Finasteride vs minoxidil vs dutasteride: Hair loss treatments compared

If you’re reading this article because hair loss has been out of control for a while, and you’re not sure which medicine will work best for you, trust us, you are not alone.

Between finasteride, minoxidil, and dutasteride, it’s hard to figure out which medicine can help you regrow hair quickly and safely.

This is what this guide is for. It offers a complete side-by-side comparison of finasteride, minoxidil, and dutasteride, so that when you do consult your prescriber for hair loss, you know exactly what to ask and how to decide.

This article is not a recommendation.

Whether any treatment suits you is decided by a GMC-registered prescriber who has read your medical history.

The job here is to lay out the evidence clearly so the conversation is easier.

Before you begin: A little bit about OnlineClinic

OnlineClinic has been operating since 2011 and has treated more than 2.1 million patients.

The pharmacy is registered with the General Pharmaceutical Council (GPhC), our prescribers are registered with the General Medical Council (GMC), and the service is regulated by the Care Quality Commission (CQC).

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Male pattern hair loss is genetic, and the mechanism is fairly simple once someone explains it.

Your body converts a small amount of testosterone into a stronger hormone called dihydrotestosterone, usually shortened to DHT.

In men with the inherited sensitivity, DHT gradually shrinks the follicles on the top and front of the scalp.

Each growth cycle produces a slightly finer, shorter hair, until eventually the follicle produces nothing visible at all.

That explains why the two families of treatment look so different.

• Finasteride and dutasteride reduce how much DHT your body makes, so they slow or stop the shrinking.
• Minoxidil does not touch DHT at all. It improves blood supply to the follicle and keeps hairs in their growing phase for longer, which makes existing hairs thicker and holds them in place.

Being "licensed" means the MHRA, the UK medicines regulator, has assessed the evidence and approved the medicine for that specific use.

Where a medicine has a licence, its quality, dosing and safety warnings are all formally regulated for that purpose.

Here’s the licensing status for finasteride, minoxidil, and dutasteride in the UK:

Licensed in the UK

Finasteride 1mg. Licensed for male pattern hair loss in adult men. Prescription only. Sold as Propecia and as generic finasteride, which contain the same active ingredient.

Licensed in the UK

Topical minoxidil 2% and 5%. Licensed for hair loss and available to buy without a prescription, including Regaine and its generic counterparts.

Not licensed for hair loss in the UK

Dutasteride. Licensed in the UK for an enlarged prostate only. It is not licensed here for hair loss, although it is licensed for the condition in South Korea, Japan, and Taiwan.

Not licensed for hair loss in the UK

Oral minoxidil tablets. Licensed only as a blood pressure medicine. Any use for hair loss is outside the licence.

Not licensed for hair loss in the UK

Topical finasteride sprays. Approved in a handful of European countries, including Italy, Germany, Portugal, and Luxembourg. Not approved in the UK.

We prescribe within UK licences.

So finasteride is what our prescribers can offer for hair loss, and topical minoxidil is something you can pick up yourself and use alongside it.

We include dutasteride and oral minoxidil below because it is better to see the whole picture and understand it properly than to buy them from an unregulated website.

Trial figures behind these summaries are set out in the sections below and referenced at the end.

Finasteride has the longest and most detailed evidence base of the three medicines compared here.

The pivotal research was published in the Journal of the American Academy of Dermatology in 1998, covering 1,879 men aged 18 to 41 across three randomised trials.

Researchers counted hairs in a marked circle on the scalp about the size of a 50p piece, which is a more reliable measure than asking men whether they thought it was working.

At the crown, compared with placebo, finasteride produced:

• After one year: Around 107 more hairs in the counted area.
• After two years: Around 138 more hairs.
• Photographic assessment at one year: 48% of men were rated improved, against 7% on placebo.
• Photographic assessment at two years: 66% of men were rated improved.

Hair count peaked at about two years into the trial, then drifted down slowly, but was still above where those men started.

The placebo group, meanwhile, had lost an average of 239 hairs from the same patch.

