Minoxidil vs finasteride in 2026: a London prescriber's guide
The two most-prescribed hair loss medications. Different mechanisms, different side effect profiles, often used together. Here is the 2026 evidence-based comparison.
Dr. Amara Okafor
Consultant Trichologist · Harley Street
In short
- Minoxidil prolongs the anagen growth phase; finasteride blocks DHT at the follicle.
- Combined therapy outperforms either alone in 12-month density studies.
- Topical finasteride is the fastest-growing London prescription for under-35s.
- Oral minoxidil low-dose (1.25–2.5mg) is replacing topical for many patients.
If you have done any research on hair loss treatment in the last decade, you have hit these two names. The mechanisms are different. The evidence is strong for both. The right answer is often: both.
Minoxidil: what we know in 2026
Topical 5% twice daily remains the licensed standard. Low-dose oral minoxidil (1.25–2.5mg daily, off-label) has overtaken topical in many London clinics for compliance, scalp tolerance and superior density at 12 months. Side effects: facial hypertrichosis, ankle oedema, postural lightheadedness — manageable with dose titration.
Finasteride: what we know in 2026
Oral 1mg daily slows or halts androgenetic alopecia in ~83% of men over 12 months. Topical formulations (0.25%) deliver comparable scalp efficacy with substantially lower serum levels, addressing the libido and mood concerns that drove some users off oral.
Combining the two
Combination therapy (oral or topical finasteride + topical or low-dose oral minoxidil) is the London standard of care for moderate androgenetic alopecia. Expect £35–£90 monthly through a registered private prescriber.
Frequently asked
Common questions
Can women take finasteride?+
Post-menopausal women can take finasteride under specialist supervision. Pre-menopausal women cannot due to teratogenic risk; spironolactone is the alternative.
How long until I see results?+
Reduced shedding by month 3. Visible regrowth by month 6. Maximum result at month 12–18.
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