By Dr. John Robinson, NMD & Dr. Cristina Romero-Bosch, NMD | The Hormone Zone®

Hair loss is one of the most frustrating and often overlooked changes women experience during perimenopause and menopause. For many women, thinning hair isn’t simply a cosmetic concern. It affects confidence, self-image, and how they feel about aging.

At The Hormone Zone®, we routinely treat women experiencing hormonal changes and hair thinning. Our approach includes evaluating hormonal health and prescribing targeted hair restoration treatments, including topical finasteride, topical minoxidil, and low-dose oral minoxidil, depending on each patient’s needs.

Now, a new 2026 study published in the International Journal of Dermatology provides encouraging evidence supporting one of these treatments: topical finasteride.

New Research: Significant Hair Growth Improvements Over 52 Weeks

Researchers evaluated 26 postmenopausal women, ages 52 to 81, who used a 0.25% topical finasteride solution daily for one year.

The investigators measured hair density, hair shaft thickness, and the ratio of thicker terminal hairs to thinner, miniaturized hairs.

The results were impressive.

Importantly, the women used topical finasteride alone, without concurrent minoxidil or other hair growth treatments. This makes the findings particularly interesting because the improvements were observed with a single treatment.

Although the study was relatively small and did not include a control group, the results add to growing evidence supporting topical finasteride as an option for postmenopausal female pattern hair loss.

Why Does Hair Thin After Menopause?

Hair follicles are hormonally sensitive structures. Estrogen, testosterone, and dihydrotestosterone (DHT) all influence the hair growth cycle.

During menopause, estrogen levels decline substantially. This changes the hormonal environment surrounding the follicle and may increase the relative influence of androgen signaling in genetically susceptible women.

DHT is produced when the enzyme 5-alpha-reductase converts testosterone into its more potent androgenic metabolite.

In susceptible scalp follicles, DHT signaling contributes to a process called follicular miniaturization. Over time, thick, healthy terminal hairs become progressively finer, shorter, and less visible.

This helps explain why many women notice widening of the hair part, decreased volume around the crown, and increased scalp visibility as they age.

Importantly, female pattern hair loss can occur even when circulating testosterone and DHT levels are normal. Local follicular sensitivity and genetics are often more important than the absolute hormone concentration.

How Topical Finasteride Works

Finasteride inhibits the enzyme 5-alpha-reductase, reducing the conversion of testosterone into DHT.

When applied directly to the scalp, topical finasteride is intended to reduce DHT activity around susceptible hair follicles while limiting systemic exposure compared with oral administration.

By reducing this androgenic influence, finasteride may help slow follicular miniaturization and support the growth of thicker, healthier hair.

The 2026 study demonstrated improvements not only in the number of hairs but also in their diameter. This distinction matters because hair thickness is a major contributor to overall hair volume.

Topical finasteride can still be absorbed systemically, however, and appropriate dosing and patient selection remain important.

Why We Often Combine Finasteride With Minoxidil at The Hormone Zone®

At The Hormone Zone®, we frequently prescribe topical finasteride alongside topical or oral minoxidil as part of an individualized hair restoration program.

These medications work through different mechanisms, making them potentially complementary.

Finasteride addresses androgen-related follicular miniaturization. By inhibiting DHT production, it helps reduce one of the biological signals contributing to progressive patterned hair thinning.

Minoxidil promotes hair growth. It supports follicular activity, helps prolong the anagen or active growth phase, and can increase hair shaft diameter.

We prescribe both topical minoxidil and low-dose oral minoxidil, selecting the formulation based on the patient’s clinical presentation, preferences, and medical history.

Topical minoxidil delivers medication directly to the scalp and is an established treatment for female pattern hair loss. Oral minoxidil offers an alternative for patients who prefer not to use a daily scalp application or who have difficulty tolerating topical preparations.

Low-dose oral minoxidil is used off-label for hair loss and requires individualized assessment, particularly regarding blood pressure, edema, palpitations, and other cardiovascular effects.

