6 Most Effective Alternatives To Finasteride
Written by
Morgan German
Medically approved by
Dr. Andrea Ortega M.D.

Finasteride has been a leading treatment for male pattern hair loss for decades. However, the side effect rate is high, and many men suffer from depression, erectile dysfunction and other sexual problems while having more hair. But treating hair loss should not be so dangerous. Here are some alternatives to Finasteride to regain your hair and safeguard your wellbeing.

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How does Finasteride work?

finasteride before and after

The androgens testosterone and dihydrotestosterone (DHT) have somewhat different actions. The enzyme 5α-reductase converts testosterone to DHT. There are two enzyme isoforms; while type I predominates in the liver, type II resides mostly in the prostate, seminal vesicles, hair follicles and liver. At all these sites, testosterone is converted to DHT.

Finasteride is a selective inhibitor of alpha-5-reductase isoform II, making it a specific drug for the scalp and other organs with the same enzyme, and after its intake, DHT in the scalp decreases up to 60% or more, which explains its great effectiveness on androgenic hair loss.

Why do you need alternatives to Finasteride? What are Finasteride side effects?

Just as other drugs have side effects, Finasteride also has them, including mental alterations and sexual problems.

Mental outcomes

a woman looking mentally stressed at hair loss

The influence of Finasteride on brain chemistry is not well understood yet. The enzyme alpha-5-reductase is thought to play a key role in producing neurosteroids that modulate susceptibility to stress, anxiety, and depression.

Stress can also cause hair loss. Figure out how to solve stress-related hair loss with our handy list!

In this case, Finsteride would act as a neurosteroid inhibitor making you more susceptible to mental disorders. However, this correlation has not yet been proven to date.

Sexual problems

Sexual problems as side effects range from 0.9 to 38 per cent. Androgens are extremely important in men sexual function. However, not all men taking Finasteride experience ejaculation, erection or libido problems.

It is thought that there is a relationship between blood testosterone levels and the potential for side effects, being more common and possible in those men with low blood testosterone or less than 224 ng/dL. One study found that men with lower baseline testosterone values experienced more sexual side effects than men with normal levels, suggesting that baseline levels may be useful when considering treatment with A5R inhibitors.

Another scientific report suggests that it is possible to suffer these unwanted effects once it is known that they are possible to have when taking the medication. It is called the nocebo effect, where events were higher in patients who had counselling about possible sexual side effects compared to a group in which counselling was omitted.

How common are the side effects of Finasteride?

Finasteride belongs to the alpha-5-reductase inhibitors, an important enzyme that supports the conversion of testosterone into dihydrotestosterone (DHT).

Testosterone is a sex hormone considered the main androgen. When elevated, it can cause alopecia in some people, known as male pattern alopecia or androgenetic alopecia.

Male hair loss is genetically transmissible between family relatives, making you more or less likely to have it. Your hair follicles may be too sensitive to DHT and degenerate over time if you are genetically susceptible. But androgens are not only responsible for hair loss. They are also crucial for libido, sexual function and mood in men.

Studies reveal that sexual side effects occur at 2.1% up to 3.8% in men, with erectile dysfunction (ED) the most common, followed by premature ejaculation and loss of libido.

In addition to the emotional burden of hair loss, the side effects can further increase and make you stressed, anxious, sad, and feeling without motivation. These undesirable results are what often lead men to forgo treatment and seek new alternatives.

What are the best alternatives to Finasteride?

Here are the most demanded and effective alternatives against hair loss.

1. Hair transplant

Interest in hair transplantation has increased considerably in the last ten years. Almost 17 out of 20 men suffer from hair loss around their 50s, leading to more and more treatment alternatives every day.

Hair implantation is nothing more than a surgery in which follicles are extracted from areas where hair still exists and implanted in those where it has disappeared in the hope that in a few months, they will grow.  

In short, the surgeon takes hair from one area to transplant it to another. 

It is an effective and permanent treatment for hair loss but involves higher costs and considerable recovery time. Therefore, hair transplants are usually used only when other treatments have not worked, or the patient wants a permanent solution instead of taking pills daily.