What men actually report, in our experience and in the trial data, is that hair shedding in the shower reduces first, before anything looks different in the mirror. That is usually the earliest sign that medicine is working.

For a fuller month-by-month picture, our guide on Finasteride results timeline: what to expect month by month walks through the same timeline in more detail.

This deserves its own section, because the safety information changed recently.

Side effect rates in the original 12-month finasteride trials were low, and close to placebo’s side effect rates:

• Reduced sex drive: 1.8% on finasteride, 1.3% on placebo.
• Erectile difficulties: 1.3% on finasteride, 0.7% on placebo.
• Reduced volume of ejaculate: 0.8% on finasteride, 0.4% on placebo.
• Stopping treatment for any side effect: 1.7% on finasteride, 2.1% on placebo.

By year five, reports of these effects had fallen to around 0.3%.

Most men who did experience the side effects found that they settled, either after stopping or while continuing the treatment.

Alongside that, there is a smaller group of men who report sexual or mood symptoms that continue after they stop the tablets.

The regulators have looked at this closely, and here’s what happened next.

Two other points that come up in consultations:

• PSA blood tests. Finasteride roughly halves PSA readings, which are used in prostate checks. It does not hide a problem, but whoever interprets the test needs to know you take it, because the figure should be doubled.
• Pregnancy. Women who are or may become pregnant should not handle crushed or broken tablets, since they may affect the unborn fetus if the medicine gets absorbed into the skin. Intact coated tablets are fine to handle.

Our companion article on Finasteride side effects covers this in depth, including what is known and not known about persistent symptoms.

The clearest results for topic minoxidil came from a 2002 study, following 393 men for 48 weeks.

The 5% strength produced about 45% more regrowth than the 2% strength.

The group taking the 5% strength also responded faster.

They did report more itching and irritation, much of it linked to propylene glycol in the liquid formulation, which is why the foam versions were developed without it.

The practical realities are worth being straight about.

• The medicine goes on a dry, product-free scalp twice daily or once daily for some foams. Miss it regularly, and it stops working.
• There is usually a hair shedding phase in the first few weeks. You may see more hair in the sink for some weeks.
• Irritation and flaking are the most common side effects, and switching from liquid to foam often fixes it.
• Facial or body hair growth happens occasionally, almost always from not washing your hands after applying it.
• It has to continue indefinitely to hold on to the benefit.

Minoxidil is not something we dispense, because you do not need us for it. Any pharmacy will sell you Regaine or its generic equivalent without a prescription.

Low-dose minoxidil tablets, usually between 0.25mg and 5mg daily, have become popular with dermatologists over the last few years.

If you have seen it mentioned on Reddit or TikTok, this is what people mean.

It is worth understanding for two reasons. It is genuinely promising, and it is genuinely not licensed for hair loss anywhere in the world. Minoxidil tablets are licensed as a blood pressure medicine.

For this reason, oral minoxidil cannot be prescribed for hair loss with an online consultation, and we do not offer it.

Dutasteride is the one that generates the most online debate, and the reason is straightforward: On the measures that matter, it does more.

Finasteride blocks one of the two enzymes that produce DHT, reducing blood levels by roughly 70%. Dutasteride blocks both, taking that reduction past 90%.

That translates into better trial results.

A 2014 phase III trial following 917 men for six months, compared the two medicines head-to-head.

Dutasteride 0.5mg significantly increased hair counts compared with finasteride 1mg.

The difference between the two active treatments was statistically significant.

So why is Dutasteride not the obvious choice in the UK?

• It has no UK licence for hair loss. The MHRA has assessed it for prostate enlargement only.
• It stays in your body far longer. Dutasteride has a half-life of around five weeks, against six to eight hours for finasteride. If you get a side effect, it takes considerably longer to clear.
• You cannot donate blood until six months after your last dose, because the medicine in donated blood could reach a pregnant recipient, and it is unsafe for pregnant women.
• Its safety record for hair loss is shorter. Most long-term data comes from prostate use and from countries where it is licensed for hair loss, particularly South Korea.

The picture may change if the MHRA licenses it here.

