Medication questions Finasteride
What is topical finasteride, and is it available in the UK?
Short answer
Topical finasteride is finasteride applied to the scalp as a liquid or spray instead of a tablet. No topical finasteride is licensed in the UK: every finasteride product on the UK medicines database is a tablet. When it is prescribed, it is an unlicensed special, made to order and used off-label. The MHRA mood and sexual side-effect warnings are not specific to tablets, so they still matter.
Key facts
- No topical finasteride is licensed in the UK. All ten finasteride products on the eMC (checked 22 October 2026) are tablets.
- A UK prescriber can prescribe an unlicensed special for an individual patient, but must explain that it is unlicensed and used off-label.
- The main published trial tested a 0.25% spray in men aged 18 to 40 for 24 weeks. The manufacturers of the spray funded it.
- In that trial, blood levels of finasteride were far lower with the spray than with the tablet, but blood DHT still fell.
- The MHRA warnings (mood, sexual side effects that may persist) are on the tablets' product information. The updates do not mention topical products, so a prescriber should apply the same caution.
Licence status in the UK
A medicine needs a UK marketing authorisation, or licence, before it is sold as a licensed product. The UK medicines database (eMC) lists ten finasteride products, among them Propecia 1 mg and Proscar 5 mg and their generics. All are tablets. There is no licensed finasteride spray, solution or lotion for the scalp.
When a topical finasteride is prescribed in the UK, it is therefore an unlicensed special. The MHRA describes specials as products "specially manufactured or imported for the treatment of an individual patient". A prescriber can order one when a patient has a clinical need, and because the use is outside any licence it is off-label. The prescriber takes responsibility for the decision and must give you enough information to decide, including that the product is unlicensed. Our glossary explains compounded medicines and off-label use. Unlicensed specials have no summary of product characteristics or leaflet of their own.
At WMG Meds, topical finasteride is available only as a compounded combination with minoxidil, prescribed off-label after an individual assessment by a GMC-registered doctor.
What the trial evidence covers
The main published study is a phase III trial of a 0.25% finasteride spray (Piraccini and colleagues, Journal of the European Academy of Dermatology and Venereology, 2022). It enrolled 458 men aged 18 to 40 with mild to moderate vertex hair loss and ran for 24 weeks, with the spray, a placebo and finasteride 1 mg tablets in separate groups. It was funded by the companies that make the spray, and several authors are employees of one of them.
For hair, the spray group's hair count in the target area (a 1 square centimetre patch of the vertex, not the whole scalp) rose by 20.2 hairs against 6.7 with placebo. For exposure, average blood levels of finasteride at week 24 were 48.0 pg/ml with the spray and 5,029 pg/ml with the tablet. Blood DHT fell by 34.6% with the spray (against 55.6% with the tablet). Treatment-related sexual side effects were reported by 2.8% of the spray group, 3.3% of the placebo group and 4.8% of the tablet group.
Three cautions. It is one trial of one product in young men, and it tells you nothing about a different strength, vehicle or pharmacy-made preparation. Hair counts in a small target area are not the same as what you see in the mirror. And lower exposure is not no exposure: DHT still fell, so a spray is still a systemic medicine. We do not use these figures to say one form is better than another, and a reduction in reported side effects in a trial is not a guarantee for you.
Safety: the MHRA warnings and handling
The MHRA's Drug Safety Updates of 29 April 2024 and 11 May 2026 warn that finasteride is associated with low mood, depression, suicidal thoughts and sexual dysfunction that may persist after stopping. The updates concern the licensed tablets and do not mention topical use. Because topical finasteride still reaches the bloodstream, a prescriber should apply the same precautions: ask about any history of depression, explain the warnings, and review you for mood and sexual changes. WMG Meds does. See finasteride side effects and what the MHRA says.
If you develop depression or thoughts of suicide, stop and contact your doctor as soon as possible. If you are struggling, call Samaritans free on 116 123, call NHS 111, or call 999 or go to A&E if you feel at serious risk.
Handling. Finasteride can affect the development of a male baby, and the tablet's product information says women who are or may be pregnant must not handle crushed or broken tablets. A woman who is or may be pregnant should likewise not handle a topical solution or apply it for you, because it can be absorbed through the skin.
Local effects. Scalp irritation and dryness are the commonest problems with any scalp liquid; the solvent as well as the active ingredient can be the cause.
Blood donation, PSA and other practical points
JPAC, which sets the UK donor selection guidelines, says a donor who has only used topical finasteride can be accepted, while finasteride taken systemically in the last 4 weeks rules out donation. Tell the donor service exactly what you use. See finasteride and blood donation.
Finasteride lowers the PSA blood test, so tell any doctor ordering one that you use it in any form. See finasteride and the PSA test.
For the full comparison of the two forms, including licensing and absorption, read topical versus oral finasteride.
What about combining it with minoxidil?
Finasteride and minoxidil work differently, and some pharmacies make a solution containing both. Trials of mixed solutions exist, and a 2025 meta-analysis of seven randomised trials (396 men) has pooled them, but the strengths and ingredients in those trials differ from any given pharmacy's preparation, so their results cannot simply be read across. There is no licensed combination product in the UK. Our guides on oral versus topical minoxidil and stopping the finasteride and minoxidil combination cover related questions.
If you would like a GMC-registered doctor to talk through whether any form of finasteride is right for you, start the free online assessment.
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Start your free assessment →Related questions
Is topical finasteride licensed in the UK?
No. Every finasteride product on the UK medicines database is a tablet. Topical finasteride is prescribed as an unlicensed special, made to order for an individual patient.
Is topical finasteride safer than tablets?
Not something we can promise. In one trial of a 0.25% spray, blood levels of finasteride and the fall in blood DHT were smaller than with tablets, but the MHRA warnings still apply in principle, and that result does not transfer to every preparation.
Can I buy topical finasteride without a prescription?
No. Finasteride-containing products for hair loss need a prescription, and an unlicensed special can only be supplied against a prescriber's order for an individual patient.
Can a pregnant partner touch topical finasteride?
A woman who is or may be pregnant should not handle the solution or apply it for you, because finasteride can be absorbed through the skin and could affect the development of a male baby.
Can I give blood if I use topical finasteride?
The UK donor guidelines say a donor who has only used topical finasteride can be accepted. If you also take finasteride tablets, the 4-week deferral applies. Tell the donor service what you use.
Sources
- Electronic medicines compendium (eMC): finasteride products
- MHRA: Supply of unlicensed medicinal products (specials)
- MHRA Drug Safety Update: Off-label or unlicensed use of medicines, prescribers' responsibilities
- Piraccini BM et al. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial. JEADV 2022
- Li Y et al. Comparing minoxidil-finasteride mixed solution with minoxidil solution alone for male androgenetic alopecia: a systematic review and meta-analysis. Front Med 2025 (PMID 41127390)
- JPAC, Guidelines for the UK Blood Transfusion Services: Alopecia (whole blood, 11 August 2026)
- Propecia 1 mg: summary of product characteristics (eMC, revised 29 June 2026)
- MHRA Drug Safety Update, 11 May 2026: Finasteride and dutasteride, updated safety warnings
Facts checked against these sources on 22 October 2026. This page is general information, not personal medical advice. Read our editorial policy.