Finasteride Vs Pyrilutamide: How They Compare For Hair Loss
Last reviewed on 16 October 2026. We review our treatment guides every six months to keep them accurate.
Key points
They fight the same hormone, but at different points. Finasteride and pyrilutamide (also known as KX-826) both target DHT, the hormone that drives male pattern hair loss, but finasteride lowers how much DHT the body makes, while pyrilutamide blocks DHT from acting on the follicle.
Finasteride is the proven, first-line tablet. Taken daily, it blocks the enzyme that makes DHT, cutting the hormone by around 70 per cent and protecting follicles from being shrunk. It is licensed for hair loss and backed by long-standing evidence.
Pyrilutamide is an experimental topical anti-androgen. Applied to the scalp, it blocks DHT at the follicle without lowering the hormone in the body, which is meant to limit whole-body side effects. It is not an approved medicine, and its trial results have been mixed, but the same compound is now sold over the counter as a cosmetic.
The decisive differences are approval and evidence. Finasteride is a licensed medicine with strong evidence; pyrilutamide is sold over the counter as a cosmetic but is not an approved medicine, and its trial results have been mixed.
Pyrilutamide’s appeal is being a topical, not a tablet. Some people want to avoid a hormonal tablet, which is why a topical that blocks DHT only at the scalp has drawn interest, but it cannot yet be chosen.
Because they work at different points, they are not strictly rivals. One lowers the hormone and the other blocks it at the follicle, so in principle they could complement each other rather than compete.
Neither adds hair or restores a bald scalp. Both aim to protect 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 pyrilutamide are often set against each other because they tackle the same hormone, DHT, in two different ways: finasteride lowers how much the body makes, while pyrilutamide blocks it at the follicle. Finasteride is a proven, licensed tablet. Pyrilutamide (KX-826) is a newer topical still in development. The key differences are how they work, and how proven and available each is.
This guide compares finasteride and pyrilutamide 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 pyrilutamide both target DHT, the hormone that causes male pattern loss, but from different directions and at very different stages. Finasteride is a proven, first-line tablet: it blocks the enzyme that makes DHT, cutting it by around 70 per cent and protecting follicles from being shrunk. It is licensed for hair loss, cheap, and backed by long-standing evidence, though it is a hormonal drug that some people would rather avoid. Pyrilutamide, also called KX-826, is an experimental topical that blocks DHT at the follicle without lowering it in the body, which is designed to keep whole-body effects low. The appeal is obvious, a topical that tackles the hormone only at the scalp, but it is still in development, not approved, and its trial results have been mixed. So, in practice, finasteride is the proven, licensed option, while pyrilutamide is now sold over the counter as a cosmetic, though not as an approved, proven medicine. Because one lowers the hormone and the other blocks it at the follicle, they are not strictly rivals, and could in principle be used together. Neither, in any case, 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. As a 2023 review of 5-alpha-reductase inhibitors explains, the enzyme it blocks "converts testosterone to dihydrotestosterone (DHT), which amplifies androgen effects in certain tissues", and finasteride produces "a substantial reduction in serum (around 70%)" DHT. By cutting the hormone, it protects the follicles and slows, halts or partly reverses the loss. It is the standard first-line medical treatment, licensed for hair loss in men, and its evidence is strong and long-standing: the same 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. It is a hormonal drug taken by mouth, which is why a minority of men are concerned about side effects. Our guide on finasteride for hair loss covers it in detail, and finasteride versus minoxidil compares it with the other mainstay.
What is pyrilutamide (KX-826)?
