Hair Loss Treatment in the UK: Finasteride or Minoxidil, Prescription or Pharmacy, and Is It on the NHS?

If your hair is thinning on top or your hairline is moving back, you are not alone. The British Association of Dermatologists says male pattern hair loss is the most common type of hair loss in men, and that men can notice it at any time after puberty. The NHS says finasteride and minoxidil are the main treatments for male pattern baldness.

This guide explains how the two differ, whether you need a prescription, what the NHS offers, the side effects to know about, and when to see a pharmacist or doctor before you start.

Is it male pattern hair loss?

Male pattern hair loss usually shows as a hairline that moves back at the front, or thinning on the top of the head. The hair at the sides and back of the head is spared, and the scalp itself usually looks normal. It tends to run in families and to get worse slowly, over years or even decades. It is caused by a mix of genes and hormones: a hormone called DHT makes the hair follicles on the scalp shrink, so the hairs they grow become thinner and lighter until the follicles stop producing hair.

Not all hair loss is this kind. The NHS says hair loss can also follow an illness, stress, cancer treatment, weight loss or a lack of iron, and that this kind may be temporary. If you have lost hair while losing weight, read does Mounjaro cause hair loss?

Hair loss that is patchy or sudden, or comes with a red, sore or flaky scalp, is different. These signs point to a cause other than male pattern hair loss. Your GP should look at your scalp first, because finasteride and minoxidil are only for male pattern hair loss.

I need hair loss treatment: what are my options?

The British Association of Dermatologists lists two licensed medicines for male pattern hair loss: finasteride 1mg tablets and minoxidil 5%, which you put on your scalp.

The NHS says these treatments:

• do not work for everyone
• only work for as long as they are used
• are not all available on the NHS, so can be expensive if you have to pay

It also says no treatment is 100% effective, and that most hair loss does not need treatment at all, because it is either temporary or a normal part of getting older. Treatment is something you can try if your hair loss is causing you distress. The NHS lists other options too, such as wigs and hair transplants, and some of these may not be available on the NHS either.

You can see both medicines side by side on our hair loss page.

How do finasteride and minoxidil differ?

Delivery is £2.99.

Finasteride: one tablet a day

Finasteride reduces the conversion of testosterone into DHT, the hormone behind male pattern hair loss. One 1mg tablet each day, at roughly the same time. It can be taken with or without food. Swallow it whole, without breaking or crushing it, and do not take two tablets to make up for a forgotten one. It is licensed for men with male pattern hair loss, and not for women, children or teenagers. For more detail, read our pharmacist's guide to finasteride.

Minoxidil: 1ml on the scalp twice a day

The minoxidil we supply is Sons Minoxidil 5%, a solution you spray onto your scalp. Its product information says the way minoxidil helps hair grow is not fully understood. It is thought to work by widening blood vessels, which improves blood flow to the hair follicles, and by lengthening the growing phase of the hair cycle. Unlike finasteride it does not affect hormones.

How to use it:

• Part dry hair to expose the thinning area
• Apply 1ml to the scalp, not the hair, twice a day
• Massage gently, allow 4 hours before washing
• Wash hands thoroughly after use

Its leaflet also says to wash your hands before you apply it as well as after, that your hair and scalp must be completely dry, and that 1ml is 10 sprays of the pump. Do not use more than 2ml in 24 hours, and do not try to make up for a missed application by using extra. This product is licensed for men aged 18 to 65.

Do I need a prescription?

Finasteride: it is a prescription-only medicine. You cannot buy it off the shelf. At Solira you fill in an online consultation, and a GPhC-registered pharmacist reviews every request. If finasteride is suitable for you, it is supplied after that review. Repeat supplies need a review every 3 months, including a check for psychiatric symptoms. You can read whether we tell your GP.

Minoxidil 5%: no prescription is needed. It is a pharmacy medicine, supplied after a pharmacist consultation, so a pharmacist checks it is suitable for you first.

Can I get finasteride or minoxidil on the NHS?

Not on an NHS prescription for male pattern hair loss. The NHS hair loss page says finasteride and minoxidil are not all available on the NHS, so you may have to pay. Its finasteride page is more direct: for hair loss, you can only get finasteride on a private prescription, and you pay the full cost of the medicine. The British Association of Dermatologists' leaflet says minoxidil is not available on an NHS prescription.

It is still worth seeing your GP if you are worried about your hair loss. The NHS says a GP may be able to tell what is causing it by looking at your hair, and you can ask what treatments are available. If your hair loss is affecting how you feel, tell them. A GP may be able to help you get some counselling.

If you decide to pay for treatment, at Solira finasteride 1mg costs £12.99 for a pack of 28 tablets or £22.99 for 84 tablets. Minoxidil 5% costs £24.99 for a single bottle or £59.99 for a 3-bottle pack. Delivery is £2.99, and your order comes in plain packaging, with no medicine names on it.

Can I use finasteride and minoxidil together?

There is not enough evidence to recommend using finasteride and minoxidil together, so we do not supply the two together as a plan. If you already use minoxidil, tell our pharmacist during your consultation so they can advise you.

The finasteride product information says the same: because data on using finasteride with minoxidil on the scalp for male pattern hair loss are lacking, the combination is not recommended.

How long before you can tell if it is working?

Finasteride

Generally, three to six months of daily treatment are needed before hair loss stabilises. We check how well it is working at 6 months. If it is working, you can carry on taking it. If it has not helped after a year, we recommend stopping it, and your GP can refer you to a dermatologist if you would like. Individual results vary.

