Topical vs Oral Finasteride: What's the Difference?

Medically reviewedby Dr. Amy Revene M.B.B.S.
WrittenbyLuat Duong
Last updated

In the dynamic world of hair loss treatments, finasteride has long been a cornerstone solution, lauded for its efficacy in combating male pattern baldness. 

However, one frequently asked question that echoes through the corridors of dermatology is, "Should I choose oral or topical finasteride?" 

As modern research delves into the nuances of this powerhouse ingredient, a noteworthy evolution has transpired, providing a newer, topical variant to the traditional oral tablet. 

This article illuminates the critical differences between topical and oral finasteride, dispelling myths, elucidating facts, and helping you discern which treatment option best suits your needs. 

So, dive in as we peel back the layers of this hot topic in hair loss treatment, setting the record straight on 'Topical vs Oral Finasteride'.

What is finasteride?

finasteride spray vs pill

Finasteride is a prescription medication primarily used to treat male pattern baldness and benign prostatic hyperplasia (BPH). It works by inhibiting the enzyme 5-alpha reductase, which converts testosterone into dihydrotestosterone (DHT), a hormone that can contribute to hair loss and prostate growth.

Further, finasteride's mechanism of action makes it a valuable tool in managing conditions sensitive to DHT. 

In the case of hair loss, DHT can shrink hair follicles, leading to thinner, shorter hairs and, eventually, hair loss. 

Finasteride can slow down or even reverse this process in some individuals by inhibiting the conversion of testosterone to DHT. 

While it's typically prescribed for men due to its potential side effects in women, it has been used off-label in post-menopausal women or those not planning to conceive. 

However, women of childbearing age should not use finasteride due to the risk of birth defects.

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How does finasteride work?

Finasteride works by inhibiting the enzyme 5-alpha reductase, which is responsible for converting testosterone into its more potent form, dihydrotestosterone (DHT). By reducing DHT levels, finasteride can help slow down or even reverse the process of hair miniaturisation and hair loss caused by androgenetic alopecia.

What is topical finasteride?

finasteride spray vs pill

Topical finasteride is a medication applied directly to the scalp to help treat hair loss, specifically male pattern baldness or androgenetic alopecia. It works by inhibiting the enzyme 5-alpha reductase, which converts testosterone into dihydrotestosterone (DHT), a hormone that contributes to hair loss.

Compared to its oral counterpart, topical finasteride has emerged as a novel intervention in the fight against hair loss. 

The topical form is designed to target the scalp directly, offering a localised hair loss treatment intended to reduce systemic exposure and potential side effects. 

It's typically available as a liquid or a gel and applied directly to the scalp, where it can directly interact with hair follicles.

The main advantage of topical finasteride over the oral version is its reduced systemic absorption, which could lead to fewer side effects. 

However, research is ongoing to fully understand this form of treatment's efficacy and safety profile. 

Some studies suggest topical finasteride can be as effective as oral finasteride in promoting hair growth and preventing further hair loss. 

Individuals should consult with a healthcare professional before starting any new medication regimen.

How effective is topical finasteride?

Topical finasteride is effective in treating male pattern baldness or androgenetic alopecia. Its efficacy is highlighted by its potential to stimulate hair growth and prevent further loss. However, effectiveness can vary between individuals, influenced by factors such as consistent application and concentration of the medication.

What is oral finasteride?

finasteride spray vs pill

Oral finasteride is a prescription medication used primarily to treat male pattern baldness, known as androgenetic alopecia. It works by reducing dihydrotestosterone (DHT) levels, a hormone that contributes to hair loss in men.

Oral finasteride, usually available in 1mg tablets, is often prescribed under Propecia for hair loss.

It operates on a systemic level, affecting the whole body. Inhibiting the conversion of testosterone to DHT can slow down, halt, or even reverse hair loss in some men.

However, while oral finasteride can be effective, it's important to note that it can also lead to side effects in some individuals, with potential issues ranging from sexual dysfunction to mood changes. 

It's a long-term treatment, meaning its effects will only last as long as the medication is taken. 

Therefore, it's crucial for anyone considering oral finasteride to consult with a healthcare professional to fully understand its potential benefits and risks.

