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The Definitive Guide to Finasteride

Finasteride is a prescription medicine and one of the most treatments available for androgenetic hair loss. It is also the only oral medicine licensed for hair loss in the UK. Finasteride started out as a prostate medication. Doctors then noticed it regrew hair, and it became a first-OnabotulinumtoxinAAbobotulinumtoxinAIncobotulinumtoxinAPrabotulinumtoxinALetibotulinumtoxinARimabotulinumtoxinBHyaluronic Acid FillersCalcium Hydroxylapatite FillersPoly-L-lactic Acid FillersPolymethylmethacrylate FillersAutologous Fat GraftingForehead Lines TreatmentGlabellar Frown Lines TreatmentCrow's Feet TreatmentBunny Lines TreatmentChemical Brow LiftLip FlipGummy Smile CorrectionMasseter ReductionJaw SlimmingDimpled Chin SmoothingCobblestone Chin SmoothingNefertiti Neck LiftMicro-BotoxMesotoxHyperhidrosis TreatmentChronic Migraine ReliefBruxism TreatmentTMJ TreatmentCervical Dystonia TreatmentNeck Spasm TreatmentBlepharospasm TreatmentLip AugmentationLip ContouringCheekbone EnhancementTear Trough FillersNasolabial Fold SofteningMarionette Line FillersLiquid RhinoplastyNon-Surgical Nose JobJawline ContouringJawline DefinitionChin AugmentationTemple VolumisingHand RejuvenationAcne Scar Subcision Filling treatment for in men. Whilst its licensed for use as an oral tablet, it is also increasingly used in topical treatments that you apply to the scalp. This guide explains how finasteride works and who it is suitable for. We review the key differences between the oral and topical forms, what results to expect and explore its side . Discover the latest regulatory updates and how to get it in the UK for hair loss.

What is Finasteride?

Finasteride is a 5-alpha-reductase inhibitor. It was first as a 5mg tablet (Proscar) to treat enlarged prostates. Later, in 1997, Finasteride 1mg (as Propecia) tablets got . It is one of only a handful of hair loss treatments with decades of strong evidence behind it.

The way finasteride works is by blocking 5-alpha-reductase. This is the enzyme that converts testosterone into dihydrotestosterone (). DHT is the main hormone behind genetic hair loss. In people who are susceptible to it, DHT binds to receptors in the scalp’s hair follicles and gradually shrinks them. Each then produces a finer, shorter and weaker hair, until the eventually stops producing visible hair at all. This process is and it is what drives the receding hairline and thinning crown. By lowering DHT, finasteride slows this miniaturisation, which is why it is one of the most effective we have. At the standard 1mg dose, oral finasteride reduces DHT in the scalp by .

What Does Finasteride Treat?

The way finasteride works is critical for understanding what it can and cannot do. Finasteride is only useful for reducing DHT level as this is what drives androgen-related hair loss. This means that protects more than it restores. Its main job is to stop further loss, with regrowth a welcome bonus rather than a guarantee. also only works whilst you use it. This is because DHT climbs back once treatment stops and the original pattern of loss returns over the following 6 to 12 months. As such, finasteride is a long-term treatment rather than a quick fix. Based on available evidence, the main uses of finasteride for hair loss are:

At City Skin Clinic, we use topical finasteride sometimes compounded with other actives where appropriate as part of our and in occasionally .

What’s the Difference Between Oral vs Topical Finasteride?

Both forms block the same enzyme and treat the same problem. The difference is that drug delivery affects how much of it ends up circulating around the rest of the body. This is crucial as it determines effectiveness and side effect profile. The main forms of finasteride are:

Is Finasteride Available in the UK?

This is an important question, and the answer depends on the form. There are three different ways you can prescribe finasteride in the UK for hair loss:

These three terms cause a lot of confusion, so it is worth being clear about them. A licensed medicine is one a regulator has formally approved for a use. An medicine is a licensed used outside its approved terms. An unlicensed medicine is one made to order for each individual patient without a product licence. This is how compound treatments work. All three are legal and routine in UK medicine. We explain this in more detail in our guide to .

What Doses & Concentrations of Finasteride are Typically Available for Hair Loss?

Dosing depends on the form as well as whether its use is licensed or otherwise. For oral finasteride, the licensed dose for hair loss is 1mg once daily. This is the dose you find across the major trials and the one with the longest track record. However, there is also growing interest in which means taking doses below 1mg. The reason this is plausible is that finasteride’s effect on DHT is logarithmic rather than linear. In other words, most of the DHT suppression happens at very low doses, with only small gains as the dose rises. A landmark dose-ranging study showed scalp DHT was already reduced by around 62% at 0.05mg compared with 64% at the standard 1mg. Some doctors may prescribe finasteride on a patient by patient basis.

