Compare Fincar (Finasteride) with Alternatives for Hair Loss and Enlarged Prostate

Compare Fincar (Finasteride) with Alternatives for Hair Loss and Enlarged Prostate Oct, 28 2025

Finasteride is one of the most prescribed medications for male pattern hair loss and benign prostatic hyperplasia (BPH). Sold under the brand name Fincar in many countries, it’s been used by millions since the 1990s. But it’s not the only option. If you’re considering Fincar-or already using it-you might be wondering: Are there better, safer, or more effective alternatives? The answer isn’t simple. It depends on your goal, your body, and what side effects you’re willing to tolerate.

How Finasteride Actually Works

Finasteride blocks the enzyme 5-alpha-reductase, which turns testosterone into dihydrotestosterone (DHT). DHT is the main hormone that shrinks hair follicles in genetically prone men, leading to thinning and balding. It also causes the prostate to swell. By lowering DHT levels by up to 70%, Finasteride slows or reverses both processes.

For hair loss, studies show that about 65% of men using 1 mg daily see improved hair growth after a year. For BPH, 5 mg daily reduces prostate size by about 20-30% over 6-12 months. But it doesn’t work for everyone. And for some, the side effects are too much to ignore.

Common Side Effects of Finasteride

Most men tolerate Finasteride fine. But around 1-4% report sexual side effects: lower libido, erectile dysfunction, reduced semen volume. These usually go away after stopping the drug-but for a small group, they persist. A 2012 study in the Journal of Sexual Medicine found that 2.1% of users still had sexual side effects after stopping Finasteride for over a year. That’s rare, but it’s real.

Other possible side effects include breast tenderness, depression, and fatigue. These are less common, but they matter. If you’re already dealing with stress, anxiety, or low energy, Finasteride might make it worse.

Alternative #1: Dutasteride (Avodart, Zagorin)

Dutasteride is often called the "stronger" version of Finasteride. It blocks both types of 5-alpha-reductase (Type I and II), while Finasteride only blocks Type II. This means Dutasteride cuts DHT levels by about 90-95%, compared to Finasteride’s 70%.

In hair loss trials, Dutasteride showed slightly better results: 70-80% of men saw improvement after 12 months, versus 65% with Finasteride. For BPH, it reduces prostate size more quickly and lowers the risk of needing surgery.

But here’s the catch: Dutasteride has a longer half-life-about 5 weeks. That means it stays in your system much longer. If side effects happen, they might stick around longer too. It’s also not FDA-approved for hair loss, though doctors prescribe it off-label all the time. In Ireland, it’s available by prescription for BPH, but not officially for hair thinning.

Alternative #2: Minoxidil (Rogaine, Regaine)

Minoxidil is the only FDA-approved topical treatment for male pattern baldness. It’s sold as a liquid or foam you apply to the scalp twice a day. Unlike Finasteride, it doesn’t touch hormones. Instead, it opens potassium channels in hair follicles, increasing blood flow and extending the growth phase.

Studies show about 40-50% of men using 5% minoxidil see moderate to dense regrowth after 4-6 months. It works best on the crown and top of the scalp. It won’t help a receding hairline as much. And you have to keep using it forever-if you stop, you lose the gains in 3-6 months.

Side effects are mild: scalp irritation, dryness, itching. Rarely, it can cause unwanted facial hair or heart palpitations in sensitive people. It’s safe to combine with Finasteride. In fact, many doctors recommend both together-they work in different ways, and the combo boosts results by up to 20%.

A man using a laser hair cap at home, with natural supplements and medications floating nearby in a peaceful setting.

Alternative #3: Saw Palmetto

Saw palmetto is a herbal supplement made from the berries of the American dwarf palm tree. It’s been used for centuries in Native American medicine for urinary issues. Today, it’s marketed as a "natural Finasteride" for hair loss and prostate health.

Some small studies suggest it may mildly inhibit 5-alpha-reductase, but the effect is weak-maybe 10-20% DHT reduction. A 2012 trial in Phytotherapy Research found saw palmetto was as effective as Finasteride for mild BPH symptoms, but the study was small and short-term. For hair loss, results are inconsistent. Most men don’t see noticeable regrowth.

The upside? Fewer side effects. Most users report no sexual issues. The downside? It’s not regulated like medicine. Supplements vary wildly in potency. One bottle might have 320 mg of extract; another might have 80 mg. You can’t trust the label. And if you’re relying on it for serious hair loss, you might be delaying real treatment.

Alternative #4: Low-Level Laser Therapy (LLLT)

LLLT devices-like laser combs, caps, or helmets-use red light to stimulate hair follicles. The theory is that photons boost cellular energy (ATP), helping follicles stay in growth mode longer.

Several FDA-cleared devices exist: the iRestore, Capillus, and Theradome. A 2019 meta-analysis in Lasers in Surgery and Medicine found LLLT increased hair density by about 17-20% over 16-26 weeks. Results are slower than drugs-expect to wait 4-6 months. But side effects? None reported. It’s safe, non-invasive, and can be used with other treatments.

