Finasteride Combined with Topical Minoxidil for Pattern Hair Loss: Chen 2020 Research Summary

Last verified: Apr 2026Oral FinasterideLimited evidence

This is a plain-language summary of the original published research. We do not add conclusions or opinions of our own. This is not medical advice — consult a certified healthcare practitioner before making any decision.

Original research published in Aesthetic Plastic Surgery, 2020

Finasteride Combined with Topical Minoxidil for Pattern Hair Loss

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Study conclusion

Meta-analysis of 5 randomised controlled trials found that combining finasteride with topical minoxidil produced better results than either treatment alone for pattern hair loss. The combination scored higher on global photographic assessment — meaning independent reviewers rated overall hair appearance as significantly better.

Strength of evidence

Strength of evidence
Limited evidence · 6/10

This was a systematic review and meta-analysis of 5 RCTs. The score is limited because only 5 trials were available, 2 of the 5 compared the combination against finasteride alone while all 5 compared against minoxidil alone, and individual trial sample sizes were small.

Who it applies to

Who was studied

Adults with pattern hair loss. 5 RCTs included. All compared a combination of oral finasteride with topical minoxidil against minoxidil alone (all 5 trials) or finasteride alone (2 trials).

Who was NOT studied

Women of childbearing age — finasteride is contraindicated in this group. People with advanced hair loss.

What to look for when shopping

Both oral finasteride 1mg and topical minoxidil are FDA-approved for pattern hair loss. Combining them is common clinical practice but is not itself FDA-approved as a combination.

What research cannot help you decide

What the optimal concentration of minoxidil to combine with finasteride is. Whether the combination reduces sexual side effect risk of finasteride.

Key findings

  • Combining finasteride with topical minoxidil produced better results than minoxidil alone on global photographic assessment
  • The combination also outperformed finasteride alone on photographic assessment (in 2 trials)
  • Global photographic assessment measures overall hair appearance rated by independent reviewers
  • Both treatments in the combination are individually FDA-approved for pattern hair loss

What they did

Researchers searched Embase, PubMed, and the Cochrane Library for all RCTs comparing finasteride plus topical minoxidil against monotherapy for pattern hair loss. Five trials met the inclusion criteria. Global photographic assessment was the main outcome. Results were combined statistically.

What they found

ComparisonResultSignificant?
Combination vs minoxidil alone — photographic assessmentCombination significantly betterYes
Combination vs finasteride alone — photographic assessmentCombination significantly better (2 trials)Yes

What this study does not show

  1. 1.Whether the combination reduces sexual side effects compared to finasteride alone.
  2. 2.What the optimal dose or concentration of each component is.
  3. 3.Whether the combination works for women. Finasteride is contraindicated in women of childbearing age.
  4. 4.Long-term effects beyond the trial periods studied.

Limitations

  1. 1.Only 5 trials included
  2. 2.Only 2 of 5 trials compared the combination against finasteride alone
  3. 3.Global photographic assessment is a subjective outcome though independent reviewers were used
  4. 4.Individual trial sample sizes were small
  5. 5.Published in 2020 — more recent trials may change conclusions

Who funded it

Funded by the Innovation Foundation of Southwest Hospital. No conflicts of interest declared.

Used in these articles

Links added as fact-checks and articles citing this study are published.