Finasteride alternatives: what to try when finasteride isn't for you

Not everyone can or wants to take finasteride. Maybe you worry about side effects, are planning a family, or didn’t see results. Good news: you don’t have to give up. Several treatments and lifestyle moves can slow hair loss or even regrow hair. Below I break down practical options, what they do, and what to ask your doctor.

Medical alternatives that work

Minoxidil (topical) is the most common go-to. It’s available as 5% foam or 2% solution and helps by widening blood vessels in the scalp to boost growth. Many clinical trials show visible results after 3–6 months when used consistently. Expect daily application and patience—stop and gains can fade.

Dutasteride is like finasteride but stronger at blocking DHT. It’s used off-label for hair loss in some countries. It may be more effective than finasteride for some men, but it also carries similar hormonal risks, so discuss fertility and long-term effects with your doctor first.

Spironolactone is often recommended for women with androgen-driven hair loss. It lowers androgen effects systemically and can help when other treatments fail. It’s prescription-only and requires monitoring of blood pressure and electrolytes.

Ketoconazole shampoo isn’t a magic cure, but regular use (2–3 times a week) can reduce scalp inflammation and may mildly lower local DHT. It’s a helpful add-on, especially if you have dandruff or irritated scalp.

Non-medical and in-office options

Low-level laser therapy (LLLT) devices—caps or combs—can boost hair thickness for some people. Results are gradual and best when paired with a topical like minoxidil. Platelet-rich plasma (PRP) injections are another clinic-based option: your blood’s platelets are concentrated and injected to stimulate follicles. Some patients see meaningful improvement after a few monthly sessions.

Hair transplant surgery gives permanent density in treated areas. It’s more invasive and pricier, but modern techniques deliver natural-looking results if you’re a good candidate.

Herbal or supplement options like saw palmetto, pumpkin seed oil, and zinc claim DHT-blocking effects. Evidence is limited but some people notice mild benefits. Use them as supportive measures, not replacements for proven therapies.

Combine therapies for better results: topical minoxidil + ketoconazole shampoo, or LLLT + minoxidil, often works better than one treatment alone. Track progress with photos every 3 months so you know what’s helping.

Safety first: check with a dermatologist or primary care doctor before starting any drug or procedure. Ask about side effects, drug interactions, and fertility concerns. If you want a tailored plan, a scalp exam and possible blood tests (thyroid, iron, hormones) will point to the best next steps.

If you’re unsure where to start, try a dermatologist consult to map a short-term plan and set realistic goals. Hair treatments take time—stick with the plan for at least 6 months to judge if it’s working.