Finasteride is more effective for long-term hair maintenance by addressing the root cause of hair loss, while minoxidil acts as a growth stimulant with faster visible results. Combining both treatments is optimal, with oral minoxidil often showing better results for some individuals.
Aminexil/Kopexil may help reduce hair loss by addressing perifollicular fibrosis in androgenetic alopecia, but it lacks the extensive clinical backing of finasteride and minoxidil. Some users find it effective, but availability and cost are issues, especially in the US where it's not FDA-approved.
Hair growth relies on mechanical forces, not just chemicals, with tissue acting like a motor. Minoxidil and finasteride help, but maintaining tissue elasticity and addressing mechanical issues are essential.
Some people may not respond to topical minoxidil due to low SULT1A1 enzyme activity, but oral minoxidil can be effective. Tretinoin may enhance minoxidil's effectiveness, and some users prefer oral minoxidil despite side effects.