Oral finasteride 1 mg is one of two FDA-approved treatments for male pattern hair loss, the other one being topical minoxidil 2% or 5%. Since oral finasteride has been shown to cause sexual side effects in a small number of men (3.8% of men who took finasteride vs 2.1% of men who took placebo in phase III clinical trials for finasteride), researchers have been interested in whether topical finasteride applied to the scalp may be effective in treating male pattern hair loss with a lower potential for side effects.
A 2018 systematic review of the results of seven different studies concluded that topical finasteride is effective for the treatment of male pattern hair loss but also lowers plasma (blood) DHT levels which can lead to undesired side effects like low libido. Still, it appears that the incidence of side effects was lower with topical finasteride than oral finasteride. Also, some researchers found that plasma DHT levels were only minimally decreased with topical finasteride.
At this time, topical finasteride is not FDA-approved for the treatment of male pattern hair loss and must be specially compounded by a compounding pharmacy and requires a doctor’s prescription. For this reason, compounded topical finasteride is not available through Roman.