For topical finasteride, the most studied concentration in trials is 0.25% but there is no licensed strength and is becoming more common. Much lower concentrations are also increasingly in use to keep absorption to a minimum and attempt to reduce risk of side effects. How often you apply it also matters as much as the strength. Many clinics, including City Skin Clinic, compound topical across a range of concentrations typically from 0.001% up to 0.25% depending on each needs individual. It is also possible to combine it with , , or in a single formula. In practice, the concentration and frequency require a balance between optimising the effect on the scalp and reducing systemic exposure.

What Results Can You Expect from Finasteride?

Finasteride is one of the most reliable hair loss treatments available. That said, expectations are where much of the disappointment comes from, so it is important to keep the in mind:

Does Finasteride Work on a Receding Hairline?

This is one of the most common questions about finasteride and the honest answer has some nuance. Finasteride works best at the crown and mid-scalp. The frontal hairline and the temples are harder. The Propecia licence itself states that its effect on the temples is still in question. A bears this out, finding the vertex improved in around 90% of men but the frontal in closer to 44%.

This does not mean finasteride does nothing for the hairline. By lowering DHT across the whole scalp, it still helps defend the frontal region. It is most useful for a caught early, before those follicles have miniaturised away completely. The realistic goal at the hairline is to hold the line and what is already there.

There are a couple of practical points that may also help navigate this. The first is that this is exactly why you often combine finasteride with and . These work through different mechanisms and can help where DHT suppression alone is not enough, particularly at the front. The second is that it is worth knowing the difference between a receding hairline and a . A maturing hairline is a normal part of getting older rather than a sign of pattern hair loss.

Is Finasteride Safe?

Finasteride is effective and for the most part safe. However, there are some serious potential risks that are, rightfully so, getting a lot of attention and . The most side effects are due to systemic absorption and how much DHT suppression it causes across the whole body. If finasteride significantly lowers DHT systemically, then it can lead to a wide range of side effects including:

These side effects can occur with any form of finasteride. In theory, however, they are less likely with the topical form, because far less of the drug reaches the bloodstream. Topical finasteride also carries possible local side effects on the area where you apply it. These include scalp irritation, itching and dryness. They are usually mild and tend to settle as the skin adjusts. Side effects usually settle once treatment stops. In a small number of men, though, sexual, psychological and physical symptoms continue long after stopping, a controversial and still poorly understood condition known as .

UK regulators have strengthened their warnings on finasteride in recent years. a safety review in 2024, the MHRA introduced a patient alert card in every finasteride pack. A provided confirmation that finasteride is can cause depression, suicidal ideation and sexual dysfunction that may persist after treatment stops. Anyone taking finasteride who develops depression or suicidal thoughts should stop it and contact a healthcare professional as soon as possible. Always raise any side effects (sexual or otherwise) immediately with your prescriber. This is one of the reasons finasteride is a prescription only medicine that requires monitoring.

What Other Treatments Work Best with Finasteride?

Finasteride tackles the hormone that drives pattern hair loss, but it does not stimulate growth directly. This is why it is so often combined with treatments that work in other ways, so their benefits add up rather than overlap. The actives most often combined with finasteride are:

Because the benefits of finasteride depend on continued use, stopping means the loss will gradually return over 6 to 12 months. If you are considering it, make it an informed decision and discuss it with your clinician first. Our posts on what to do after and cover best options.

Who Can and Cannot Use Finasteride?

Finasteride suits many adults with hair loss, but it is not right for everyone. People who whould avoid or exercise caution when it comes to using finasteride include:

Before starting any treatment, it is worth confirming the cause of your hair loss. Finasteride does for shedding driven by , thyroid problems or a , all of which need treating in their own right.

How to Get Finasteride in the UK

The licensed tablet is a private prescription only and is not available on the NHS. Topical finasteride, being unlicensed, is offered by clinics that compounded prescription treatments. our reviews of how to access including if appropriate in the UK.

At City Skin Clinic, we believe hair loss treatment should be personal. We provide compounded hair loss treatments containing topical and other actives where appropriate. After an online consultation one of our doctors will design a bespoke treatment plan for you. Read more about our and service. with one of our doctors today and take the first step towards regrowing your hair.

This article is for general information and does not constitute medical advice. Finasteride is a prescription-only medicine and should be used only under the supervision of a qualified prescriber. Always read the patient information leaflet and report any suspected side effects to the MHRA via the Yellow Card scheme.

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