Most hair loss in men is androgenetic alopecia — pattern baldness driven by genetics and DHT sensitivity in hair follicles. Two treatments have real evidence behind them. They're not interchangeable, and knowing the difference matters.
Finasteride: works on the cause
Finasteride blocks the conversion of testosterone into DHT, the hormone most responsible for shrinking susceptible hair follicles over time. Clinical trials have shown it slows or stops further loss in a majority of men who use it consistently, with some regrowth in many cases. It's a daily oral medication, and results take months, not weeks — hair growth cycles are slow, and there's no way to speed that up.
Worth knowing upfront: a small percentage of men report sexual side effects. It's worth discussing directly with your NP rather than deciding based on a forum thread, so you can weigh it against your specific situation.
Minoxidil: works on the follicle
Minoxidil doesn't touch DHT. It works locally, extending the growth phase of hair follicles and improving blood flow to the scalp. It's applied topically (or taken as a low-dose oral in some cases) and tends to work best on the crown, less reliably on a receding hairline.
Why they're often used together
Because they work through different mechanisms — one addressing the hormonal cause, one supporting the follicle directly — combining them is a well-supported approach for men who want a more complete response than either alone typically provides. Neither is a cure, and neither works if you stop using it; hair loss treatment is maintenance, not a one-time fix.
What actually matters
Start early. Treatment works better at slowing loss than reversing it, so the men who see the best results are usually the ones who started before things progressed significantly. Consistency matters more than which product you pick.