There are two types:

  • FUE
  • FUT or FUSS

The FUE technique (Follicular Unit Excision or Follicular Unit Extraction) is the most advanced micro-grafts and consists of extracting follicles one by one or in small groups of 1 up to 4 from an area full of hair to the baldness area.

Is one session of FUE enough?

You will need one or more sessions depending on the severity of the alopecia since about 3,000 follicles are transplanted in each session. For this reason, and because large hair areas are necessary, FUE is not for total baldness, but only for alopecia with receding hairline or small areas, scars, eyebrows, beards, etc.

FUT or FUSS: Follicular unit extraction with a strip. It consists of extracting a scalp strip from the donor area, from which the hair follicles will be separated one by one and then implanted in the recipient area. This strip is usually 20 to 25 cm long and 1 to 2.5 cm wide and will produce a visible scar.

What's the difference between FUE and FUT?

It is a more aggressive procedure, requires anaesthesia and the recovery time is longer than the previous one.

The FUSS is mainly intended for extensive alopecia, and you can combine it with an FUE session to enhance the results.

2. Minoxidil

minoxidil

Did you know that Minoxidil was initially created for hypertension? Yes, Minoxidil was intended to lower blood vessel tension, and along the way, scientists found that patients grew too much hair! It was a side effect when developed as an antihypertensive.

This led to the formulation of a product for baldness and scalp only. To date, topical Minoxidil is the first treatment of androgenetic alopecia in men, female pattern baldness in women, and an off-label for other hair loss conditions. This promising medication touches follicular cells by shortening the telogen phase and increasing follicles in the anagen (growth) phase.

Clinical trials in patients with male alopecia treated with 2% or 5% Minoxidil showed a noticeable increase in hair growth and a decrease in hair loss, and the top results were with the 5% formulation.

In addition, to use in androgenic alopecia, it has been used as an off-label medication for several disorders such as alopecia areata (AA), cicatricial alopecia and hair shaft disorders, as well as to improve body hair growth in other areas, including the eyebrows and beard.

When applied, its main advantage is that it also increases capillary blood flow and allows more nutrients and oxygen to reach the follicle easily, keeping it healthier and stronger.

Want to learn more about Minoxidil? Check out all our Minoxidil guides:

3. Low-Level Laser Therapy (LLLT)

It is a non-invasive treatment for hair loss based on medical-grade laser light to stimulate capillary blood circulation. The red light passes through the skin surface with regenerative effects and biological reactions on the scalp tissues.

By activating the cellular function of the follicles, the LLLT slows and minimizes the progression of hair loss while promoting new hair growth. One study reported that LLLT has beneficial effects on hair loss even greater than if used with high frequency, proving that the treatment considerably increases hair density, including in patients with male pattern hair loss.

How does LLLT work?

It works in two ways. The first is by improving blood flow to the scalp, bringing more oxygen, nutrients and growth factors directly to each follicle, the second by inducing phototherapy, a biological process where the cellular activity increases. Together, these powerful effects help reactivate hair follicles and produce thicker, fuller hair.

4. Platelet-Rich Plasma Therapy (PRP)

The hair platelet-rich plasma, better known as PRP, is a unique procedure that restores those follicles in the ageing phase, allowing them to produce thicker and stronger hair again.

It is an autologous treatment of your blood, avoiding rejection while strengthening hair and preventing alopecia in those who suffer from excessive hair loss.

Once applied, it works by stimulating collagen production, elastin and hyaluronic acid and increasing the hair follicle vascularization since the platelets contain many growth factors that help regenerate the hair, bringing more nutrients and boosting cellular proliferation.

PRP is a safe alternative to Finasteride with little or no side effects once done, in addition to being effective according to different recent studies.

5. Saw palmetto

saw palmetto

Saw palmetto extract oil is a natural compound that works similarly to Finasteride. It is obtained from the Serenoa Repens plant, with benefits in hair loss beyond slowing it down since it does not have any side effects.

