Can You Take Finasteride With Minoxidil For Hair Loss?

Both finasteride and minoxidil are among the most common medications used in the treatment of hair loss, especially one that’s caused by androgenic alopecia. While both drugs are effective when it comes to aiding hair growth and preventing its loss, combining both medications is common practice for patients suffering from androgenic alopecia.

In this article we explain how the medications can help with your hair loss and why they might be useful when taken together.

Hair Growth cycle

Hairs are lost on a daily basis secondary to the hair growth cycle. Thus, it’s normal to lose strands of hairs each time you wash or even brush your hair. Aside from the regular shedding of hairs, there are different factors that can cause hair loss. Some of these factors include various lifestyle factors such as diet restrictions, maturing or ageing of the hair and hormonal changes.

The human hair is generally made up of two separate structures: the hair shaft and the hair follicle. The hair shaft is the visible part above the skin, while the hair follicle lies beneath the skin or scalp. The follicles are the main structure from which our hair grows.

On a typical basis, the development of the human hair follicles is cyclical. It happens in three phases, in particular: the anagen (growth) stage, the catagen (transition) stage, and the telogen (rest) stage.

• The anagen stage is where the hair follicles effectively develop hair strands. It goes on for about 3 to 5 years. In this stage the hair follicle continues to grow for up to 3-5 years.
• After the anagen or development stage, hair follicles proceed to the transition stage. This stage is know as the catagen phase. It is short-lived, and only lasts for around 2 to 3 weeks. During this stage, hair follicles start to shrink, and hair growth begins to slow down. In reality, hair strands actually separate from the lower part of the follicle, but they still remain attached to the scalp.
• In the last phase of the hair follicle cycle, the telogen or resting stage, hairs stay in a resting period for as long as 90 days. It is thought that around 10-15% of all hairs on the body are in a resting stage. It is at this stage that the hair sheds before the hair follicle grows a new hair again.

What is finasteride and minoxidil?

Finasteride is a drug that suppresses the activity of the 5-alpha reductase enzyme, which converts testosterone to dihydrotestosterone. Thus, it is used to treat conditions that are caused by high DHT levels, such as the most common form of hair loss, androgenic alopecia or male pattern baldness. Finasteride is also known by its brand name Propecia.

On the other hand, minoxidil’s discovery against hair loss was actually accidental. In the late 1950, the UpJohn pharmaceutical company researched potential treatments for ulcers. Unfortunately, their drug didn’t cure ulcer. But the most surprising part of their research was an unexpected hair growth that was seen in its trial patients. This led to series of further studies, after which minoxidil became officially approved for improved hair growth. Today, minoxidil is sold under the brand name, Regaine.

How does finasteride work?

Finasteride works to improve hair growth and prevent hair loss by inhibiting the activity of the 5-alpha reductase enzyme, which is responsible for converting testosterone to dihydrotestosterone (DHT). DHT has been shown to shrink the follicles, and cause them to lose their ability to produce new hair strands (miniaturisation) eventually causing hair loss.

Finasteride acts on the 5-alpha reductase enzyme to prevent the production of DHT. As a result the hair is not subject to the ongoing effect of DHT so hair becomes thicker and grows longer in the anagen phase of its growth cycle.

How does minoxidil work?

Unlike finasteride, which suppresses the conversion of testosterone into the DHT that can harm the follicles, minoxidil works directly on the hair follicles to stimulate local hair growth. Research-based findings have shown that minoxidil can shorten the telogen or resting cycle of the hair. When this occurs, hair follicles maintain their growing phase of the hair cycle. Minoxidil has been shown to shorten the resting stage of the hair cycle thereby preventing hair shedding too. Due to its effect in promoting more hair follicles to stay in the anagen phase and out of the telogen (resting) phase, taking minoxidil can result in a healthier hair growth.

Can you take finasteride along with minoxidil?

Finasteride and minoxidil can be taken at the same time. This is what doctors often refer to as a combination therapy, as it involves using more than one treatment to fight a particular problem.

As hair loss drugs, both finasteride and minoxidil work through different mechanisms. While one focuses on fighting the hormonal root cause of your hair loss, the other looks to directly stimulate your hair follicles and positively affect its cycle.

• By taking finasteride, you allow your body the ability to suppress the production of DHT, which can adversely impact hair growth by shrinking the hair follicles.
• By using minoxidil, you stimulate the hair growth by having less hairs follicles in the resting phase and more in the growth phase.

There is some scientific evidence exploring combination therapy. In 2015, a study was published in the Dermatologic Therapy Journal, where the effect of combined treatment with finasteride and minoxidil was checked in males patients suffering with androgenic alopecia.

• 428 men with androgenic alopecia were enrolled for the study, out of which 154 were give finasteride, 122 minoxidil, and 152 combined medication that included both drugs. At the end of the experiment:
• 80.5% of those given finasteride showed improvement in hair growth.
• 59% of those given minoxidil also showed improvement in hair growth.
• 94.1% of those given a combination therapy that included both finasteride and minoxidil showed hair growth improvement.
• The study further concluded that adverse reactions to the treatment were rare, and can go away immediately after halting drug intake

How much should you consume?

Generally, your doctor should be in the best position to prescribe a dosage for you based on your existing health conditions and nature of your hair loss. Typically, 1 ml of liquid solution minoxidil is applied to the scalp two times daily; in the morning and at night time. For finasteride, 1 mg twice a week or 3 times a week can be the ideal dosage.

Summary

Finasteride and minoxidil are both effective treatments when it comes to improving hair growth and preventing hair loss. Evidence has suggested that using both Finasteride and Minoxidil in combination can improve hair growth in 94% of men.

References

1. https://www.ncbi.nlm.nih.gov/books/NBK499948
2. https://www.ncbi.nlm.nih.gov/books/NBK513329/
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472916
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691938/
5. https://onlinelibrary.wiley.com/doi/abs/10.1111/dth.12246