Should You Use Finasteride and Minoxidil Together for Hair Loss?

Medical Disclaimer: Freebird provides general information, not medical advice. For any health or medical advice, consult a licensed healthcare professional

Your hairline's retreating faster than your savings account, and you're tired of watching your crown thin out. You've heard about finasteride. You've heard about minoxidil. But here's what most guys don't know: using both together could be the difference between keeping your hair and losing it.

Most guys pick one or the other and hope for the best. I spent months researching every study, every forum post, every doctor's opinion on combination therapy. What I found changed how I think about hair loss treatments entirely.

Here's the deal: Combination therapy provides 94% improvement rates and even better, the potential side effects remain the same.

Let's dive deep into why both work well together and find out whether combination therapy is worth the lifetime commitment. I'll also share a hack on how to make both even more effective.

What is Minoxidil?

Minoxidil started as a blood pressure medication in the 70s, but doctors noticed something weird: patients were getting hairy. Happy accident for baldies, right? 

They found out that Minoxidil increases blood flow to the scalp. More blood means more oxygen and nutrients, which wakes up hair follicles. It's like giving your scalp a caffeine boost.

You can buy minoxidil in two forms: 

Topical minoxidil comes as a liquid solution or foam you apply directly to your scalp. The FDA approved it for hair loss in 1988. It's available over the counter in 2% and 5% concentrations.

Oral minoxidil is a pill originally prescribed for severe high blood pressure. Doctors now prescribe it off-label for hair loss at much lower doses (0.25 mg to 5 mg daily). The FDA hasn't officially approved oral minoxidil for hair loss, but it's gaining popularity because it's more convenient than rubbing liquid on your head twice a day.

Brand names for Minoxidil are Rogaine, Regaine, and Loniten.

What is Finasteride?

Finasteride is a DHT (dihydrotestosterone) blocker, which is good news for baldies because a genetic sensitivity to DHT is one of the main reasons for male pattern baldness.

Finasteride blocks the enzyme that converts testosterone into DHT. Less DHT means your follicles stop shrinking, which slows hair loss and sometimes reverses it.

Oral finasteride is available under the brand names Propecia and Proscar.

Does Finasteride Work Better with Minoxidil?

Minoxidil and finasteride work differently; Minoxidil stimulates hair follicles, while Finasteride blocks DHT, which makes it an ideal one-two punch to stop hair loss.

A study published in 2015 in the Dermatologic Therapy Journal showed that 152 patients took finasteride and minoxidil, and 94% showed improvement in hair growth. While 80.5% of finasteride only users and 59% of minoxidil only users showed improvement.

That's a massive difference. The combo nearly doubled minoxidil's effectiveness and significantly beat finasteride alone.

In 2023, a study showed that a combination treatment of finasteride and minoxidil may create sustained hair growth over a 24-week treatment period.

The combination gives you defense (finasteride blocking DHT) and offense (minoxidil promoting growth). That's why the results are so much better than single therapy.

What are the Side Effects of Combining Minoxidil with Finasteride?

Here's the good news: Using finasteride and minoxidil together doesn't increase your side effect risk compared to taking each drug individually. The side effects remain drug-specific.

Minoxidil Side Effects:

• Rash

• Headache

• Nausea

• Unwanted hair growth

Finasteride Side Effects:

• Erectile dysfunction

• Rash

• Nipple tenderness

• Decreased libido

• Testicular pain

• Depression and anxiety

A study was conducted to determine the safety of the combination treatment of minoxidil and finasteride, and the results show that no adverse effects have been observed so far.

Before jumping the gun, keep in mind that by taking finasteride and minoxidil together, you're at risk of experiencing the side effects of both treatments.

The bottom line? You're rolling the dice with each drug's individual side effects, but they don't multiply when combined.

To learn more, you can read our comprehensive articles on the potential side effects of finasteride and minoxidil. 

What Happens if You Stop?

Here's the harsh truth: Both medications require lifetime use. Stop taking them, and you'll lose your gains within 6-12 months.

Finasteride's effects reverse faster. Once you stop, DHT levels return to normal within weeks, and hair loss resumes.

Minoxidil's effects also wear off. Your follicles go back to their baseline state, and regrown hair sheds. 

How to Use Finasteride and Minoxidil Together

If you decide to try combination therapy, here's the practical guide:

Dosing Protocol

Standard regimen:

• Finasteride: 1 mg once daily (usually at night)
• Topical minoxidil: 1 ml of 5% solution or half a capful of foam, applied twice daily (morning and evening)

Alternative oral regimen:

• Finasteride: 1 mg once daily
• Oral minoxidil: Start with 0.25-1.25 mg daily for women or 2.5 mg for men, adjust based on response
  
  

How to Enhance the Effectiveness of Minoxidil and Finasteride (Big 4 Approach)

Some guys take combination therapy even further by adding two more treatments.