Pyrilutamide, also known as KX-826, is an experimental topical anti-androgen developed specifically for hair loss by the company Kintor. Unlike finasteride, it does not lower DHT; instead it blocks DHT from acting on the follicle. As a 2026 review of emerging hair-loss pharmacotherapies describes, it is a "topical non-steroidal androgen receptor antagonist" that "blocks DHT at follicle without systemic DHT reduction", and it "works by blocking DHT’s effect on hair follicles without lowering overall DHT levels". The idea is to tackle the hormone only at the scalp and so keep whole-body effects low. The review is clear, though, that it remains experimental: it reports "mixed phase III results (some trials met safety/efficacy endpoints in China; prior failures noted); ongoing long-term/1.0% trials", and lists it as "not FDA-approved; investigational". It is not approved or licensed as a prescription medicine for hair loss by regulators such as the UK’s MHRA or the US FDA. The same compound is, however, now sold over the counter as a cosmetic scalp solution, directly to consumers including in the UK, by its developer and its commercial partners. It is the same substance either way: being sold as a cosmetic rather than a licensed medicine does not mean it is a different or weaker product, only that it has not been through the trials and approval that would confirm how well it works. Our guide on pyrilutamide (KX-826) for hair loss covers where it stands.
Which is more effective for hair loss?
On the evidence available, finasteride is clearly the more proven treatment, because it is established and licensed while pyrilutamide is not. Finasteride has decades of use and strong trial support for holding on to and partly regrowing hair, as the 5-ARI review sets out. Pyrilutamide has a plausible mechanism, blocking DHT at the follicle, but its results have been inconsistent: the emerging-pharmacotherapies review describes "mixed phase III results", with some endpoints met in China and "prior failures noted", and it is not approved.
The two are also not directly comparable, because they act at different points in the same pathway. Finasteride reduces the amount of DHT the body makes, with proven results; pyrilutamide tries to stop the DHT that is made from acting on the follicle, with a plausible but, as yet, unproven and inconsistent effect. So the honest position is that finasteride is the proven, available option, while pyrilutamide is a promising but unsettled one that tackles the same hormone in a different way.
Finasteride vs pyrilutamide: how do they compare?
They tackle the same hormone, but differ in route, evidence and availability:
What they are: finasteride is an oral prescription tablet; pyrilutamide (KX-826) is an experimental topical.
How they work: finasteride lowers how much DHT the body makes, protecting follicles from the hormone; pyrilutamide blocks DHT from acting on the follicle without lowering it in the body.
Where they act: finasteride works throughout the body to cut DHT at source; pyrilutamide works only at the scalp, blocking DHT locally.
Availability: finasteride is licensed and available for hair loss now; pyrilutamide is investigational and not approved.
Evidence: finasteride has strong, long-standing evidence; pyrilutamide’s trial results have been mixed, with some endpoints met and some failures.
Hormonal reach: finasteride is a hormonal drug taken by mouth, which a minority find off-putting because of possible side effects; pyrilutamide is applied to the scalp and designed to keep whole-body effects low, which is part of its appeal.
Rivals or partners: because one lowers the hormone and the other blocks it at the follicle, they are complementary rather than competing, and could in principle be used together.
What neither does: neither adds new hair or restores a bald area, so both are for protecting 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, inexpensive and works on the cause by lowering DHT. The main reason some people look elsewhere is that it is a hormonal drug taken by mouth, and a minority are concerned about side effects, which is exactly the gap a scalp-only topical like pyrilutamide might one day fill. But pyrilutamide is not approved, and its trial results have been mixed, so however appealing the idea of blocking DHT only at the scalp, you can now buy it as a cosmetic, but it is not an approved or proven medicine, so it is best approached with caution rather than relied on as a proven treatment. The more useful way to think about them is as two approaches to the same hormone: finasteride to lower DHT at source, proven and available; pyrilutamide to block it at the follicle, experimental and one to watch, with the possibility that, in time, approaches like these could sit alongside the mainstays.
Neither, in any case, suits someone whose follicles are already gone, because both only aim to protect follicles that are still there. Because finasteride is a prescription medicine and pyrilutamide is still experimental, the sensible step is to discuss your options with a clinician, who can weigh up your pattern of loss and your feelings about a hormonal drug, and keep you informed as newer treatments reach approval.
Can they be combined with other treatments?
