Finasteride spray: what we know

Why a spray?

Finasteride tablets lower DHT, the hormone that shrinks hair follicles in pattern hair loss. They work, but because the drug travels around the whole body, it also lowers DHT elsewhere. That is the likely reason a small number of men get sexual side effects, and the reason some men never start. Read the full picture in our finasteride guide.

A spray tries to keep the effect where you need it. You apply it to the scalp, where the follicles are. Some of the drug still passes into the blood, but much less than with a tablet. In the main trial, the highest blood level of finasteride with the spray was about a hundredth of the level with the tablet.¹

What the main trial found

The best evidence comes from a phase III trial run at 45 sites in five European countries.¹ It included 458 men aged 18 to 40 with mild to moderate thinning at the crown. For 24 weeks, each man used one of three treatments:

• finasteride spray (0.25%) on the scalp and a dummy tablet
• a dummy spray and a dummy tablet
• a dummy spray and a finasteride 1 mg tablet

Neither the men nor the researchers knew who had what.

Treatment	Hairs gained
Finasteride spray	about 20
Finasteride tablet	about 21
Placebo	about 7

The spray grew clearly more hair than the placebo, and about as much as the tablet.¹ The trial was not designed to prove the two are equal, so treat "about the same" as a good sign rather than a final answer.

The spray lowered DHT in the blood by about a third, against more than half with the tablet.¹ That is the point of a spray: a smaller effect on the rest of the body.

Side effects

In the trial, side effects were about as common with the spray as with the placebo:¹

• Sexual side effects linked to treatment were reported by 2.8% of men on the spray, 3.3% on placebo and 4.8% on the tablet.
• 2.8% of men on the spray stopped because of a side effect, against 2.2% on placebo and 7.1% on the tablet.
• The most likely local problems are the usual ones for anything you put on the scalp: itching, redness or irritation.

Two limits matter. The trial lasted 24 weeks, so it cannot tell us about years of use. And rare side effects need far larger and longer studies to show up.

In 2025 the European Medicines Agency reviewed finasteride and suicidal thoughts. It confirmed this as a possible side effect of finasteride tablets, but found no evidence of a link with the skin spray, so the spray's information did not change.² As with any medicine, if you notice a change in your mood, stop and talk to a doctor.

Who it may suit

The spray may suit men who:

• want to treat pattern hair loss with finasteride, but are worried about the side effects of the tablet
• had side effects on the tablet and want to discuss an alternative with their doctor
• are happy to use a scalp product every day

It is not for women who are or may become pregnant, for the same reason as the tablet: finasteride can affect a male baby's development. Keep it away from partners and children, and wash your hands after applying it.

The 2017 European guideline on pattern hair loss made no recommendation for or against topical finasteride, because the main trial had not yet been published.³

How it is used

Follow your prescription and the leaflet. In the trial, men used the spray once a day on dry scalp over the thinning area.¹ General tips:

1. Apply to a dry scalp, not to wet hair.
2. Part the hair so the spray reaches the skin.
3. Let it dry before you put on a hat, lie down or style your hair.
4. Wash your hands straight away.
5. Keep the timing the same each day, for example after your morning shower once your hair is dry.

Judge it like the tablet. The trial measured results at 24 weeks, and the European guideline advises assessing finasteride at six months, with some men seeing the effect only at 12.^1,3 Take progress photos before you start.

How to get it

Finasteride spray is a prescription medicine. It is registered in some EU countries; in Czechia, for example, it appears in the national medicines register.⁴ Availability differs between countries and changes over time, so ask your doctor or pharmacist what is available where you live. It usually costs more than generic tablets.

Some clinics and online services offer compounded finasteride sprays, mixed for you, often together with minoxidil. These are not the product tested in the trial. Their strength and how much reaches the blood can differ, so ask what is in them and who checks the quality.

For how the spray compares with the tablet and with minoxidil on cost, access and side effects, see finasteride, minoxidil, or both?.