Hair Loss Medications Compared: The Two Evidence-Based Prescription Options for Australian Men
If you have spent any time researching male pattern hair loss, you have almost certainly come across two names: finasteride and minoxidil. They are the two most studied treatments for androgenetic alopecia in men, with decades of clinical evidence behind them. But they are not the same thing. They work differently, suit different people, and come with different considerations.
The volume of information online can make it difficult to sort through what actually matters. Some of it is marketing. Some of it is anecdotal. What tends to get lost is a straightforward comparison grounded in what the clinical evidence actually shows.
That is what this guide sets out to do. We will walk through how each treatment works, what the research says about effectiveness and side effects, and what factors might influence which option is right for you.
The goal is not to tell you what to take. It is to help you have a more informed conversation with your GP, because this is ultimately a clinical decision that should be made with a doctor who understands your health history.
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These two treatments target hair loss through different mechanisms. Understanding that difference matters, because it affects how each one is used, what results to expect, and why some men benefit from using both.
Minoxidil: A Topical Growth Stimulant
Minoxidil is a topical treatment applied directly to the scalp as a liquid or foam once or twice daily. Originally developed as an oral medication for high blood pressure, its hair growth properties were discovered as a side effect. It is classified as a Schedule 5 (pharmacy) medicine in Australia, meaning you can purchase it without a prescription.
Minoxidil works as a vasodilator. It increases blood flow to the hair follicles and is believed to prolong the anagen (active growth) phase of the hair cycle. This can lead to thicker, longer-lasting hair in areas where follicles are miniaturising but have not yet died.
It does not address the underlying hormonal cause of androgenetic alopecia. Instead, it supports the follicles that remain active, encouraging them to produce stronger hairs for longer. Its effects are localised to the area where it is applied, and it needs to be used consistently to maintain results.
Finasteride: A Hormonal Blocker
Finasteride is an oral prescription medication, classified as Schedule 4 in Australia, meaning it must be prescribed by a registered medical practitioner. It was originally developed for benign prostatic hyperplasia (enlarged prostate) at higher doses, and a lower dose was subsequently approved for male pattern hair loss.
Finasteride works by inhibiting the enzyme 5-alpha reductase, which converts testosterone into dihydrotestosterone (DHT). DHT is the primary androgen involved in miniaturisation of hair follicles in men with a genetic predisposition to pattern baldness.
By reducing DHT levels by approximately 60 to 70 percent, finasteride slows or halts the process that causes follicles to shrink and eventually stop producing visible hair.
Because finasteride addresses the hormonal driver of hair loss rather than stimulating growth directly, it is particularly effective at preventing further loss. Like minoxidil, its benefits are maintained only while the medication is being taken.
Both finasteride and minoxidil have substantial clinical evidence behind them. They are among the most thoroughly studied treatments in dermatology, and the body of research stretches back decades.
Minoxidil
A Cochrane systematic review examining the efficacy of topical minoxidil for androgenetic alopecia found that minoxidil was significantly more effective than placebo in promoting hair regrowth.
Studies consistently show that approximately 40 to 60 percent of men using minoxidil experience some degree of regrowth, with the majority experiencing at least a slowing of hair loss. The 5 percent concentration has been shown to be more effective than the 2 percent formulation for men.
Results typically begin to become visible after three to six months of consistent daily use. The initial response often includes a temporary shedding phase in the first few weeks, which can be discouraging but is generally considered a sign that the treatment is taking effect as follicles transition into a new growth cycle.
For most men, minoxidil is effective at maintaining existing hair and producing moderate regrowth, particularly in the crown area. It tends to be less effective at regrowing hair along a receding hairline.
Finasteride
The landmark clinical trial published in the Journal of the American Academy of Dermatology by Kaufman and colleagues followed men taking finasteride over a five-year period. The results were significant: 90 percent of men taking finasteride maintained or increased their hair count, compared with a continued decline in the placebo group. Approximately two-thirds of participants experienced measurable regrowth.
A separate study published in the New England Journal of Medicine confirmed that finasteride at 1 mg daily significantly increased hair count compared to placebo over a two-year period. These findings have been replicated across multiple trials and are consistent with guidelines from the American Academy of Dermatology and the Australasian College of Dermatologists.
Combination Therapy
Clinical evidence suggests that using finasteride and minoxidil together may produce better results than either treatment alone. A study published in Dermatologic Therapy found that combination therapy led to greater improvements in hair density than monotherapy.
