If you’ve spent more than five minutes searching for treatments for male pattern baldness, more commonly known as androgenetic alopecia, there are probably three words you’ve constantly heard: Minoxidil, Finasteride and Dutasteride. These three have now commonly become the ‘big three’ when talking about the medicinal hair loss treatment used to stop the loss of the hair that you still possess.
However, beneath the overwhelming forum jargon and social media trends, there often seems to be a mass general confusion regarding:
* What each respective drug actually works to do to your scalp.
* Which treatment will work best, not only for you individually, but for the possibility that it could even be a combination of multiple treatments as well?
* What is actually the real difference between the respective side effect profile of each drug?
Here at Evolved Hair Restoration we practice clinical pharmacology, no guesswork is applied, we have been sure since we were established to ensure there is absolute certainty regarding each particular treatments used at the Evolved Hair Restoration clinics. This honest, clinical and evidence based account lays out the real differences between each of these 3 drugs, up to date with 2026 standards.
The Underlying Difference: The Growth Stimulator vs. The Hormone Inhibitor
The one fundamental, and single BIGGEST,difference which is crucial to understand between the drug Minoxidil, and Dutasteride/Finasteride; is that Minoxidil’s one target is to promote growth whereas Finasteride/Dutasteride actually prevent hair loss by inhibiting a specific hormone on the scalp and thereby stopping hair loss before it can even have the potential to miniaturize any further miniaturized hairs.
Minoxidil (The Growth Stimulator)
Minoxidil is a potassium channel opener and it essentially expands local blood supply, thereby increasing a patients supply of growth factors- VEGF; all that are important factors of growth stimulation. The drug is also believed to “awaken” dormant (telogen) hairs and encourage them to return to an active, growing phase (anagen). It achieves this mainly via improving the thickness and growing pace of already miniaturized hairs and the important characteristic of Minoxidil is that is has absolved absolutely NO effect on the hormone driving this miniaturization process, DHT. Because of this, Minoxidil hair will still continue to be miniaturized further down at the follicle level; as these hair follicles will not be aware that it is in fact DHT that drives their own regression!
Finasteride (The Targeted Shield)
Finasteride is what would be described as a type 2, 5 alpha- reductase inhibitor and blocks the conversion process by the 5 alpha- reductase enzyme of testosterone to more potent testosterone called dehydrotestosterone or DHT. DHT specifically influences male pattern hair loss causing the hair follicles to reduce their growth potential, and therefore to miniaturize with use over time. Generally using Finasteride at a standard prescription of 1mg/day reduces circulatingDHTlevels in men by approximately 70%, and there have been numerous studies performed showing that over 85% of the study patients either maintained their level of hair loss or did not experience any hair loss at all, with a majority seeing regrowth.
Dutasteride (The Double Inhibitor)
So what separates Dutasteride from Finasteride? Both are in the same classification of drug, however, Dutasteride achieves almost double the reduction of hair follicle destroying hormone DHT on your scalp compared to Finasteride. Dutasteride has this superior result by simultaneously acting as a type 1 AND a type 2, 5- alpha reductase inhibitor meaning that less, not more, androgenetic alopecia will be able to have any detrimental affect to your scalp health, and this drug is typically now the prescribed option to most patients, especially for male pattern baldness which is very aggressive.
Oral vs. Topical Delivery: The Modern Approach to Medicinal Treatments
Over the past two years we’ve seen an undeniable movement in medication delivery of not only Minoxidil but also its DHT-inhibiting counterparts:
The Introduction of Low-Dose Oral Minoxidil (LDOM)
It’s common that men often neglect taking treatments consistently due to the general hassle they may present-the slick, oily feel of a topical treatment on the scalp can be an unpleasant and undesirable daily chore-well LDOM aims to put a stop to this. LDOM, usually within the doses of 1.25mg to 5mg/day is given out by doctors with approval, is prescribed after assessing men with health conditions, but has in numerous clinical trials proven just as effective as topical Minoxidil. It improves patient adherence as it is quick and easy to take and may sometimes be slightly more effective than its topical counterpart.
Topical Finasteride & Dutasteride
Many men are hesitant about potential hormonal side effects associated with oral formulations of both Finasteride and Dutasteride, and although with the appropriate medication, and doctor supervision, side effects should be a minimised concern to users, it does allow for some peace of mind to opt for the alternative: topical Finasteride/Dutasteride. It is given in a gel-like format directly applied onto the skin around the hair follicle with minimal absorption throughout the rest of the body meaning it only targets what it needs too. The local application is more patient dependent and can produce great results in patients who opt out of traditional pills and who also want to experience both increased rate of growth as well as increased strength with its reduction of the miniaturization causing hormone DHT at the local skin level.
Safety & Side-Effect Profiles of each medication:
Naturally every drug prescription has potential side effects. Here’s what to keep in mind:
Minoxidil: When applied topically, irritation/ dryness can occur to your scalp. During treatments, you will usually experience what’s called a telogen shed (i.e. Old / diseased hair pushed out, therefore making new, healthier and more potent hairs grow) after 4-8 weeks in this process.
Any reported potential side effects with the oral route usually relate to higher dosages of oral minoxidil and are typically to fluid retention.
This can sometimes make one feel lightheaded and there may be unwanted hair growth in areas which are undesired as well (hypertrichosis).
Finasteride: Common side effects reported in 1.5-3% of users are sexual with diminished libido and, or erectile dysfunction, again if these do arise, this can easily be circumvented by stopping treatment, or halving the prescription dose.
Dutasteride: It has a similar side-effect profile as Finasteride however its half-lifeis substantially larger, at up to 4-5 weeks compared to Finasteride’s meager 6-8 hours, and as such side-effects, although few and far between, tend to linger longer in some men taking the pill form.
The “Right” Option For YOU?
To be completely frank-there isn’t one. The only proven, scientifically effective means of controlling hair loss will virtually always involve combination therapies, that is, using Minoxidil as well as both oral or topical Finasteride or Dutasteride depending on preference. At the Evolved Hair Restoration centers in either Perth, or Brisbane, all of our specialist hair loss doctors/hair transplant surgeons aim to tailor each prescription to your exact individual need and also taking into account family history/ lifestyle factors of every client.
Want to find out which modern, sophisticated, medical intervention will benefit you?
Just talk to our team at Evolved hair Restoration today.