Finasteride Vs Breezula (Clascoterone): How They Compare For Hair Loss
Last reviewed on 7 October 2026. We review our treatment guides every six months to keep them accurate.
Key points
Both fight the same hormone, but in different ways. Finasteride and Breezula (the brand name for clascoterone) both target DHT, the hormone that drives male pattern hair loss, but one lowers how much DHT your body makes while the other blocks DHT from acting on the follicle.
Finasteride is an oral tablet that lowers DHT production. It blocks the enzyme that makes DHT, cutting it by around 70 per cent throughout the body, and it is a proven, licensed, first-line treatment.
Breezula is a topical that blocks DHT at the scalp. Clascoterone is applied to the scalp and sits on the follicle’s androgen receptor so DHT cannot bind, acting locally rather than lowering hormone levels in the body.
The big practical difference: finasteride is available now, Breezula is not. Clascoterone is approved as a cream for acne, but for hair loss it is still in development and not approved, so you cannot currently get Breezula for hair loss.
Breezula’s appeal is being topical, with the aim of fewer whole-body effects. Because it works at the scalp and is quickly broken down, it is designed to avoid the systemic hormonal side effects that put some people off finasteride.
Its hair-loss evidence is promising but incomplete. Early studies are encouraging, and later-stage trials have been reported, but the full results have not yet been published in peer-reviewed journals.
Neither adds hair or restores a bald scalp. Both are for keeping and supporting the hair you still have; for bald areas a hair transplant is the only option that adds hair. Which suits you is best decided with a clinician.
Finasteride and Breezula are both "anti-androgen" treatments, meaning both work against DHT, the hormone behind male pattern hair loss. But they do it differently: finasteride is an oral tablet that lowers how much DHT the body makes, while Breezula (clascoterone) is a topical that blocks DHT from acting on the scalp. The other crucial difference is availability: finasteride is a proven, licensed treatment you can use today, while Breezula, for hair loss, is still in development.
This guide compares finasteride and Breezula neutrally: what each is, how they differ, how effective they are, where each stands, who each suits, and how they fit with other treatments. It is general information and not a substitute for advice from a doctor.
The short answer
Finasteride and Breezula both target DHT, the hormone that causes male pattern loss, but by different routes. Finasteride is an oral tablet that lowers how much DHT the body produces, and it is a proven, licensed, first-line treatment. Breezula is the brand name for clascoterone, a topical that sits on the scalp’s androgen receptors and blocks DHT from acting there, working locally and designed to avoid the whole-body effects of a tablet. The catch is that Breezula is not yet available for hair loss: clascoterone is approved as a cream for acne, but the hair-loss version is still in development, with promising but incomplete evidence. So, in practice, finasteride is the proven option you can use now, while Breezula is a promising topical to watch for the future. Neither, though, can regrow a scalp that is already bald.
What is finasteride?
Finasteride is a daily tablet that treats male pattern hair loss by lowering DHT, the hormone that shrinks genetically sensitive follicles. It blocks the enzyme 5-alpha reductase, which, as a review of these drugs in dermatology explains, "converts testosterone to dihydrotestosterone (DHT), which amplifies androgen effects in certain tissues". By blocking it, finasteride produces "a substantial reduction in serum (around 70%)" DHT, and the review notes that "long-term use of finasteride at a 1-mg dose proved to be safe and effective in treating male-pattern" hair loss. So it works on the cause of the loss by reducing how much DHT the body makes, which is why it is a first-line, licensed treatment. Our guide on finasteride for hair loss covers it in detail, including the possible side effects.
What is Breezula (clascoterone)?
Breezula is the brand name under development for clascoterone used on the scalp for hair loss. Rather than lowering DHT, it blocks DHT from acting on the follicle. As a narrative review of clascoterone explains, "clascoterone cream is the first topical androgen receptor inhibitor approved by the U.S. Food and Drug Administration (FDA) for the treatment of acne vulgaris", and it works "by binding to androgen receptors in a manner competitive with DHT", blocking the signalling that DHT would otherwise trigger. Crucially, "topical administration of clascoterone enables selective targeting of cutaneous androgen receptors, while its rapid metabolic inactivation to cortexolone, an inactive metabolite, minimizes the potential for systemic adverse effects", which is the point of a scalp treatment: to act locally and avoid whole-body effects. For hair loss specifically it is not yet approved; our guide on Breezula (clascoterone) for hair loss covers where it stands.
Which is more effective for hair loss?
Finasteride has the far stronger evidence, simply because it is established and Breezula is not yet. Finasteride is a proven, licensed first-line medicine with decades of use behind it. Clascoterone for hair loss is promising but early: the same review notes it "has emerged as a promising candidate for the treatment of androgenetic alopecia", while being clear that "emerging but still incomplete data suggest potential applications in androgenetic alopecia", and that "in phase 2 studies, clascoterone treatment showed favorable outcomes in measures such as scalp sebometric measurement, hair diameter, follicular density, and pull test/wash test".
Importantly, the later-stage hair-loss trials have not yet been independently published. The review notes that the pivotal phase 3 AGA programme "was reported to be completed in 2025", but that "the complete results of these trials have not been published in peer-reviewed journals and are available only through sponsor-issued announcements", and that "because these findings have not undergone independent scientific evaluation, they cannot be presented as established evidence". So the honest position is that finasteride is proven and available, while Breezula is a promising but still unproven and unapproved option for hair loss.
Finasteride vs Breezula: how do they compare?
