Using finasteride and minoxidil together to treat hair loss

Reviewed by Sheena Bagga

Finasteride and minoxidil are two popular hair loss treatments, each working in different ways to reinvigorate hair growth. Some users decide to use both treatments at the same time to treat their hair loss. But does this approach work for you?

In this article, we cover:

• All you need to know about finasteride and minoxidil - How they work, the differences between the two and how combining treatments can lead to more effective regrowth
• How to use hair loss treatment effectively - You’ve received your treatment, now how do you use it? From first-time users to post-hair transplant care, find out how to optimise your hair regrowth routine
• Benefits and side effects - Find out what your journey on finasteride and minoxidil might look like – side effects, benefits and what to expect if you stop hair loss treatment

What's the difference between finasteride and minoxidil?

Male pattern baldness affects nearly half of men by the time they’re 50, and for lots of men it’s just a natural part of getting older.  

Some men don’t feel the need to try and slow their hair loss, but by using finasteride and minoxidil together patients are addressing their condition in two separate ways, theoretically increasing the chance of their hair growing back.

• Finasteride is available as a tablet which is taken daily to stop hair loss by blocking DHT. It can also promote hair regrowth.
• Minoxidil is available as a foam or liquid. This is applied to your head to help reverse hair loss. It can also help to promote hair growth by improving blood flow to your hair follicles.

Can you use finasteride and minoxidil together?

While each treatment works in different ways, it is safe to use finasteride and minoxidil together – it can even be recommended as a part of hair loss recovery.

“Using finasteride and minoxidil together tackles hair loss on two fronts, bolstering the chance of recovery and finding a treatment that works. Try our consultation to be sure that a combined treatment is right for you." - Sheena Bagga

How do finasteride and minoxidil work together to increase effectiveness?

To understand how finasteride and minoxidil can work together, it is good to first know what causes hereditary male pattern baldness. 

Hereditary male pattern baldness is a result of genetic factors and a male hormone called dihydrotestosterone (DHT). DHT can contribute to hair loss by inducing a change in the hair follicles on the scalp. 

The hairs produced by the affected follicles become progressively smaller in diameter, shorter in length and lighter in colour, leading to thinning, receding hairlines and baldness.  

Finasteride works by reducing the effects of DHT on the follicles. In this sense, it's a “DHT blocker”, though it is not referred to by this name amongst medical professionals. 

Finasteride doesn't provide a permanent cure for male baldness, so if you stop taking it, hair loss will resume. Finasteride is not thought to have any interactions with minoxidil, so they are sometimes recommended to use together by hair loss specialists. 

Minoxidil, the active ingredient in Regaine for men, works by: 

• Stimulating the shrunken hair follicles 
• Helping increase the blood flow to your scalp, which helps follicles to increase in size and diameter 
• Reinvigorating the hair growth cycle

As mentioned above, finasteride and minoxidil each interact with the root causes of hair loss in different ways. Using both treatments together confronts pattern baldness on two different fronts, giving a higher chance for hair to grow back.

In studies treating patients with pattern hair baldness, using both minoxidil and finasteride together was found to be more efficient (and similarly safe) for treating hair loss than using one of the treatments exclusively.

How to use finasteride and minoxidil

Finasteride (also branded as Propecia) 

• Take a 1mg tablet of finasteride each day
• There is no evidence to suggest diet affects finasteride - eat and drink as you'd like
• Do not take more than one tablet in a 24 hour period. Doing so can increase chances of side effects
• If you have missed a dose of finasteride, take the next dose as soon as you remember

Minoxidil (also branded as Regaine for Men)

• Apply 1g of minoxidil foam in its cap
• Massage foam directly onto treatment area on scalp
• Wash your hands thoroughly with soap and water
• Wait for foam to dry
• Style your hair as normal
• Repeat process twice a day, at least 12 hours apart

Daily routine for using finasteride and minoxidil together

To get used to a regular treatment it can be useful to plan out a daily routine. So, what time of day is best take and apply your finasteride and minoxidil?

According to the NHS it doesn’t matter what time you take finasteride, as long as it is taken around the same time each day. Similarly, there isn’t a golden hour for applying minoxidil – but it is recommended that you wait 12 hours between each treatment.

With the above in mind it may be helpful to apply your minoxidil first thing in the morning, then again in the early evening. This allows you to utilise the recommended 12-hour gap. What time you take finasteride doesn’t matter as long as it’s consistent – it could even be while you’re waiting for your foam to dry.

