The Changes Seen When Two Hair-Loss Drugs Are Used Together

In the treatment of male-pattern hair loss, there are two main pillars. One is suppressing dihydrotestosterone (DHT), the signal that puts pressure on hair follicles. The other is amplifying growth signals that keep follicles alive. In other words, there is a defensive side and an offensive side. Addressing both at the same time has emerged as the main trend in hair-loss treatment.


Finasteride (or dutasteride) targets the first pillar. It reduces the production of DHT involved in hair loss, easing the pressure on hair follicles. It is a drug that makes hair "fall out less." With long-term use, hair shedding decreases and the rate at which hairs become thinner slows down. However, in many cases finasteride alone does not lead to a visibly fuller head of hair. Finasteride is excellent at protecting follicles, but it is relatively weak when it comes to actively promoting the growth of new hair.

If finasteride is the defender, minoxidil is the attacker. It prolongs the growth phase of hair follicles and improves blood flow and cellular activity, which increases hair thickness and density. In most cases, gradual changes become noticeable after a few months. However, when minoxidil is used alone, its effect may plateau over time, and hair can start to fall out again. This is because DHT continues to exert pressure from the other side.

The treatment paradigm has recently shifted. In the past, the question was whether to use minoxidil or finasteride. Now, the focus is on how to use the two together. Multiple clinical studies have shown that combining the two drugs produces more stable results than using either one alone. This is not just a statistical coincidence; it reflects how the drugs work pharmacologically. The treatment activates both a mechanism that prevents shedding and a mechanism that promotes growth at the same time.
When the two drugs are used in combination, the first six months are spent observing changes. Visible improvement may be slow at first. Even so, treatment should be continued without interruption. Only after about 12 months can the response to therapy be reasonably evaluated. After that, the detailed strategy is adjusted based on individual response, side effects, convenience, and cost.
An important principle is not to fixate on the formulation. Some patients respond well to topical products, while others prefer oral medication. The key is to continue without frequent breaks. Repeatedly stopping and restarting treatment destabilizes hair follicles and worsens the outcome.
Lifestyle habits also influence treatment. Lack of sleep, chronic stress, insufficient protein intake, and frequent irritation of the scalp can impair follicle function by causing inflammation and changes in blood flow. In contrast, regular sleep, a balanced diet, and avoiding excessive styling can significantly enhance the treatment response.

If you set your goal as complete restoration, you may end up disappointed. A realistic goal is to maintain a better state than now over the long term. Areas where a large amount of hair has already been lost are unlikely to show dramatic recovery with medication alone. A more reasonable approach is to use drugs to protect the remaining hair and, when necessary, consider supplementing with hair transplantation.
Side effects must also be considered. Changes in sexual function have been reported with finasteride, and minoxidil can cause scalp irritation or unwanted body hair growth. However, in most cases these issues can be adequately managed by adjusting the dose or changing how the medication is used.
The core principle of treating male-pattern hair loss has not changed: protect and promote. It is therefore reasonable to use together the two drugs that protect existing hair and encourage new growth. This approach is supported by accumulated clinical experience and research. Until a new drug emerges, it is likely to remain the standard treatment method.

kind@fnnews.com Kim Hyun-seon Reporter