The catch? Cost. A good laser cap costs €300-€800. You need to use it 3-4 times a week for life. It’s not a magic fix, but for men who can’t tolerate pills or want to avoid them, it’s a solid option.

Alternative #5: Spironolactone (for men)

Spironolactone is a diuretic usually prescribed for high blood pressure or heart failure. It also blocks androgen receptors-meaning it stops DHT from binding to hair follicles. It’s commonly used for female pattern hair loss, but some doctors prescribe it off-label for men with mild to moderate hair thinning.

Studies are limited, but a 2020 case series in Journal of the American Academy of Dermatology showed improvement in 5 out of 7 men using 50 mg daily. Side effects can include breast enlargement, fatigue, and electrolyte imbalances. It’s not ideal for men with kidney or heart issues. Most men avoid it because of the risk of feminizing effects.

Alternative #6: Hair Transplant Surgery

If you’ve lost a lot of hair and other treatments haven’t worked, a transplant might be your best bet. Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE) move healthy hair follicles from the back of your head to thinning areas.

Results are permanent. A skilled surgeon can restore a natural hairline. But it’s expensive-€4,000 to €12,000 in Europe. Recovery takes weeks. You’ll need to keep using Finasteride or Minoxidil afterward to protect the remaining hair. It’s not a cure-it’s a restoration.

A doctor and patient reviewing hair loss treatment options with illustrated icons, showing progress and informed choice.

Which Alternative Is Right for You?

Here’s a simple way to decide:

  • If you want the strongest DHT blocker and don’t mind long-term medication → Dutasteride
  • If you want something topical, safe, and easy to combine → Minoxidil
  • If you prefer natural options and have mild symptoms → Saw Palmetto (but manage expectations)
  • If you want zero pills and can invest upfront → LLLT
  • If you’ve lost most of your hair and want immediate visual results → Hair transplant
  • If you’re young, have early thinning, and want to prevent further loss → Finasteride + Minoxidil combo

Most men who stop Finasteride do so because of side effects. But many don’t realize that stopping without a plan leads to rapid hair loss. If you’re thinking about switching, don’t quit cold turkey. Talk to your doctor. Taper off slowly. Start your new treatment before stopping the old one.

What Doctors in Ireland Are Saying

In Dublin and Cork, dermatologists and urologists agree: Finasteride remains the gold standard for male pattern hair loss and BPH. But they’re seeing more patients ask about alternatives. Many are turning to Minoxidil + LLLT combos. Others are trying Dutasteride under supervision.

One key point: no alternative works as well as Finasteride for DHT suppression. But that doesn’t mean you have to take it. If side effects are a dealbreaker, there are other paths. The goal isn’t to find the "best" drug-it’s to find the best fit for your life.

What Not to Do

Don’t buy Finasteride or Dutasteride from online pharmacies without a prescription. Many sell counterfeit or contaminated versions. In 2023, Irish health authorities warned about fake Finasteride pills containing steroids or toxic fillers.

Don’t assume natural = safe. Saw palmetto can interact with blood thinners. LLLT devices can damage eyes if misused. Always check with a pharmacist or doctor before combining treatments.

And don’t wait too long. Hair follicles die after 3-5 years of inactivity. The earlier you act, the more you can save.

Is Finasteride better than Dutasteride for hair loss?

Dutasteride reduces DHT more than Finasteride and may lead to slightly better hair regrowth. But it stays in your system longer, so side effects may last longer too. Finasteride is the only one approved for hair loss in most countries, including Ireland. Dutasteride is often used off-label when Finasteride fails or isn’t tolerated.

Can I use Minoxidil and Finasteride together?

Yes. Many dermatologists recommend this combo because they work differently: Finasteride blocks DHT from within, while Minoxidil stimulates blood flow to the scalp. Studies show the combination improves results by 15-20% compared to either alone.

Does saw palmetto really work for hair loss?

It might help with mild thinning, but results are inconsistent. It doesn’t reduce DHT as effectively as Finasteride. Most men see little to no regrowth. It’s safer than drugs but not as reliable. Use it as a supplement, not a replacement.

How long before I see results from Finasteride?

For hair loss, most men start seeing less shedding after 3-4 months. Visible regrowth usually takes 6-12 months. For prostate size, it takes 6-12 months to notice improved urine flow. Patience is key-results don’t come quickly.

Are there any permanent side effects of Finasteride?

For most men, side effects go away after stopping. But a small percentage report lasting sexual, mental, or physical symptoms-even after stopping for over a year. This is called Post-Finasteride Syndrome. It’s rare, but real. If you have persistent issues, see a specialist.

Can women use Finasteride or its alternatives?

Finasteride is not approved for women and can cause birth defects if taken during pregnancy. Minoxidil is safe for female pattern hair loss. Saw palmetto and LLLT are also options. Spironolactone is sometimes prescribed for women with hormonal hair loss. Always consult a doctor before starting any treatment.

