed. After a few months of continuous treatment, my hair density and thickness have clearly increased.
Full transparency, I have an entire early hair loss prevention protocol that considers my diet and uses dermarolling. So, while I can’t say that the results are ONLY from the finasteride+minoxidil spray, it has played a big role in my hair regrowth journey.
Does the topical finasteride+topical minoxidil combination have any side effects?
I haven’t had any issues at all. And I even like to walk on the wild side and use it right after derma rolling. However, I’m only one guy, and so to be fair, we have to consider other people’s issues when using this.
Fortunately, there don’t seem to be many people who experience side effects and those who do are more annoyed than anything else.
According to the Food and Drug Administration, the most common side effects of topical finasteride are:
- Contact dermatitis
- Skin rash
The side effects are localized to the application site.
Most of these side effects are also caused because of one of the inactive ingredients in the combination topical solution, propylene glycol. These symptoms usually go away within several days. Other possible side effects include headache, nausea, and rash. Those are also short and hardly severe.
Generally speaking, topical finasteride & minoxidil spray is well tolerated and has a safety profile that’s nearly identical to the placebo.
Do minoxidil+topical finasteride formulations work for female pattern hair loss?
In theory, sure. Both minoxidil and finasteride have been shown to work as a treatment of hair loss for women (source), so there’s no reason to assume that when they’re combined, the effect would be any different. With that said, finasteride is known to have teratogenic effects on women.
I had to look up the word “teratogenic,” by the way.
To save you time, I’ll tell you since there’s a good chance you’ve never heard it before. Teratogens are substances that can cause physical or functional defects in developing fetuses. In other words, any woman reading this should DEFINITELY not use any product containing finasteride if they’re pregnant. That includes topical products.
Where to get your topical finasteride & minoxidil spray?
I can only speak to the place that I use. There are a few players in this space, but I can only talk about who I buy from. While I’d obviously love if you used my company and purchased through my link so I earn a commission, I’d be lying to you if I told you that I tried them all and they were the best.
I just know that the price is right, the service is tight, and I’ve had no complaints at all.
I get my mix from Forhims.com. Their mixture is 0.1% minoxidil and 6% topical finasteride. The 2-in-1 spray special costs me $120 for 3 bottles, which is supposed to last about 3 months if used once daily. I believe this is also the price of a subscription, which ships out every 3 months. Your credit card is automatically charged.
If you only buy one bottle at a time, it’s $50/month. I have no idea why you’d elect to do it this way since every study indicates that you need at least 2 months of treatment to see results, AND the results last only as long as you use it. This means that for one year, on the subscription model, you’d spend $480 compared to $600 if you bought them on a per-month basis.
The recommended application frequency is only once per day, but I have old habits from using Minoxidil. Plus, I was committed to maintaining my hair after my hair transplant, so I use it twice a day. Even still, I have a bit left over by the time my next shipment arrives. However, the bottle does come with a “use by” date, which seems like a good idea to follow. Either way, this is a fantastic deal.
Because finasteride is still a prescription medication, you’ll have to go through a quick interview with their doctor. I know some guys worry when they see they need a prescription, but it’s fine. For whatever reason, I never could ask my medical provider in person for a prescription to treat my hair loss, but it’s much easier to do this over the internet.
Forhims.com takes care of all of that for you. Also, in case you’re embarrassed about seeking help to spark your hair growth, your topical combination is delivered in discrete packaging.
Final verdict on topical minoxidil fortified with finasteride
This is a fantastic product. Once you make it a habit to use, you should see good results. This is especially important if you spent the money on an FUE hair transplant. Then you may as well maintain what you have.
If you’re just starting to lose your hair, this—along with other strategies—will make a huge difference in the amount of hair you’re able to keep on your head. It’s so cheap too.
Definitely pick up a bottle.