If you’re looking into finasteride as a treatment for hair loss, you’ll quickly discover that it comes in two main forms: a daily tablet and a spray applied directly to the scalp. In scientific research, you’ll usually see these referred to as oral finasteride and topical finasteride, but we’ve referred to them as ‘spray’ and ‘tablet’ to keep things easy.
What you’ll learn
Ø How finasteride works as a hair loss treatment
Ø The key differences between the spray and tablet
Ø How their effectiveness compares
Ø How their side effects differ
What is Finasteride?
Finasteride is a 5a-reductase inhibitor, meaning it blocks the enzyme which converts testosterone into another hormone: dihydrotestosterone (DHT). By stopping this conversion from happening, Finasteride effectively brings levels of DHT down. Reducing DHT levels is key in stopping the progression of male pattern baldness, as DHT binds to hair follicles and causes them to gradually stop producing new hairs.
What is the difference between the formulations?
How you take them
Finasteride tablets are swallowed once daily whereas the spray is a liquid which is sprayed directly on to the scalp once a day.
How they are absorbed
The spray is absorbed directly by the scalp and targets the hair follicles locally, whereas the tablets are absorbed ‘systemically’ (into the bloodstream).
Licensing
Finasteride 1mg tablets have been officially approved by the MHRA for treating male pattern baldness since 1997. In contrast, finasteride sprays aren’t licensed, even though they use the same active ingredient. They can still be prescribed, but this is done off-label, which simply means a medicine is used outside the exact terms of its licence. It’s a common and accepted part of medical practice. For example, if a blood pressure medication is licensed for people aged 45–60, a doctor could still prescribe it to a 61 year old if it’s appropriate for them.
Tablet vs Spray: which is more effective?
Finasteride tablets and finasteride spray are thought to be equally effective at treating hair loss, according to comparative studies.
In a large 2021 study, both oral and topical finasteride boosted hair count much more than a placebo. The results were very similar between the tablet and the spray, and many men started to see improvements by around 12 weeks.
The study also showed that topical finasteride leads to less finasteride entering the bloodstream. Finasteride levels were more than 100 times lower in the men using the spray than those taking the tablet. Because of that, the spray caused a smaller drop in blood DHT levels (about 34.5%) compared with the tablet (about 55.6%)
Another study looking at a 1% topical finasteride gel found that both the gel and the tablet increased hair count after six months, with no major difference in results between them.
Side Effects
The most commonly reported side effects of finasteride tablets are sexual in nature, such as reduced libido or difficulty maintaining an erection. These effects may be related to lowered DHT levels in the bloodstream, although the scientific community has not reached a definitive conclusion. If you’d like to explore the evidence in more detail, we have a dedicated blog article that looks specifically at finasteride tablets and sexual performance.
As finasteride spray affects blood DHT levels less, the risk of sexual side effects appears to be lower. Side effects with the spray tend to be mild and localized to the scalp, such as itching, irritation, burning, dryness, flaking, or occasional contact dermatitis.
Choosing between the two
Both treatments can be effective at stopping hair loss and promoting regrowth, so your decision will likely come down to your personal goals and preferences.
If you want long-term data, a licensed product, and a convenient once-daily pill: finasteride tablets may be the right choice.
If you’re concerned about side effects, finasteride spray offers similar efficacy with significantly less systemic absorption which potentially reduces the risk of side effects.
If you’re still not sure what the best fit is for you, you can take our free consultation which offers personalised recommendations. Your consultation is always reviewed by a prescriber at our partner pharmacy.
All of our blog articles are reviewed by our Medical Director before publication.
