Topical Finasteride for Pattern Hair Loss: Lee 2018 Systematic Review Research Summary
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 Journal of Drugs in Dermatology, 2018
Topical Finasteride for Pattern Hair Loss
Study conclusion
Systematic review found that all 7 studies of topical finasteride showed significant decreases in hair loss rate and increases in total and terminal hair counts. Topical application also markedly reduced DHT in both the scalp and bloodstream but caused much less systemic DHT reduction than oral finasteride.
Strength of evidence
This was a systematic review of 7 studies. The score is limited because the included studies were small and used varied designs, topical finasteride is not FDA-approved, and none of the included studies were large Phase III placebo-controlled trials. Evidence was described as promising but preliminary.
Who it applies to
Who was studied
Adults with pattern hair loss — men and women across the included studies. Various topical finasteride concentrations and formulations.
Who was NOT studied
People compared in large phase III trials with placebo arms. Long-term users beyond 12–16 months.
What to look for when shopping
Topical finasteride is not FDA-approved. All topical finasteride products in the US are compounded and off-label. The FDA issued an adverse event communication about compounded topical finasteride in 2024.
What research cannot help you decide
How topical finasteride's reduced systemic DHT suppression translates to lower sexual side effect risk. Long-term safety and efficacy.
Key findings
- All 7 included studies showed significant decreases in hair loss rate with topical finasteride
- All 7 studies showed increases in total and terminal hair counts
- Topical finasteride reduced scalp DHT significantly
- Systemic DHT reduction with topical application was much lower than with oral finasteride
- Topical finasteride is not FDA-approved — all US products are compounded and off-label
What they did
Researchers searched for all human in vivo studies of topical finasteride for pattern hair loss, including RCTs, prospective studies, and case reports. Seven studies met inclusion criteria. Hair loss rate, hair count, scalp and serum DHT levels were the main outcomes reviewed.
What they found
| Comparison | Result | Significant? |
|---|---|---|
| Topical finasteride — hair loss rate | Significant decrease in all 7 studies | Yes |
| Topical finasteride — total hair count | Significant increase in all 7 studies | Yes |
| Topical finasteride — scalp DHT | Significant decrease | Yes |
| Topical vs oral finasteride — systemic DHT suppression | Topical caused markedly lower systemic reduction | Yes |
What this study does not show
- 1.Whether topical finasteride causes fewer sexual side effects in controlled trials. No large placebo-controlled safety trial was included.
- 2.Long-term efficacy and safety beyond 16 months.
- 3.Whether topical finasteride is safer than oral finasteride for women of childbearing age.
Limitations
- 1.Only 7 studies included — evidence base is thin
- 2.Study designs varied widely — some were small case series
- 3.Topical finasteride is not FDA-approved. The FDA issued a 2024 adverse event communication
- 4.The review was published in 2018 — a Phase III trial published in 2022 supersedes some conclusions
Who funded it
No funding source was declared. No conflicts of interest were reported.
Used in these articles
Links added as fact-checks and articles citing this study are published.