How effective is oral finasteride?

Oral finasteride is highly effective in treating male pattern baldness, also known as androgenetic alopecia. Numerous studies have shown that it can significantly slow down, halt, or even reverse hair loss in some men. 

However, its effectiveness can vary between individuals, and its hair regrowth benefits are usually only sustained as long as the medication is taken.

What are the side effects of finasteride?

Finasteride, whether oral or topical, can have potential side effects. It's important to note that while these side effects are possible, they may not occur in all individuals. Always consult with a healthcare professional before starting any new medication.

Sexual side effects:

Physical side effects:

  • Swelling in your hands or feet
  • Swelling or tenderness in your breasts
  • Dizziness, weakness
  • Feeling like you might pass out
  • Headaches

Psychological side effects:

  • Depression
  • Anxiety
  • Mental fogginess
  • Sleep disturbances

Allergic reactions:

  • Hives
  • Difficulty breathing
  • Swelling of your face, lips, tongue, or throat

Long-term side effects:

  • In rare cases, possible long-term sexual dysfunction
  • Prostate cancer risk - ongoing debate and research has been into whether using finasteride may increase the risk of developing high-grade prostate cancer.

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finasteride spray vs pill

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Finasteride spray vs pill: What are the differences?

Finasteride, a popular hair loss treatment, can be administered in two fundamental forms: a spray (or other topical forms) applied directly to the scalp and a pill taken orally. The method of application and the way the drug interacts with the body differ significantly between these two forms.

Method of administration

Oral finasteride is consumed as a pill, typically once a day. The medication circulates throughout the body, affecting hair growth systemically. 

In contrast, finasteride spray is applied directly to the scalp, targeting hair follicles at the application site and minimising systemic exposure.

Absorption and effect

Being systemic, oral finasteride affects the entire body. It can lead to more widespread side effects. 

Conversely, topical finasteride, such as a spray, is absorbed primarily in the scalp, potentially reducing systemic side effects.

Side effects

While both forms can cause side effects, oral finasteride is more commonly associated with systemic side effects, including sexual dysfunction or mood changes. 

The topical spray limits these by confining most of the drug's action to the scalp.


Both forms of finasteride have been found effective in treating androgenetic alopecia. However, individual results can vary based on factors like dosage, consistency of use, and particular physiological responses.

Always consult with a healthcare professional to understand which form of finasteride is most suitable for your needs.

Topical vs oral finasteride: Which one is right for you?

As a systemic medication, oral finasteride might be more suitable for those who do not mind taking a daily pill and are not excessively concerned about potential systemic side effects. On the other hand, topical finasteride might be a better choice for individuals who prefer a more targeted treatment and those concerned about the systemic side effects associated with oral finasteride. 

Consulting with a healthcare professional is essential in making this decision.


Oral and topical finasteride have shown efficacy in treating male pattern baldness, or androgenetic alopecia. 

While oral finasteride has been a long-standing option, topical variants like sprays or solutions offer an alternative approach with potentially fewer systemic side effects. 

Individual preferences, the comfort of administration, and personal response to treatment are crucial in choosing between the two. 


Can I use both oral and topical finasteride together? 

It's best to consult with a healthcare professional before starting any new medication or combining treatments. Combining the two could increase the risk of side effects.

How long does it take to see results from finasteride? 

Visible results from finasteride treatment typically take at least three to six months due to the slow nature of hair growth. Patience and consistent use are essential.

What happens if I stop using finasteride? 

If you stop using finasteride, you'll likely lose any hair gained during treatment within 9 to 12 months.

Are there alternatives to finasteride for treating hair loss? 

Yes, alternatives include minoxidil, another FDA-approved treatment for hair loss, and various natural remedies. Consult a healthcare professional for the best advice.

Is it safe to use finasteride for an extended period of time?

Long-term use of finasteride is generally considered safe. However, discussing any concerns and potential risks with your healthcare provider is crucial.



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Luat Duong

Luat Duong is a Copenhagen-based writer and content strategist specializing in hair loss and health. His work has been featured in MyHealthGuide, The Right Hairstyles, and Woman's Era. He is a graduate of Vaasa University. You can connect with him on LinkedIn.