Can you get topical finasteride?: Availability, Efficacy, and Safety

October 11, 2025 •

4 min read

According to the American Hair Loss Association, approximately 85% of men will experience some degree of hair loss by age 50. For those seeking an alternative to the oral medication, a common question arises: Can you get topical finasteride? Yes, it is available, but it requires a prescription and is primarily obtained through compounding pharmacies and telehealth services, as it is not an FDA-approved product.

Quick Summary

Topical finasteride is a prescription-only, non-FDA-approved medication for androgenetic alopecia, typically accessed through compounding pharmacies and telehealth providers. Studies suggest comparable efficacy to oral finasteride in promoting hair regrowth, though with different side effect profiles. Recent FDA warnings highlight risks of systemic side effects, even with topical application. It is vital to consult a healthcare provider to understand potential benefits and risks before starting treatment.

Key Points

Prescription Required: Topical finasteride is a prescription-only medication, typically obtained through compounding pharmacies and online telehealth platforms.
Not FDA-Approved: Unlike its oral counterpart, no topical finasteride product has received FDA approval; it is prescribed off-label.
Comparable Efficacy: Studies suggest topical finasteride can be as effective as the oral form in increasing hair count, particularly in combination therapies with minoxidil.
Potential Systemic Side Effects: While theorized to have fewer systemic risks than oral finasteride, the FDA has warned that topical application can still lead to serious side effects like sexual dysfunction and mood changes, which have been reported to persist in some cases.
Risk to Pregnant Women: Topical finasteride poses a significant risk to pregnant women due to potential fetal harm if absorbed through the skin; extreme caution must be taken with handling.
Patient Counseling is Essential: Due to its non-FDA-approved status and potential side effects, it is critical for patients to have an informed discussion with a healthcare provider before starting treatment.

Understanding Topical Finasteride and Its Availability

While the oral version of finasteride (Propecia) has been an FDA-approved treatment for hair loss since 1997, topical finasteride is a newer and less-regulated option. It is a compounded preparation, meaning a licensed pharmacy creates a custom formulation containing finasteride in a liquid, gel, or spray base. This contrasts with standardized, mass-produced FDA-approved drugs.

Since no topical formulation has been evaluated or approved by the FDA for safety or efficacy, it is prescribed "off-label" by a licensed healthcare provider, such as a dermatologist. The primary channels for obtaining this prescription are compounding pharmacies and online telehealth platforms. These platforms connect patients with providers who can write the prescription and have the compounded product shipped directly to the patient's door.

Accessing Topical Finasteride Through Telehealth

Several prominent telehealth companies specialize in providing hair loss treatments, including compounded topical finasteride. The process typically involves a few steps:

Online Consultation: Patients fill out a health questionnaire detailing their hair loss and medical history.
Provider Review: A licensed medical provider reviews the patient's information and determines if a compounded topical treatment is appropriate.
Prescription and Fulfillment: If approved, a prescription is sent to a partner compounding pharmacy, which prepares the medication.
Discreet Delivery: The medication is then shipped to the patient, often on a subscription basis.

The Role of Compounding Pharmacies

Compounding pharmacies play a critical role in the availability of topical finasteride because they can create custom formulations. For example, they might combine finasteride with other ingredients like minoxidil, tretinoin, or melatonin, which may enhance efficacy or absorption. This personalization is a key feature, as it allows for tailoring the treatment to individual needs, such as modifying the concentration or using a different vehicle (e.g., spray vs. gel).

Efficacy, Risks, and Considerations

Recent studies have shown promising results for topical finasteride's efficacy. A 2021 study found that a topical finasteride spray significantly increased hair count compared to a placebo, with results numerically similar to oral finasteride. Critically, this study also found that the topical group had plasma finasteride concentrations and a reduction in serum DHT levels that were markedly lower than the oral group. This is the basis for the claim that topical application results in fewer systemic side effects. It is important to note that results can vary, and consistency is key for any finasteride treatment. Most individuals require 3 to 6 months of continuous use to see visible improvements.

Understanding the Side Effects

While often promoted as having fewer side effects than its oral counterpart, topical finasteride is not without risks. An April 2025 FDA alert warned healthcare providers and consumers about reports of adverse events associated with compounded topical products. These reports described systemic side effects consistent with oral finasteride, including:

Erectile dysfunction
Anxiety
Depression and suicidal ideation
Brain fog
Insomnia and fatigue
Decreased libido
Testicular pain

Many of these adverse effects were reported to persist even after the patient stopped using the product. The FDA noted that the topical formulation allows for systemic absorption, and some patients were reportedly told there was no risk of such side effects. Additionally, topical application introduces the risk of local side effects, such as scalp irritation, redness, itching, and dryness.

