Finasteride tablets have long been a cornerstone of treatment for male pattern baldness, backed by decades of clinical evidence and real-world use. But interest in an alternative has emerged in recent years: Finasteride Spray. The same active ingredient is reformulated into a liquid which can be sprayed directly onto the scalp and works locally on the hair follicles. This may offer a alternative to tablets with similar benefits and fewer systemic effects.
Learn more about how the spray compares to the tablet in efficacy, side effects, and other considerations below.
What You’ll Learn
Ø How finasteride works
Ø What’s the difference between the spray and tablets?
Ø How effective finasteride spray is compared to the tablets
Ø How side effects differ
How does finasteride work?
Finasteride prevents hair loss by stopping the conversion of testosterone into another hormone called dihydrotestosterone (DHT). Some men are genetically sensitive to DHT, which binds to hair follicles and causes them to gradually shrink. Over time, the shrunken hair follicle produces thinner and weaker hairs, until eventually they stop growing new hair at all.
By blocking the enzyme which turns testosterone into DHT, 5α -reductase, finasteride lowers DHT levels and protects the hair follicles from damage.
Finasteride has been prescribed as a 1mg tablet for male pattern baldness since 1997 – it is one of only two medications approved by the MHRA for treating this condition, alongside Minoxidil Spray. In clinical studies, it has been shown to stop hair loss in 90% of men. When used with Minoxidil Spray, the effectiveness goes up to 94%.
What is the difference between finasteride spray and tablets?
How it is applied: The spray is applied once a day, directly to the scalp. The tablets are swallowed once daily, with or without food.
Impact on DHT levels: Instead of being absorbed ‘systemically’ (entering the bloodstream and circulating around the whole body), the spray works locally on the hair follicles. This means it has less of an impact on overall DHT levels. A study found that DHT levels were 34.6% lower in men using Finasteride Spray compared to 55.6% lower in men using finasteride 1mg tablets after 24 weeks of treatment.
Licensing: Topical Finasteride in the UK and Ireland is currently an unlicensed preparation of the active ingredient. It can be prescribed off-label by pharmacists, which is a common medical practice which involves prescribing to patients outside of the particular terms of its license.
How effective is finasteride spray compared to finasteride tablets?
Finasteride tablets have been the licensed first line treatment for male pattern hair loss for decades, meaning they have plenty of studies and real-world evidence to back up how well they work at stopping hair loss and promoting regrowth.
Across all seven studies in this review, it helped slow down hair loss and boosted the number of hairs growing back, especially the thicker, terminal ones, while consistently giving people better looking hair overall. It also lowered DHT levels in both the scalp and bloodstream but didn’t change testosterone levels, which suggests it may come with fewer whole‑body side effects than the tablet version. Overall, the research shows topical finasteride works well, is generally well‑tolerated, and could be a great option for people who want effective treatment with potentially fewer risks.
How do side effects differ?
Some men hesitate to try finasteride tablets because they’re concerned about potential side effects. Finasteride Tablets can rarely cause sexual side effects such as erectile dysfunction, loss of libido and decreased semen volume, which clinical trials have reported occur in approximately 2% of users.
Using a Finasteride Spray is thought to reduce the risk of side effects, as it reduces DHT directly at the scalp, rather than throughout the whole body. Side effects with the spray tend to be mild and localized to the scalp: itching, irritation, and occasionally contact dermatitis being the most common.
If the risk of side effects with the finasteride tablet concerns you, or you have experienced them in the past, finasteride spray may bring the same benefits with a lower risk.
If you’re not sure which option is best for you, you can take our free consultation which takes your preferences, stage of hair loss and medical history into consideration to offer personalized recommendations.
All of our blog articles are reviewed by our Medical Director before publication.