Next Steps: What to Do Today

If you’re on Finasteride and happy with results, keep going. Don’t stop without a plan.

If you’re experiencing side effects, talk to your GP or a dermatologist. Don’t just quit. Ask about switching to Minoxidil or LLLT. Ask if Dutasteride is an option.

If you haven’t started treatment yet, take a photo of your scalp now. Track changes monthly. Start with Minoxidil-it’s safe, affordable, and has minimal risk. If you don’t see progress in 6 months, consider adding Finasteride.

There’s no single best option. But there is a best option for you. The key is starting early, staying consistent, and choosing based on your body-not just your hopes.

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9 Comments

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    Ron Prince

    October 29, 2025 AT 11:54
    Finasteride? More like fina-lose. If you're still losing hair after a year of this junk, you're just bad at life. I've been on it for 3 years, no side effects, and my hairline looks like a 22-year-old's. Stop making excuses and take the pill. Saw palmetto? That's what you give your grandpa who thinks tea tree oil cures cancer.
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    Sarah McCabe

    October 30, 2025 AT 23:50
    Just wanted to say as someone in Dublin, I've seen so many guys here switch to minoxidil + laser caps 💆‍♂️✨ It’s wild how many are ditching pills now. My cousin tried dutasteride and got the weirdest mood swings. Now he’s all in on LLLT and says he feels like a sci-fi character. Also, pls don’t buy pills off shady sites-I know someone who got fake finasteride with glitter in it 🤢
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    King Splinter

    November 1, 2025 AT 01:17
    Look, I get it. Everyone’s obsessed with DHT like it’s the devil’s spit. But here’s the thing: if you’re spending $800 on a laser cap because you’re too lazy to take a daily pill, maybe your real problem isn’t hair loss-it’s your inability to commit to anything. And saw palmetto? That’s just a fancy way of saying ‘I want to feel good about myself while doing literally nothing.’ Also, who approved this article’s formatting? It looks like a Word doc from 2007.
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    Kristy Sanchez

    November 2, 2025 AT 18:56
    I took finasteride for 8 months. Lost 30% of my libido, started crying during dog commercials, and still looked like a balding raccoon. Then I tried minoxidil. My scalp itched like I’d been dipped in wasp nests. I switched to LLLT. Now I sit there like a robot with a red helmet on, wondering if I’m saving my hair or just wasting $600 on a fancy hair dryer. At least I don’t feel like a broken man anymore. But god, I miss my old self. Or maybe I just miss the version of me that didn’t think about hair every 12 minutes.
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    Michael Friend

    November 3, 2025 AT 06:32
    The real issue here isn’t finasteride vs. dutasteride. It’s that we’ve turned hair loss into a moral failing. Men are being sold a narrative: if you’re bald, you’re weak. If you’re not taking pills, you’re lazy. If you’re using herbs, you’re delusional. We’ve created a $10 billion industry out of male insecurity. The real cure? Stop caring. Let it go. You’re not a billboard for testosterone. Your worth isn’t measured by follicle density.
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    Jerrod Davis

    November 5, 2025 AT 01:57
    It is imperative to note that the utilization of pharmacological agents such as finasteride and dutasteride must be undertaken under the strict supervision of a licensed medical practitioner. The absence of regulatory oversight in the procurement of aforementioned compounds from unverified online vendors constitutes a significant public health hazard. Furthermore, the efficacy of botanical alternatives, including saw palmetto, remains empirically unsubstantiated in large-scale, peer-reviewed clinical trials. One must exercise due diligence.
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    Dominic Fuchs

    November 6, 2025 AT 13:42
    I used to think hair was everything until I realized my beard grew thicker after I stopped finasteride. Who knew? The real trade-off isn’t hair vs side effects-it’s control vs surrender. You take the pill and you think you’re in charge. But you’re just feeding a machine that wants you to pay forever. LLLT? Fine. Minoxidil? Okay. But don’t pretend any of this is a victory. It’s just damage control. And hey, if you go bald? Cool. I’ve met a lot of bald men who looked like kings. You don’t need hair to be whole
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    Asbury (Ash) Taylor

    November 7, 2025 AT 13:05
    To anyone considering a change in treatment: please don’t quit cold turkey. I speak from experience. I stopped finasteride abruptly after 2 years and lost 70% of my regrowth in 3 months. It was devastating. I switched to minoxidil + LLLT and gave it 9 months. Slow, yes. But steady. I’m not back to 20, but I’m not 60 either. The key is consistency-not perfection. You’re not failing if progress is slow. You’re just human. And that’s okay.
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    Kenneth Lewis

    November 7, 2025 AT 16:04
    wait so saw palmetto is just like… a fancy tea? lol i tried it for 3 months and my hair looked the same but my pee smelled like berries 🤡 i think i just spent $40 on a placebo with a nice label. also why does everyone say "talk to your doctor" like they’re a priest and we’re sinners? my gp just handed me a sample and said "good luck". no advice. no follow up. just… here’s your pill. goodbye.

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