Crucial Handling and Safety Precautions

Proper handling of topical finasteride is vital to minimize the risk of accidental exposure to others, especially women who are pregnant or may become pregnant. Unlike coated oral tablets, compounded topical products lack this protective layer. Absorption of finasteride by a pregnant woman can cause abnormalities in a male fetus.

Apply the product carefully to the scalp and avoid letting it run onto the face or neck.
Wash your hands thoroughly with soap and water immediately after application.
Allow the product to dry completely before going to bed or coming into close physical contact with others.

Topical vs. Oral Finasteride: A Comparison


Feature	Topical Finasteride	Oral Finasteride
Availability	Prescription only via compounding pharmacies/telehealth; custom formulations.	Prescription only (Propecia); generic versions available.
FDA Status	Not FDA-approved for topical use; prescribed off-label.	FDA-approved for male pattern baldness.
Mechanism	Inhibits DHT primarily in the scalp; lower systemic DHT reduction.	Inhibits DHT systemically throughout the body; higher systemic DHT reduction.
Efficacy	Studies show comparable efficacy to oral form for hair count, particularly when combined with minoxidil.	Strong, long-standing evidence for slowing hair loss and promoting regrowth.
Common Side Effects	Local scalp irritation, redness, itching.	Decreased libido, erectile dysfunction, ejaculation disorders.
Systemic Side Effects	Possible, though theorized to be less frequent due to lower systemic absorption. FDA warns of reported serious adverse events.	Known risk of sexual side effects, depression; lower risk if used at correct dosage.
Risk to Pregnant Women	High risk from contact with product. Must be handled with extreme care.	Risk from handling crushed or broken tablets. Tablets are coated to prevent contact.
Best Suited For	Men seeking to minimize potential systemic side effects; those who cannot tolerate oral medication.	Men seeking a well-researched, FDA-approved treatment with a known safety profile.

Conclusion

Can you get topical finasteride? Yes, it is accessible through prescription via compounding pharmacies and telehealth services, offering a route to treatment for individuals with androgenetic alopecia. While it has shown promising efficacy in studies, potentially minimizing some systemic side effects associated with the oral pill, it is crucial to understand that it is not FDA-approved. Furthermore, recent FDA alerts highlight the potential for serious side effects, including sexual dysfunction and psychological issues, even with topical application. A detailed discussion with a licensed healthcare provider is essential to weigh the benefits and risks of compounded topical finasteride and to determine the most suitable hair loss treatment plan for your individual health profile.

Disclaimer: The information in this article is for educational purposes and should not be considered medical advice. Always consult with a qualified healthcare professional before starting any new medication or treatment, including topical finasteride.

Frequently Asked Questions

No, topical finasteride is not a standard generic medication. It is a compounded drug, meaning it is custom-prepared by a pharmacy based on a licensed healthcare provider's prescription, and it has not been reviewed by the FDA for safety or effectiveness.

While topical finasteride was initially thought to carry a lower risk of systemic side effects due to reduced absorption, an April 2025 FDA alert warned of reports describing sexual dysfunction, depression, and other serious issues consistent with the oral form. Local side effects like scalp irritation are also possible.

Application depends on the specific formulation (spray, gel, or solution) but typically involves applying the prescribed amount directly to the affected areas of a clean, dry scalp once daily. You should gently massage it in and wash your hands thoroughly afterward.

No, finasteride is not recommended for women, especially those who are pregnant or may become pregnant, due to the risk of causing birth defects in male fetuses. Pregnant women should not handle the product, and alternative hair loss treatments are available for women, such as topical minoxidil.

Most individuals begin to notice results, such as reduced hair shedding or new regrowth, after 3 to 6 months of consistent, daily application. Visible improvement is generally seen within 6 to 12 months.

Yes, many compounded formulations combine finasteride with other active ingredients like minoxidil to potentially boost effectiveness. Combining topical finasteride with oral finasteride is not recommended and could increase the risk of side effects.

The FDA issued a warning because of reports of serious adverse events associated with compounded topical products, including sexual dysfunction and psychological effects. The alert noted that some patients were reportedly misinformed that topical use carried no risk of systemic side effects.