Until then, prescribing it for hair loss in the UK means prescribing outside the licence, and that is not how we operate.

If you want to explore it, talk about it with a consultant dermatologist who can supervise it directly.

Comparing treatments across separate trials is unreliable, because the men, the measurements, and the timeframes all differ. Network meta-analysis is the method used to pull them onto a single scale.

The most cited study was published in JAMA Dermatology in 2022 by Gupta and colleagues, covering 23 trials.

Its ranking, from most to least effective, was as follows:

• Oral dutasteride 0.5mg
• Higher-dose oral finasteride
• Oral minoxidil
• Oral finasteride 1mg
• Topical minoxidil 5%
• Topical minoxidil 2%

This is what many men end up doing, and the evidence supports it.

A 2025 systematic review and meta-analysis published in Frontiers in Medicine, pooling seven randomised trials, found that finasteride and minoxidil combination treatment beat minoxidil alone on hair density, hair thickness, and photographic assessment, with all three differences large enough to be visible rather than merely statistical.

Side effect rates in these studies were broadly similar to using either treatment on its own.

The logic is the same as before. One reduces the hormone shrinking your follicles, the other keeps the follicles you still have in their growth phase for longer.

Both licensed treatments hold hair loss in check rather than curing it. When you stop, DHT levels return to normal, and the genetic process resumes.

In practice, men lose the ground they gained within about six to twelve months of stopping, and the hair typically returns to roughly where it would have been had they never treated it.

That is the real commitment involved, and it is a fair thing to weigh up before starting rather than after. It is closer to managing blood pressure than to finishing a course of antibiotics.

Finasteride is not suitable if you:

• Are a woman. It is licensed for men only, and must not be taken by women who are or may become pregnant.
• Are under 18.
• Have had an allergic reaction to finasteride previously.

Discuss it carefully with a prescriber if you:

• Have a history of depression, low mood, or suicidal thoughts.
• Are currently experiencing sexual difficulties, since it can be hard to separate cause from coincidence later.
• Are trying to conceive, or your partner is pregnant.
• Have liver problems, or a PSA test or prostate check coming up.

Topical minoxidil is not suitable if you:

• Have broken, inflamed, or infected scalp skin.
• Are outside the age range on the product licence, which differs between products.
• Have uncontrolled high blood pressure or existing heart problems.

If hair loss has come on suddenly, in patches, with scalp pain or scaling, or alongside other symptoms, that may not be male pattern hair loss at all, and it is worth being examined before starting any treatment.

There is no single right answer, and a prescriber makes the final call on suitability. That said, the decision usually comes down to a handful of practical points.

Finasteride tends to suit you if:

• Your loss is at the crown or mid-scalp, where the evidence is strongest.
• You would rather take one tablet a day than apply something twice daily.
• You want the treatment with the longest UK track record.
• You are comfortable having read the MHRA safety advice above.

Topical minoxidil tends to suit you if:

• You would rather not take an oral medicine that affects hormone levels.
• You want to start today without a consultation.
• Sexual side effects are your main worry, since minoxidil does not act on hormones at all.
• You are willing to keep up a daily routine and ride out the initial hair shed.

Both together tend to suit you if:

• You want the best results the licensed options can offer.
• Your loss has been progressing steadily rather than slowly.
• The daily routine is realistic for you.

Neither is likely to help much if:

• The areas concerning you have been completely bald for years.
• Your hair loss is not male pattern hair loss, which is worth confirming first.

At OnlineClinic, finasteride prices start from £14.99.

Every price includes the prescription, the consultation, the packaging, and delivery. There are no hidden fees.

Our process is straightforward. From start to finish, this is what happens when you order with us:

1. Fill in the medical questionnaire. It takes 5 to 10 minutes. The questions are thorough on purpose
2. A GMC-registered prescriber reviews your answers. If they need more details, they will message you through your account
3. If treatment is approved, it is dispensed and dispatched. Next-day delivery, with the full patient information leaflet included
4. If it is not approved, the prescriber explains why. You are not charged for treatment that is not issued