Oral vs Topical Finasteride: Which is Better for Hair Loss Treatment?
Male Pattern Baldness, or Androgenetic Alopecia, is the most common type of hair loss.
It affects 30-50% of men by the age of 50.
Finasteride has been widely used to treat Male Pattern Baldness since 1997.
It is available in two formulations- tablets and solution/spray.
But, how to know which one to choose between oral vs topical Finasteride?
Read along to find out.
| Basis | Oral Finasteride | Topical Finasteride |
|---|---|---|
| FDA status | FDA-approved for treating Androgenetic Alopecia | Not approved by FDA |
| Side effects | Systemic absorption is higher, hence comparatively more visible side effects. | Lower systemic absorption, hence relatively lesser side effects |
| Safety for women | Should not be used by women | Studies suggest it to be a considerable alternative. But more research is required |
| DHT inhibition | Reduces DHT more effectively than topical medication | Localized treatment, hence does not reduce DHT as effectively |
Oral Finasteride
Oral Finasteride is a prescription medication to treat Male Pattern Baldness and Benign Prostatic Hyperplasia (BPH).
It is FDA-approved to treat both conditions.
Oral tablets are often paired with other medications to maximize hair growth.
A research from 2015 revealed that 84.44% of the participants who used a combination of oral Finasteride with topical Minoxidil maintained hair density throughout the trials.
Studies have shown that less than 4% of people consuming oral Finasteride experience mild side effects.
These side effects stop when the medication is discontinued.
Topical Finasteride
Topical Finasteride comes as a solution and sprays to provide localized treatment for hair loss.
It is not FDA-approved and must be used only when your doctor prescribes it.
Topical Finasteride works the same way as oral pills but with considerably low systemic absorption.
A review published in 2018 found a significant decrease in the rate of hair loss and an increase in the total hair count on using topical Finasteride.
Another review from 2020 had similar findings, but that suggested more research is needed.
How does Finasteride work
Finasteride belongs to a class of medicine called 5-alpha reductase inhibitors.
It works by inhibiting or stopping the functioning of the enzyme called 5-alpha reductase.
The function of this enzyme is to convert Testosterone into Dihydrotestosterone (DHT).
DHT is an androgen or male sex hormone.
At puberty, DHT is responsible for the development of male secondary sex characteristics, including facial and body hair.
In adults, however, DHT can bind to the receptors in the scalp and lead to the gradual miniaturization of hair follicles.
This process makes the hair follicles incapable of producing healthy hair.
Side effects
Even though oral Finasteride works well, it does have some side effects.
The most commonly observed side effects include:
- Chills
- Confusion
- Cold sweats
- Dizziness or lightheadedness upon getting up suddenly
- Decreased sex drive
- Problem in getting and maintaining an erection
- Skin rash, including red, itchy, swollen skin
- Wheezing
- Tightness in the chest or throat
- Trouble breathing or talking
- Swelling in the mouth, face, lips, tongue, or throat
See a doctor immediately if you experience one or more of these symptoms after taking the medication.
Though topical Finasteride reduces the risk of systemic side effects, they are localized to the application site.
These include:
- Scalp pruritus
- Burning sensation
- Irritation
- Contact dermatitis
- Erythema
How to take/use Finasteride
The number of doses each day, the duration of the treatment, the strength of the medication, etc., will be determined by your doctor.
Some general guidelines to follow while on Finasteride therapy are mentioned below.
For oral Finasteride tablets:
- Swallow the pill as a whole and do not chew, crush or break it
- You can take it before or after your meal
- It is advisable to take it at a fixed time to avoid missing a dose
For topical Finasteride sprays:
- Hold the spray bottle 2-3 inches away from the scalp
- Part the hair slightly and spray the prescribed number of sprays
- Divide these sprays between the crown, top, and both sides in the front, where the hairline typically recedes
- Once sprayed, massage the solution into the scalp and let it rest
- Wash your hands afterward
For topical Finasteride solution, drop the prescribed amount into the areas mentioned above. Massage and proceed similarly.
Takeaway
Finasteride is used in the treatment of Male Pattern Baldness and BPH.
For men with hair loss, Finasteride will not only reduce hair fall but also increase the number of scalp hair.
It, however, does not increase the amount of body hair.
The side effects of the topical form of Finasteride are less severe as compared to oral pills.
However, only oral Finasteride is FDA-approved, giving it an edge over the topical version.
Frequently Asked Questions
Can oral Finasteride be used by women for hair loss treatment?
No, oral Finasteride is not FDA-approved for use in women for hair loss treatment. The risk of birth defects in male fetuses persists if a pregnant woman is exposed to the drug. Women of childbearing age should not handle crushed or broken tablets of oral Finasteride.
Is oral Finasteride better than topical?
There isn’t a definitive answer to whether oral Finasteride is better than topical Finasteride. Both have their own advantages and disadvantages. Oral Finasteride is FDA- approved and more effective at reducing DHT levels systemically. Topical Finasteride has a lower potential for systemic side effects.
How much safer is topical Finasteride?
Since topical Finasteride is primarily absorbed locally in the scalp, it has a lower risk of systemic side effects than oral Finasteride. However, it still carries a risk of localized side effects like scalp irritation and itching. Consult your doctor to know which formulation you should choose.
Does topical Finasteride affect sperm?
There is currently limited research on the effect of topical Finasteride on sperm. Some studies suggest that it may have a minimal impact on sperm parameters, but more research is needed to understand its effects fully.
Why does topical Finasteride have fewer side effects?
Topical Finasteride has fewer systemic side effects because it is primarily absorbed locally in the scalp rather than absorbed into the bloodstream, affecting the whole body. This results in a lower risk of side effects such as low libido and erectile dysfunction.
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