Minoxidil

Its leaflet says you may need to use it twice a day for at least 2 months before you see new hair growth, because hair grows slowly. The British Association of Dermatologists says it needs to be used for at least 6 months, and possibly up to 12, before any benefit may be noticed. If there is no improvement after a year, the leaflet says to stop.

Some men shed more hair when they start. The product information says this usually happens 2 to 6 weeks after starting and settles within a couple of weeks, most likely as old hairs make way for new ones. If the extra shedding lasts more than 2 weeks, stop using minoxidil and speak to your doctor.

What are the side effects and warnings?

Finasteride

• Uncommon side effects (fewer than 1 in 100 men): lower sex drive, low mood or depression, difficulty getting an erection, and changes in ejaculation, including less semen.
• The MHRA says that in some men, sexual side effects have carried on even after they stopped taking finasteride. Any concerns about sexual side effects should be discussed with a healthcare professional.
• Tell your doctor promptly about any changes in your breast tissue, such as lumps, pain or nipple discharge.
• Finasteride lowers PSA, a blood test used to check for prostate cancer. Tell your GP that you are taking finasteride.
• Some men have reported poor sperm quality or infertility. The NHS says this is not common and that sperm usually returns to normal after stopping. If you are planning to father a child, talk to your pharmacist or doctor: the product information says to consider stopping treatment.
• Finasteride passes into semen in small amounts. Use a condom if your partner is pregnant or could become pregnant.
• Women who could become pregnant should not handle crushed or broken finasteride tablets.
• Do not take it if you already take finasteride 5mg, dutasteride or another medicine that works in the same way.
• Tell our pharmacist or your GP about any side effect, so that a Yellow Card report can be sent to the MHRA.

The MHRA, which regulates medicines in the UK, introduced a patient card for finasteride packs in 2024. It highlights the risk of sexual side effects, depression and suicidal thoughts, and says what to do if they happen. On 11 May 2026 the MHRA strengthened the warnings for finasteride 1mg: the product information now makes clear that sexual side effects may contribute to mood problems, and that sexual side effects have been reported both with and without changes in mood.

The MHRA advises reading and keeping the patient card and the leaflet in your pack, and telling your pharmacist or doctor before you start if you have ever had depression or suicidal thoughts. Anyone taking finasteride who develops depression or suicidal thoughts should stop treatment and seek medical advice.

Minoxidil

• Minoxidil is for topical use on the scalp only. Avoid contact with eyes, broken skin, or other body areas. Wash hands after application.
• Its leaflet lists headache as a very common side effect, and itching or a rash, unwanted hair growth, shortness of breath, swollen hands or feet and sudden unexplained weight gain as common ones. It can also cause reactions where you apply it, such as itching, irritation, dryness or redness of the scalp.
• Avoid contact with the face after application to prevent unwanted facial hair growth.
• Do not use it if you have high blood pressure, treated or not, or if you are allergic to minoxidil or its other ingredients. Do not use it on a scalp that is broken, inflamed, sunburnt, shaved or affected by a condition such as psoriasis, under a dressing, or with other medicines applied to the scalp.
• If you have heart disease, including an abnormal heart rhythm, angina or chest pains, or a circulation problem, talk to your doctor or pharmacist before using it.
• Stop using minoxidil and contact a doctor straight away if you get swollen hands or feet or sudden unexplained weight gain (the leaflet lists both as common), chest pain, a rapid or irregular heartbeat, faintness or dizziness, swelling of the face, lips or throat, or redness, a rash or irritation of the scalp that does not go away. You may need urgent medical treatment.
• It can cause dizziness or low blood pressure. If it does, do not drive or use machines.
• Protect the areas you treat from the sun, even when it is cloudy, and do not expose them to ultraviolet (UV) lamps.
• Keep it out of the reach of children. Swallowing it by accident can cause serious heart problems, and children should not touch the parts of your scalp where you have put it.
• It is flammable. Do not use it while smoking, or near a naked flame or other heat source.

Can women use these treatments?

Finasteride: no. The NHS says women should not use finasteride, and its product information says it must not be used by women because of the risk in pregnancy: it may cause abnormalities of a male baby's sex organs. Women who could become pregnant should not handle crushed or broken finasteride tablets.

Minoxidil 5% spray: not the one we supply. It is licensed for men only, and its product information says it must not be used by women. The NHS says minoxidil can also be used to treat female pattern hair loss. That needs a minoxidil product licensed for women, and minoxidil should not be used in pregnancy or while breastfeeding. Your GP or a pharmacist can advise.

What happens if I stop?

Male pattern hair loss usually carries on slowly over time. Treatment works for as long as you keep taking it. If you stop taking it, the benefit begins to reverse by six months and is lost by 9 to 12 months.

Minoxidil also only works while you use it. Its leaflet says that within 3 to 4 months of stopping, your hair may go back to how it was before you started, and the hair loss will carry on.

If you want to stop because of a side effect, check the warnings above. For any change in mood on finasteride, stop and seek advice straight away.

Looking after your hair

Stopping smoking, keeping alcohol within recommended limits, eating a balanced diet rich in protein and avoiding stress where you can may all help your hair. You can wash your hair as often as you like. It will not make hair loss worse. The British Association of Dermatologists also advises protecting any bald areas of your scalp from the sun with sun cream, a wig or a hat.

For support, Alopecia UK (alopeciaonline.org.uk) can help, and the British Association of Dermatologists has a patient leaflet.