COMPARISON OF THE EFFICACY OF ORAL MINOXIDIL AND ORAL FINASTERIDE IN THE TREATMENT OF ANDROGENETIC ALOPECIA IN MALES

Abstract

Background: Androgenetic alopecia (AGA) is the most common hair loss pattern among men and can have a significant impact on psychological functioning and quality of life. Oral finasteride continues to be a mainstay drug, while a new low dose oral minoxidil has come to the forefront recently. There is a limited amount of comparative evidence on their relative effectiveness.

Objectives: The purpose of this study was to compare the effectiveness of oral finasteride treatment with oral minoxidil treatment in improving hair density in males with androgenetic alopecia.

Place and Duration of study: From February 2026 to May 2026 Dermatology Department, Sandeman Provincial Hospital / Bolan Medical Hospital / College, Quetta.

Methods: This prospective randomized controlled trial was conducted in the Department of Dermatology at a tertiary care hospital. A total of 60 male patients (aged 18–45 years) with clinically diagnosed androgenetic alopecia were randomly allocated into two equal treatment groups. Group A was given oral minoxidil 5 mg per day and Group B was given oral finasteride      1 mg per day for 6 months. Trichoscopy and standardized scalp photography were performed at baseline and after six months to evaluate hair density. A p-value <0.05 was deemed statistically significant, by using SPSS version 26.0.

Results: 60 patients finished the study. The overall mean age was 29.8 ± 6.4 years. There was no difference in baseline hair density between the two groups (oral minoxidil and oral finasteride) (102.4 ± 15.8 vs. 103.1 ± 16.2 hairs/cm²; p=0.84). In conclusion, all hair density parameters showed significant improvement after 6 months of treatment in both groups. But the patients on oral finasteride had significantly greater improvement in hair density and more overall treatment response compared to those on oral minoxidil (p<0.05). The drugs were generally well tolerated with hypertrichosis seen more often with the oral minoxidil compared to the oral finasteride group, and sexual adverse effects reported with only the oral finasteride group.

Conclusion: In males with androgenetic alopecia, both oral finasteride and oral minoxidil performed as an effective treatment to improve hair density. But, oral finasteride was found to be more effective in promoting hair regrowth and achieving a better clinical outcome, therefore considered as the first line drug of choice in suitable patients for oral treatment.