Is finasteride effective for topical use?

‍What is topical finasteride?

Topical finasteride is a variant of the drug finasteride that you apply directly to the scalp, usually in the form of a lotion or spray. Instead of a 1mg daily oral tablet, topical finasteride works via a spray that is applied directly to the scalp.

The action targets the enzyme 5α-reductase in the scalp. This enzyme converts testosterone into DHT (dihydrotestosterone), a hormone that can shrink hair follicles and prevent hair growth. By inhibiting it locally, DHT production in the scalp is reduced and less finasteride may move to the rest of the body.

What is the difference between oral and topical finasteride?

The main difference lies in the method of administration and the area in which the drug works. Oral finasteride is taken via a tablet and spreads through the bloodstream throughout the body. Topical finasteride is applied locally to the scalp, so it is mainly active there.

Research shows that topical finasteride works almost as well against hair loss. However, this same study shows that the rare side effects of finasteride are even less likely to occur with topical finasteride. However, other side effects such as irritated or dry scalp may occur.

Currently, topical finasteride is not approved for the treatment of hair loss by the Dutch MEB and the European EMA. As a result, there are no over-the-counter topical finasteride sprays available in the Netherlands.

What are the disadvantages of finasteride?

Rare side effects such as loss of libido, erection problems and mood changes are reported, especially with the oral variant. The complaints occur in < 1% of the users and are comparable to the placebo group, according to this study. This means that 1% of people who do not use finasteride also experience loss of libido or mood problems, as a result of the prevalence of these complaints.

However, it is good to be aware of the possibility of these possible side effects. These complaints are often the reason that men are reluctant to use finasteride. Recent studies show that topical finasteride in many cases has a more favorable side effect profile, because it enters the bloodstream less often. This means that the effect on, for example, your libido may be smaller.

Is topical finasteride available in the Netherlands?

Topical finasteride is not (yet) available at pharmacies as standard in the Netherlands. This is because topical finasteride has not been approved for the treatment of hair loss by the Dutch MEB and the European EMA. Note: you can sometimes also order it via foreign web shops, but here the composition has not always been checked and the quality may differ. Therefore, always use a reliable source via a BIG-registered doctor and pharmacy. Fellos is also currently developing topical finasteride.

Which works better: oral or topical finasteride?

There is increasing evidence that topical finasteride may be almost as effective as the oral variant. A number of meta-analyses and clinical studies from the period 2021-2024 shows that hair growth when used topically provides similar results, while the risk of systemic side effects appears to be lower. Nevertheless, everyone reacts differently. What works well for one person may have less effect for another. In addition, many men opt for oral finasteride because of the low risk of side effects and the ease of applying the treatment consistently with 1 daily tablet. In addition, topical finasteride can cause dry and irritated scalp.

Does Fellos offer topical finasteride?

At Fellos, we offer reliable and clinically proven treatments for hair loss. Currently, we are focusing on oral finasteride, combined with personalized medical advice and a discreet home delivery process. Are you interested in topical finasteride? Let us know via an intake. Our doctor will discuss the best treatment options with you, tailored to your situation. We may also be able to offer topical finasteride soon.