This makes sense given the different mechanisms — one reducing the hormonal cause of follicle miniaturisation, the other directly stimulating follicle activity. Your GP can advise whether combination therapy is appropriate based on your stage of hair loss and overall health profile.
The Timeline
Both treatments require patience. Clinical trials consistently show that a minimum of three to six months is needed before visible changes occur, and the full benefit may not be apparent for 12 months or more. Consistency matters, and early discontinuation is one of the most common reasons men do not see results.
All medications carry the possibility of side effects. Being informed about what to expect allows you to weigh the benefits against the risks alongside your GP.
Minoxidil Side Effects
Minoxidil is generally well tolerated. The most commonly reported side effects are localised to the scalp: dryness, irritation, itching, and flaking. These are often related to the alcohol or propylene glycol base in liquid formulations and may improve with a switch to the foam version.
Some men experience unwanted hair growth on the face or body, particularly if the solution contacts skin beyond the scalp. Careful application and handwashing after use can minimise this.
The initial shedding phase, while temporary, can be concerning but typically resolves within four to eight weeks. More serious side effects such as dizziness or changes in heart rate are rare with topical application but have been reported.
Finasteride Side Effects
Finasteride's side effect profile receives considerable attention, and it is worth addressing directly. Clinical trials report that a small percentage of men — typically 2 to 4 percent — experience sexual side effects including reduced libido, difficulty achieving or maintaining an erection, and decreased ejaculate volume. In the majority of cases, these resolved either during continued use or after discontinuation.
A small number of men have also reported mood changes, including low mood and anxiety. These are uncommon, but should be discussed with your GP, particularly if you have a history of mood-related concerns.
The concept of "post-finasteride syndrome" — the idea that sexual and neurological side effects persist long after stopping the medication — has been raised in online communities and some case reports. This remains a subject of ongoing research.
Large-scale controlled studies have not established a clear causal mechanism, and regulatory bodies including the TGA continue to consider finasteride safe for its approved uses. At the same time, the reported experiences of individuals who describe persistent effects deserve to be taken seriously, and your GP is best placed to discuss your personal risk profile.
Both Require Ongoing Use
One consideration common to both treatments is that their effects are maintained only for as long as they are used. If you stop, hair loss will typically resume and any regrowth gained during treatment may be lost over the following months. This reflects the progressive nature of androgenetic alopecia rather than a failure of the treatment itself.
There is no single correct answer to this question, because it depends on factors that are specific to you.
The type and stage of your hair loss matters. Finasteride tends to be most effective for men with early to moderate hair loss, particularly when the goal is to prevent further thinning.
Minoxidil can be helpful at various stages and is often preferred by men who want to try a topical, non-prescription option first. For men with more advanced loss, combination therapy may offer the strongest evidence base.
Your broader health profile also plays a role. Finasteride is a systemic medication that affects hormone levels, so your GP will consider your overall health and medical history before prescribing it. Minoxidil, as a topical OTC product, has fewer systemic interactions, though it still warrants a conversation with your doctor if you have cardiovascular concerns.
Personal preferences matter too. Some men prefer the simplicity of a daily tablet. Others prefer a topical routine and would rather avoid oral medication. Neither preference is wrong.
The most important step is to discuss your options with a GP who can assess your hair loss pattern, review your health history, and recommend a treatment plan that is tailored to your circumstances. Hair loss is a medical condition with evidence-based treatments, and there is no reason to navigate it alone.
Ready to start treatment?
Having a conversation about hair loss can feel uncomfortable, especially if you are not sure where to start. That is exactly the kind of consultation Abby Health was built for.
Through Abby Health, you can book a telehealth appointment with an experienced GP from your phone or computer. There are no waiting rooms and no need to explain your reason for visiting to anyone at a front desk.
Your GP can assess your hair loss, discuss finasteride, minoxidil, or combination therapy, organise blood work if needed, and manage ongoing prescriptions and monitoring.
Consultations are bulk billed for eligible patients and available seven days a week, including evenings, so you can fit the conversation into your schedule.
If you are ready to take the next step, book a consultation with an Abby Health GP today.
For a broader overview of what causes hair loss in men and the full range of treatment options available, read our comprehensive guide: Hair Loss in Men: Causes, Treatments, and What to Discuss With Your GP.
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