“Whenever you take your medicine, establishing a daily routine can be useful for remembering when to apply treatment. If you’re having trouble sticking to a consistent schedule try writing it out or setting an alarm on your phone. Consistent usage of finasteride and minoxidil is important to stimulate hair growth - creating a routine can be very helpful for this!” - Sheena Bagga

How long do finasteride and minoxidil take to work?

How long does finasteride take to work?

Finasteride typically takes three to six months to work. You should take finasteride every day to see the effects. 

How long does minoxidil take to work?

Minoxidil takes between eight and 16 weeks to work. The exact time will differ from person to person. For the best results you should apply the liquid or foam twice a day. 

The combination of oral finasteride (sometimes known by the brand name Propecia) and topical minoxidil (Regaine) seems to have overall better results than either of those treatments alone. 

How long should I take finasteride and minoxidil together?

You need to take finasteride every day to see the results. It’s recommended that you take the treatment for a year to give your body enough time to react. You should continue to take finasteride for as long as you want the treatment to work. If you stop taking it your hair loss will return. 

Similarly, you should keep using Regaine for as long as you want to keep the effects. If you stop using it your hair will return to how it was when you started. If you don’t see results after a year you should speak to your GP. They may be able to offer alternative treatments.

Using finasteride and minoxidil after a hair transplant

If you have recently had a hair transplant, you may have been recommended finasteride or minoxidil to assist in regrowth. 

Both minoxidil and finasteride should work as normal if used after a hair transplant, but please talk to your GP if you are on any other medications following the surgery. This will help to minimise the risk of any potential side effects or reactions to the treatments.

Side effects of using finasteride and minoxidil together

Like all treatments, finasteride and minoxidil can cause side effects. Side effects of finasteride are uncommon; however, they can include:

• A rash
• Lowered sex drive
• Low mood
• Erectile dysfunction
• Nipple tenderness 

Common side effects caused by minoxidil can include:

• Headaches
• Itching or skin rash
• Nausea
• Unwanted hair non-scalp hair growth 

Make sure to read the patient information leaflet before starting treatment.

“You should let your GP know if you have any side effects after using finasteride or minoxidil. Stop use immediately if you have an allergic reaction, depression, changes in breast tissue, low blood pressure or palpitations. Your health should take priority over your hair!" - Sheena Bagga

Does using minoxidil finasteride together cause erectile dysfunction?

While erectile dysfunction is not an expected side effect of minoxidil, it is an uncommon side effect of finasteride and can affect up to 1 in 100 users. Therefore, using the treatments together does increase the likelihood of the user suffering from ED.

Please see your GP if you are suffering from any side effects from finasteride or minoxidil and stop treatment immediately if you start to experience chest pain, low blood pressure or heart palpitations.

What happens when you stop using finasteride and minoxidil?

Finasteride and minoxidil will work for as long as you continue treatment.

If you stop using finasteride or minoxidil, your hair loss rate will eventually return to what it was before you started taking the treatment. You will lose whatever hair your have grown as a result of the treatment. This process will take several months – finasteride loss can resume within six – and is a gradual process. Your new hair won’t fall out all at once, so you have time to resume treatment if you feel you have made a mistake by stopping.

Alternative hair loss treatments

There are many online and over-the-counter foams, lotions, shampoos and supplements, as well as prescription medications to help hair loss.

Other than finasteride and minoxidil, LloydsPharmacy Online Doctor offers the following treatments:

• Propecia and Regaine (branded finasteride and minoxidil)
• Biotin capsules to support hair and nail health
• DHT blocking shampoo

Vitamins for hair loss can help to improve your hair's health but the best way to get the nutrients your hair needs is by eating a healthy balanced diet.

Find out more about the LloydsPharmacy Online Doctor hair loss clinic on our Youtube channel.

Which hair loss treatment is right for me? 

If you’re looking for treatment for male pattern baldness, it can be difficult to decide which remedies can work for you. But if you’re considering a prescription treatment, you can go through our online hair loss consultation to see if finasteride/Propecia is clinically right for you. You can also use our service to order Regaine foam on its own or request it as part of a bundle with finasteride. 

If you're using finasteride or Propecia already, you could also order our over the counter hair loss treatment bundle. The pack contains 5% minoxidil solution, DHT blocking shampoo and biotin tablets. 

References 

https://patient.info/mens-health/male-pattern-baldness
https://www.regaine.co.uk/minoxidil/how-regaine-works
https://www.medicines.org.uk/emc/product/791/smpc
https://link.springer.com/article/10.1007/s00266-020-01621-5
https://www.nhs.uk/medicines/finasteride/how-and-when-to-take-finasteride/
https://www.regaine.co.uk/men/regaine-foam/how-to-use