Both work against DHT, but they differ in mechanism, route and, crucially, availability:
What they are: finasteride is an oral prescription tablet; Breezula (clascoterone) is a topical you apply to the scalp.
How they work: finasteride lowers how much DHT the body makes; clascoterone blocks DHT from binding the follicle’s androgen receptor, so it tackles the same hormone at a different point.
Where they act: finasteride works throughout the body; clascoterone is designed to act locally at the scalp and is rapidly broken down, aiming to minimise whole-body effects.
Availability: finasteride is licensed and available for hair loss now; clascoterone is approved only as an acne cream, and the hair-loss version is still in development, not yet approved.
Evidence: finasteride has strong, long-standing evidence; clascoterone for hair loss has promising but incomplete data, with the key late-stage results not yet peer-reviewed.
Side effects: finasteride is generally well tolerated but, being a systemic hormonal medicine, can cause side effects in a minority; clascoterone’s topical, local design is intended to reduce that risk, though its long-term hair-loss safety is still being established.
What neither does: neither adds new hair or restores a bald area, so both are for keeping and supporting the hair you still have rather than replacing hair that is gone.
Which is right for you?
In practical terms today, finasteride is the option you can actually use: it is proven, licensed and cheap, and it treats the cause by lowering DHT. Breezula is not currently available for hair loss, so it is not a choice you can make right now, however appealing a topical anti-androgen with fewer systemic effects might sound. For people who are specifically worried about the whole-body effects of a DHT-lowering tablet, a topical that acts only at the scalp is an attractive idea, and clascoterone is the most advanced treatment of that kind, so it is well worth watching, but it remains promising rather than proven, and unapproved for hair loss. Neither, in any case, suits someone whose loss is advanced or whose follicles are already gone, because both only support hair that is still there.
Because finasteride is a prescription medicine and Breezula is still investigational for hair loss, the sensible step is to discuss your options with a clinician, who can set out what is proven and available now and keep you informed as newer treatments reach approval.
Can they be combined with other treatments?
For now this is largely theoretical, because Breezula is not yet available for hair loss. In principle, because finasteride lowers DHT production while clascoterone blocks DHT at the receptor, the two attack the same hormone at different points and might one day be used together, but that is not something you can do today and would be a decision for a clinician. In practice, finasteride is most commonly paired with minoxidil, a topical that stimulates the follicles by a different mechanism, which we compare in our guide on finasteride versus minoxidil; and the stronger DHT-blocking tablet, dutasteride, is compared in our guide on finasteride versus dutasteride.
Neither finasteride nor Breezula can restore hair that is already gone. Where loss is more advanced, a hair transplant is a separate option that redistributes your own permanent hair, and a DHT treatment like finasteride is often used around a transplant to protect and support the result; our guide on hair transplant versus finasteride looks at that. The key point is that these are treatments to keep the hair you have, used as part of a wider plan, not a cure.
The bottom line
Finasteride and Breezula both work against DHT, the hormone behind male pattern hair loss, but differently: finasteride is an oral tablet that lowers how much DHT the body makes, while Breezula (clascoterone) is a topical that blocks DHT from acting on the scalp. Finasteride is proven, licensed and available now; Breezula is a promising topical anti-androgen whose appeal is acting locally with fewer whole-body effects, but for hair loss it is still in development, not approved, and its late-stage evidence has not yet been independently published. Neither adds hair or restores a bald area.
If you are choosing a treatment today, finasteride is the proven, available option, while Breezula is one to watch for the future. A clinician can help you decide what suits your hair loss now, and how newer treatments might fit in once they are approved, as well as how either sits alongside other treatments or a hair transplant.
Frequently asked questions
Is Breezula better than finasteride for hair loss?
It is too early to say, and in practical terms the question is moot for now because Breezula is not yet available for hair loss. Finasteride is a proven, licensed, first-line treatment with decades of evidence. Clascoterone, the drug in Breezula, is a promising topical anti-androgen, and its appeal is acting at the scalp with fewer whole-body effects, but its hair-loss data are still incomplete and the key late-stage results have not yet been peer-reviewed. So finasteride is the established option, while Breezula is promising but unproven and unapproved for hair loss.
Is Breezula available for hair loss?
Not yet. Clascoterone, the active drug, is approved as a cream for acne, but the higher-strength scalp solution developed for hair loss, Breezula, is still in clinical development and has not been approved for hair loss in the UK or elsewhere. Later-stage trials have been reported by the company, but the full results have not yet been published in peer-reviewed journals, and an approval decision has not been made. So you cannot currently get Breezula as a hair-loss treatment.
What is the difference between finasteride and Breezula?
Both target DHT, the hormone behind male pattern hair loss, but in different ways. Finasteride is an oral tablet that lowers how much DHT the body produces, acting throughout the body. Breezula (clascoterone) is a topical that you apply to the scalp, where it blocks DHT from binding the follicle’s androgen receptor, acting locally. So finasteride reduces the hormone, while Breezula blocks its effect at the scalp; and finasteride is available now, while Breezula is still in development for hair loss.
Does Breezula have fewer side effects than finasteride?
That is the hope, but it is not yet confirmed for hair loss. Because clascoterone is applied to the scalp and is rapidly broken down, it is designed to act locally and minimise the whole-body hormonal effects that put some people off finasteride. Its acne form has a good safety record. But its long-term safety as a hair-loss treatment is still being established, and until the trials are fully published and it is approved, any advantage over finasteride on side effects remains a reasonable expectation rather than a proven fact.
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