For selected patients, combining finasteride with minoxidil allows us to address both the hormonal influences contributing to follicular miniaturization and the biological processes that promote new hair growth.

The newly published study evaluated finasteride alone, so its results should not be interpreted as directly measuring the effectiveness of our combination approach.

Hair Loss Is Also a Hormonal Health Issue

One of the most important distinctions in our approach at The Hormone Zone® is that we don’t view hair loss in isolation.

We evaluate the broader hormonal and metabolic environment that influences hair health.

Estrogen decline, thyroid dysfunction, iron deficiency, nutritional status, metabolic health, and changes in androgen activity can all contribute to hair thinning or excessive shedding.

For example, some women experience hair loss because of thyroid dysfunction, while others may have female pattern hair loss compounded by low iron stores or other physiological stressors.

This is why simply prescribing a hair growth product without understanding the underlying clinical picture may not be enough.

When appropriate, we evaluate thyroid function, sex hormones, iron status, and other relevant biomarkers. We also assess whether menopausal hormone therapy may be beneficial for the patient’s broader health.

Hormone replacement therapy is not an established standalone treatment for female pattern hair loss, but identifying and treating clinically relevant hormonal conditions is an important part of comprehensive care.

Our goal is to support healthier hair while addressing the physiological changes that may be contributing to its loss.

What About Safety and Long-Term Treatment?

One of the encouraging findings from the 2026 study was the favorable tolerability of topical finasteride.

Across the 52-week observation period, no adverse events were recorded among the 26 women included in the analysis. Patients also reported high treatment adherence and favorable satisfaction.

However, the study excluded women with prior sexual dysfunction or mood disorders and only analyzed those who completed treatment. Larger controlled studies are needed to better characterize long-term safety.

Finasteride is not FDA-approved for female pattern hair loss, and exposure during pregnancy must be avoided because of potential harm to fetal development. Its use in women requires appropriate clinical evaluation and counseling.

Hair restoration also requires patience. Hair follicles cycle slowly, and meaningful changes in thickness and density generally develop over months rather than weeks.

For many patients, ongoing treatment is necessary to maintain improvements.

A More Comprehensive Approach to Hair Restoration

Hair loss after menopause is common, but it does not mean women must simply accept progressive thinning as an inevitable part of aging.

We now have multiple treatment options that can target different aspects of follicular biology.

The latest research on topical finasteride adds another valuable piece to that picture, demonstrating measurable improvements in hair density, thickness, and follicular characteristics over one year.

At The Hormone Zone®, we routinely incorporate topical finasteride, topical minoxidil, and low-dose oral minoxidil into individualized treatment plans when clinically appropriate. We also evaluate the hormonal, thyroid, nutritional, and metabolic factors that may be influencing hair health.

We believe women deserve more than being told that thinning hair is simply part of getting older.

They deserve a thoughtful evaluation, evidence-informed treatment options, and a personalized strategy designed to preserve and improve hair health over time.

If you’re experiencing hair thinning during perimenopause or menopause, schedule a consultation with The Hormone Zone® to explore your options.

www.hormone-zone.com

Featured Research

Piraccini BM, Gupta AK, Cedirian S, et al. (2026). Topical Finasteride 0.25% Solution for Female Pattern Hair Loss (FPHL) in Postmenopausal Women: A 52-Week Retrospective Observational Study. International Journal of Dermatology.

Read the published study

Additional research referenced in the study:

• Starace et al. (2024). The Comparative Effects of Monotherapy With Topical Minoxidil, Oral Finasteride, and Topical Finasteride in Postmenopausal Women With Pattern Hair Loss. Skin Appendage Disorders. Research article

• Suchonwanit et al. (2019). Efficacy of Topical Combination of 0.25% Finasteride and 3% Minoxidil Versus 3% Minoxidil Solution in Female Pattern Hair Loss. American Journal of Clinical Dermatology. Research article

Editorial note: The numerical findings above come from the uploaded 2026 study. Discussion of combination therapy, oral minoxidil, and The Hormone Zone® clinical approach provides additional clinical context rather than results from that study.