A medical student posted a comprehensive guide to hair loss for beginners and came up with his "Big 4" to fight hair loss due to DHT. Finasteride and Minoxidil were the top two, and to complete the four-pronged attack: Ketoconazole and Derma Rolling.

Ketoconazole

You may have heard of ketoconazole, which is more popular as an anti-dandruff shampoo. But did you know of a study that shows using 1% ketoconazole shampoo may thicken hair? You can try it as a hair loss treatment and see if it works.

Derma Rolling

Derma rolling uses microneedles to create tiny punctures on your scalp skin to induce a healing response. This study shows that derma rolling combined with Minoxidil worked better in promoting hair growth compared to Minoxidil alone.

Does this "Big 4" approach work better? Probably. But you're adding more time, effort, and cost to an already demanding routine.

My Personal Decision: Why I Choose to Shave My Head

As a head-shaving expert, the idea of taking drugs (with potential side effects) to treat hair loss doesn't entice me.

Yes, the combination works. The science is solid. 94% improvement rates sound amazing. But here's what nobody talks about: You're committing to a lifetime regimen. 

• Daily finasteride pill
• The knowledge that if you stop, you lose everything
• Twice-daily minoxidil application (or one more daily pill if you go oral)
• Constant worry about side effects
• Monthly costs that add up over the years

Going through the list of side effects alone gives me the chills. Anything that causes sexual dysfunction is a no for me. I am happy with my married life, thank you very much.

In my hair loss journey, I only used hair growth products that were all-natural and had no side effects.

Eventually, I shaved my head, which I wish I had done sooner.

Head shaving is one of the best alternatives to medical hair loss treatments, which can have some nasty side effects.

But hey, your preference may be different, and that's fine.

If you've decided to join the bald club like me, check out the FlexSeries shaving kit, which comes with everything you need to get a perfect head shave in only 90 seconds.

The Bottom Line

Finasteride and Minoxidil have proven to be effective medical treatments for hair loss. Combining the two may be even more effective for some people experiencing hair loss.

But remember, combination therapy requires a lifetime commitment. Stop taking them, and you lose your results within a year. You're also doubling your monthly costs and potentially dealing with side effects from both drugs.

If side effects concern you or you're tired of fighting a losing battle, there's another path: Embrace the bald! 

If you've decided to shave your head, the first step in your journey is to pick the best electric head shaver.

We recommend the FlexSeries shaving kit as your first investment for your bald-head lifestyle.

FAQs

What's the Ideal Dosage for Combination Treatment?

In using finasteride and minoxidil, it's common for doctors to prescribe 1 ml of topical minoxidil two times a day and 1 mg of finasteride daily.

Can You Take Finasteride with Minoxidil for Hair Loss?

Yes. Doctors may recommend a combination therapy of minoxidil and finasteride to fight hair loss. Studies have shown that combination therapy of finasteride and minoxidil has proven more effective in combating hair loss than taking each individually.

How Long Does It Take to See Results with Finasteride and Minoxidil?

Generally, finasteride takes three to six months to work. You must take it daily to see results. Minoxidil takes between eight and sixteen weeks to work. Apply topical minoxidil twice a day for best results. Results will vary from person to person. The key is patience and consistency in following the recommended dosage for each treatment.

Can Women Use Finasteride and Minoxidil for Hair Loss?

Yes, finasteride and minoxidil can be used to treat female pattern hair loss, but there are potential side effects when using the combination treatment. Pregnant women or breastfeeding women are advised not to take finasteride.

Are There Natural Alternatives to Finasteride and Minoxidil?

If you prefer to go the natural alternatives route, there are several options like taking saw palmetto, applying aloe vera, or essential oils like rosemary. Just keep in mind that none of these natural alternatives have any solid medical proof that they actually work for hair regrowth, unlike the proven results (and side effects) of oral and topical finasteride and minoxidil to treat hair loss.

What Happens If You Stop Taking Finasteride or Minoxidil?

If you stop either medication, your hair loss will resume, as both treatments require lifetime use. It's the same with minoxidil; if you stop applying the solution, you will lose the effect you gained in stopping hair loss. It's important to consider this before you take minoxidil or finasteride individually or as a combination treatment. Can you sustain treatment indefinitely? If not, you should consider other alternatives.

Can Minoxidil and Finasteride Be Combined with Other Hair Loss Treatments?

You can potentially try combining finasteride and minoxidil with other hair loss treatments like laser therapy or PRP (platelet-rich plasma) therapy. Consult your doctor before adding another hair loss treatment to finasteride and minoxidil.

Are There Specific Lifestyle Changes That Can Help With Hair Loss?

There are several lifestyle changes you can make that can help deal with hair loss. Taking healthy scalp supplements, applying scalp sunscreen, eating a healthy diet, quitting smoking and alcohol are some of the ways that can help treat hair loss naturally.