Saw palmetto works by blocking or inhibiting the enzyme alpha-5-reductase that raises DHT blood levels and causes hair loss. You can use it in many forms, be it in tea or herbal infusion daily, as a food supplement 200mg several times a day, or as oil applied topically directly to the scalp.

6. The safe, formulated and natural alternative to Finasteride

Unlike the chemically-laden Finasteride and Minoxidil, our naturally-derived hair care products do not cause scalp irritation and negative health conditions.

With continuous use of our vegan and naturally-derived ingredients, the only effects you will experience are stronger, fuller, and healthier-looking hair.

Our Bio-Pilixin Formula

finasteride alternative


We have concocted a specially trademarked Bio-Pilixin Formula - the effective solution to your hair loss.

First, our Hair Strength Shampoo works to cleanse and nourish the hair and scalp.

Second, the Hair Recovery Conditioner functions to supplement the shampoo in restoring and protecting each hair strand’s integrity.

And third, the Hair Growth Serum nurtures the hair and scalp and increases hair density. Its unique formula is designed to block Dihydrotestosterone (DHT), and other hormones. It also stimulates blood flow to supply vital nutrients to the scalp.

When all three products are used in tandem and applied continuously, their effects on hair growth, density, and strength are evident within 150 days (backed by our money back guarantee).

Which alternatives should you pick?

Finasteride has been a great hair loss medication for decades. However, it is not free of side effects and does not work in all patients in the same way.

You will either have unwanted effects, no results or the desired results once treatment is started. All options are on the table, and you cannot guess which one you will be in. Given this outcomes diversity, several effective and safe alternatives are proposed but remember to consult first with your trusted medical provider.

References

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  2. Dervishi, G., Liu, H., Peternel, S., Labeit, A., & Peinemann, F. (2020). Autologous platelet-rich plasma therapy for pattern hair loss: A systematic review. Journal of Cosmetic Dermatology, 19(4), 827–835.
  3. Erdemir, F., Harbin, A., & Hellstrom, W. J. G. (2008). 5-alpha reductase inhibitors and erectile dysfunction: the connection. The Journal of Sexual Medicine, 5(12), 2917–2924.
  4. Gupta, A. K., & Charrette, A. (2015). Topical minoxidil: Systematic review and meta-analysis of its efficacy in androgenetic alopecia. Skinmed, 13(3), 185–189.
  5. Hirshburg, J. M., Kelsey, P. A., Therrien, C. A., Gavino, A. C., & Reichenberg, J. S. (2016). Adverse effects and safety of 5-alpha reductase inhibitors (finasteride, dutasteride): A systematic review. The Journal of Clinical and Aesthetic Dermatology, 9(7), 56–62.
  6. Kim, H., Woo, H., Shin, S., Park, D., & Jung, E. (2020). The potential application of Ecklonia cava extract in scalp protection. Cosmetics7(1), 9.
  7. Liu, K.-H., Liu, D., Chen, Y.-T., & Chin, S.-Y. (2019). Comparative effectiveness of low-level laser therapy for adult androgenic alopecia: a system review and meta-analysis of randomized controlled trials. Lasers in Medical Science, 34(6), 1063–1069.
  8. Marberger, M. J. (1998). Long-term effects of finasteride in patients with benign prostatic hyperplasia: a double-blind, placebo-controlled, multicenter study. PROWESS Study Group. Urology, 51(5), 677–686.
  9. Mysore, V. (2012). Finasteride and sexual side effects. Indian Dermatology Online Journal, 3(1), 62–65.
  10. Olsen, E. A., Dunlap, F. E., Funicella, T., Koperski, J. A., Swinehart, J. M., Tschen, E. H., & Trancik, R. J. (2002). A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. Journal of the American Academy of Dermatology, 47(3), 377–385.
  11. Stevens, J., & Khetarpal, S. (2019). Platelet-rich plasma for androgenetic alopecia: A review of the literature and proposed treatment protocol. International Journal of Women’s Dermatology, 5(1), 46–51.
  12. Suchonwanit, P., Thammarucha, S., & Leerunyakul, K. (2019). Minoxidil and its use in hair disorders: a review. Drug Design, Development and Therapy, 13, 2777–2786.