For now, combining finasteride and pyrilutamide is theoretical, because pyrilutamide is not approved. In principle it is an interesting pairing, because finasteride lowers how much DHT the body makes while pyrilutamide would block whatever DHT remains from acting on the follicle, so the two attack the hormone at different points. In practice today, finasteride is most often combined with minoxidil, a topical that stimulates the follicles by a different route, which we compare in our guide on finasteride versus minoxidil. The comparison with the other leading topical anti-androgen, clascoterone, is covered in our guides on finasteride versus Breezula and Breezula versus pyrilutamide.
Neither finasteride nor pyrilutamide can restore hair where the follicles have been lost. Where loss is 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 how the two fit together. The key point is that these are treatments to protect the hair you have, used as part of a wider plan, not a cure.
The bottom line
Finasteride and pyrilutamide both target DHT, the hormone behind male pattern hair loss, but at different points and at very different stages. Finasteride is a proven, first-line tablet that lowers how much DHT the body makes, protecting follicles from being shrunk; it is licensed, cheap and backed by long-standing evidence, though it is a hormonal drug some prefer to avoid. Pyrilutamide (KX-826) is an experimental topical that blocks DHT at the follicle without lowering it in the body, designed to keep whole-body effects low, but it is not approved and its trial results have been mixed. Neither adds hair or restores a bald area.
If you are choosing a treatment today, finasteride is the proven, licensed option, while pyrilutamide is now sold over the counter as a cosmetic, though not as an approved, proven medicine. The two are not strictly rivals: finasteride lowers DHT at source, and pyrilutamide would block it at the follicle, so approaches like these may one day sit alongside each other. A clinician can help you decide what suits your hair loss now, including how you feel about a hormonal drug, and how newer treatments might fit in once they are approved.
Frequently asked questions
Is pyrilutamide better than finasteride for hair loss?
On the evidence available, no, because finasteride is proven and pyrilutamide is not. Finasteride is a licensed, first-line treatment with long-standing evidence that it lowers DHT and protects follicles. Pyrilutamide (KX-826) is an experimental topical with a plausible mechanism, blocking DHT at the follicle, but its trial results have been mixed and it is not approved. Its appeal is being a scalp-only topical rather than a tablet, which may suit people who want to avoid a hormonal drug, but that is a reason to watch it, not evidence that it works better. For now, finasteride remains the proven choice.
Is pyrilutamide available for hair loss?
It is not approved or licensed as a medicine for hair loss by the UK’s MHRA or the US FDA, and its trial results have been mixed. However, the same compound is now sold over the counter as a cosmetic scalp solution, directly to consumers including in the UK, by its developer and its commercial partners, so you can buy it. It is the same substance whether sold as a cosmetic or studied as a drug: being sold as a cosmetic does not mean you are getting something different or weaker, only that it has not had the data to confirm it is effective. Finasteride, by contrast, is licensed for male pattern hair loss and available now on prescription.
What is the difference between finasteride and pyrilutamide?
They tackle the same hormone, DHT, but at different points. Finasteride is an oral tablet that lowers how much DHT the body makes, protecting the follicles from the hormone that shrinks them. Pyrilutamide (KX-826) is an experimental topical that blocks DHT from acting on the follicle, without lowering the hormone in the body. So finasteride cuts DHT at source throughout the body, while pyrilutamide blocks it locally at the scalp; and finasteride is a proven, licensed tablet, while pyrilutamide is sold over the counter as a cosmetic but is not an approved medicine.
Would pyrilutamide avoid finasteride’s side effects?
That is the hope, but it is not yet established. Finasteride is a hormonal drug taken by mouth, and a minority of men are concerned about sexual or mood-related side effects. Pyrilutamide is applied to the scalp and designed to block DHT only at the follicle, without lowering it in the body, so in principle it would not carry the same whole-body hormonal effects, which is a large part of its appeal. However, pyrilutamide is still in development, its results have been mixed, and its own long-term safety is still being established, so while it may avoid finasteride’s particular concerns, that cannot yet be taken as proven.
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