The most common cause of progressive hair thinning is androgenetic alopecia, also known as pattern hair loss. It occurs in both men and women and involves two main biological factors:

1. Hormonal sensitivity specifically to dihydrotestosterone (DHT), a byproduct of testosterone, which shortens the hair growth cycle.
   
   
2. Reduced blood flow to follicles – leading to smaller, weaker hairs and eventual dormancy.
   
   

For years, conventional treatments typically targeted one of these mechanisms. However, combination therapy with Minoxidil and Finasteride can address both.

Minoxidil: Improving Circulation and Follicle Activity

Minoxidil is a vasodilator that improves blood flow to hair follicles. As Minoxidil expands blood vessels, it increases oxygen and nutrient delivery to the scalp. It also helps extend the anagen phase, the active growth period of the hair cycle.

Originally developed as an oral blood pressure medication, Minoxidil’s hair-growth effects were discovered serendipitously. Since then, topical Minoxidil has become one of the most widely used hair growth agents, available over-the-counter in low concentrations and by prescription in compounded strengths for enhanced results.

Finasteride: Targeting Hormone-Driven Hair Loss

Finasteride works differently from Minoxidil. It inhibits the enzyme 5-alpha-reductase, which converts testosterone into DHT. It lowers DHT levels at the scalp, helping prevent follicle miniaturization and supporting longer, thicker hair shafts.

Finasteride is best known in oral tablet form, but topical delivery offers an alternative route that targets the scalp directly while potentially reducing systemic absorption.

Hair loss is multifactorial—circulation, hormones, inflammation, and genetics can all play a role—so combining minoxidil and finasteride helps address two major biological pathways at once. Minoxidil primarily supports the “growth” side of treatment by improving scalp blood flow, directly stimulating follicle activity, and helping sustain the hair growth cycle, while finasteride primarily supports the “preservation” side by reducing DHT, the key hormone associated with follicle miniaturization in androgenetic alopecia; by lowering DHT, it can also support follicle function more indirectly and contribute to maintaining the growth cycle over time.

Clinical evidence and provider experience suggest these ingredients are complementary: minoxidil is often associated with promoting new growth, whereas finasteride helps protect existing follicles by reducing the hormonal driver of ongoing thinning. Putting both actives into a single compounded topical formula can also simplify daily use—fewer steps, one application—which tends to improve consistency, and consistency is one of the most important factors for achieving and maintaining results.

At Hillstone Pharmacy, we prepare customized topical Minoxidil/Finasteride solutions for licensed providers and their patients.

Available formula:

• Minoxidil/Finasteride 10/0.1% Topical Solution (50 mL)
  

Each prescription is compounded in a stable base designed for even scalp application. Formulations may be customized for individual needs, like fragrance-free options, or strength adjustments based on tolerance and response.

Key advantages of compounding include:

• Customized concentrations: tailored to patient sensitivity and goals.
  
  
• Improved compliance: one simple topical product instead of multiple steps.
  
  
• Reduced systemic exposure: potential lower absorption compared to oral routes.
  
  
• Flexible formulations: adjusted vehicles for oily, dry, or sensitive scalps.
  

Hillstone compounds all hair restoration preparations under USP <795> non-sterile compounding standards, ensuring consistency, stability, and quality control from ingredient sourcing to packaging.

While both Finasteride and Minoxidil are available in oral forms, topical delivery has unique advantages.

Topical benefits:

• Targets the scalp directly where the issue occurs.
  
  
• Potentially lowers systemic hormone exposure.
  
  
• Reduces risk of sexual or hormonal side effects seen with oral Finasteride.
  
  

Oral benefits:

• Convenient for patients who prefer once-daily dosing.
  
  
• Easier to standardize dosage for systemic effect.
  
  

Many providers use topical formulations for patients who cannot tolerate oral Finasteride or who prefer a localized approach. Women of childbearing potential, in particular, may be prescribed topical Finasteride only under careful supervision to minimize systemic exposure.

When prescribed appropriately, compounded Minoxidil/Finasteride is generally well tolerated. Common mild effects include:

• Temporary scalp dryness or irritation.
  
  
• Mild shedding in early treatment as dormant follicles shift phases.
  
  
• Itching or flaking due to alcohol-based vehicles (reformulatable by pharmacy).
  
  

Rare systemic effects may occur if absorption is significant. This could be reduced libido or hormonal changes, though the risk is lower than with oral forms.

Providers typically recommend consistent daily use and periodic follow-ups every 3–6 months to evaluate progress and tolerance. Results usually become noticeable after 3–6 months of continuous application, with maximal improvement by 12 months.

Compounded Minoxidil/Finasteride is not FDA-approved, as each formulation is prepared per individual prescription under Section 503A of the Federal Food, Drug, and Cosmetic Act.

Cost depends on concentration, volume, and refills, but often remains competitive with long-term commercial brands. Because compounded hair formulas are typically out-of-pocket, Hillstone Pharmacy provides transparent pricing and refill scheduling to simplify ongoing care.

Patients should ensure any compounded hair therapy comes from a pharmacy that:

• Operates under state and federal compounding licensure.
  
  
• Sources active ingredients from FDA-registered suppliers.
  
  
• Adheres to USP <795> quality standards.
  
  
• Provides clear labeling, storage, and counseling documentation.
  
  

Hillstone meets all of these standards and offers direct pharmacist access for patients and providers seeking education or formulation support.

Is topical Finasteride safer than oral Finasteride?
Topical use may reduce systemic absorption, but safety and response vary. Always follow provider dosing and monitoring protocols.

How long before I see results?
Most users begin to see reduced shedding or early regrowth between 3–6 months with consistent application.

Can women use compounded Minoxidil/Finasteride?
Some women may benefit from compounded Minoxidil/Finasteride under strict medical supervision, but formulations are adjusted for safety.

What happens if I stop treatment?
Discontinuation typically results in a gradual loss of any regrown or preserved hair over several months. Maintenance is key.

Is compounded topical Minoxidil/Finasteride FDA-approved?
No. These formulations are not FDA-approved but are legal when compounded per individual prescription through a licensed 503A pharmacy.

Hillstone Pharmacy compounds Minoxidil/Finasteride topical solutions with precision, transparency, and collaboration in every step. Each prescription undergoes quality checks for concentration accuracy, stability, and uniformity.

Hillstone Advantages

• 503A licensed compounding for individualized prescriptions.
  
  
• Topical Minoxidil/Finasteride 10/0.1% (50 mL) solution compounded to order.
  
  
• Pharmacist-provider collaboration for personalized care plans.
  
  
• Patient counseling for safe application and realistic expectations.
  
  
• Documented sourcing from FDA-registered suppliers.
  
  

Hillstone’s approach centers on education, compliance, and trust. We give patients confidence that their compounded therapy is prepared to the highest standards of quality and integrity.

If you’re exploring hair restoration options, start with a consultation with a licensed provider. A medical professional can assess whether topical compounded therapy is appropriate and collaborate with Hillstone Pharmacy to design a custom formulation.