Combination Spray
Updated over a week ago

Combination Spray safety information

Combination Spray contains three active ingredients all known for helping with hair loss and regrowth, minoxidil (10%), azelaic acid (5%) and finasteride (0.1%) all in one spray! Scalp solution is a cutaneous solution that is applied to the scalp. For external use only. Combination Spray is an unlicensed medication - you can find more information on unlicensed medications here.

What Combination Spray is used for

Combination Spray is used to treat male pattern hair loss in men aged 18-65 years. There is little evidence to suggest effectiveness in patients over the age of 65 and further investigation is required. It can be used by men over 65 years of age to treat hair loss, but it may not be as effective. Minoxidil is thought to work by dilating the blood vessels and supplying nutrient-rich blood to the hair follicles. Finasteride and azelaic acid are thought to work through blocking an enzyme called 5a reductase which is known for causing hair loss. The exact process by which this occurs is not known.

How to tell if Combination Spray is suitable for you

Combination Spray works best in men with hair loss or thinning at the top of the scalp (see diagrams). It is also suitable for men who have:

  • Noticed gradual hair loss or thinning over time

  • A family history of hair loss

  • Hair loss with no other symptoms

If you have been bald for many years or have a large area of hair loss, it is unlikely that this will be an effective treatment for you.

When Combination Spray should not be used:

  • If you have any condition that affects your scalp including sunburn and psoriasis or if you use other creams, ointments, lotions etc. used to treat scalp conditions e.g. dithranol, tretinoin, corticosteroids (steroids) and petrolatum products (soft paraffin) or have any kind of dressing or bandage on your scalp

  • For sudden, unexpected hair loss which may be linked to thyroid or other medical problems

  • Total baldness or complete loss of all body hair

  • Hair loss caused by drug treatment

  • If you have a shaved head

  • If you are allergic to minoxidil, azelaic acid, finasteride, ethanol or propylene glycol

  • If you are under 18

  • If you are taking finasteride or any other 5a reductase inhibitor

  • If you are a woman

If you suffer from heart disease (including abnormal heart rhythms or rates, angina or chest pains) and/or circulation disorders you should seek the advice of your doctor before using this treatment due to it containing minoxidil.

There is a risk that minoxidil may interact with certain blood pressure medicines called “vasodilators”, and alter their effect. You should consult your doctor or pharmacist if you are taking such medication.

Using too much of this treatment can cause it to be absorbed into the blood, which may result in increased side effects.

Combination Spray can also be absorbed into the blood and side effects may occur if you are unusually sensitive to any of the active ingredients, or if it is used when there is a scalp condition (such as psoriasis) present. Therefore, it is important that you follow the recommendations and advice on this safety information page when using this treatment.

How long Combination Spray takes to work

It usually takes 2 or more months to notice hair regrowth. This is because hair growth is a slow process, so it takes time for regrown hairs to become noticeable. Regrown hair will be soft and downy at the start but should eventually become the same as normal hair. The time it takes to notice hair regrowth may vary from person-to-person.

Please be aware that some slight hair loss may occur after 2-6 weeks of use. This is likely to be a result of the hair re-growth cycle and should subside within a couple of weeks. If shedding persists for longer than 2 weeks you should stop using this treatment and consult your doctor.

If there is no hair re-growth after 12 months it is very unlikely that you will respond and you should stop using this treatment. Please consult your doctor if you are concerned at any time during treatment.

For the best results, you should continue to use Combination Spray every day if hair regrowth occurs, to maintain the hair you re-grew. If you decide to stop using this spray, it is likely that you will lose any re-grown hair within 3-4 months.


Combination Spray must only be used on the scalp. Make sure your scalp is normal and healthy before applying treatment. Do not use this treatment on other parts of the body. If accidentally applied to any other part of the body, rinse thoroughly with water.

Finasteride can affect the results of a blood test called PSA (prostate-specific antigen). If you have a PSA test done, you should inform your healthcare professional that you are taking finasteride.

Combination Spray might not be suitable for you if you're trying to conceive (have a baby) as finasteride may affect male fertility and foetal development. If your partner is already pregnant, use of a condom is recommended.

Women should not handle this treatment and if they get some on their hands they should wash them immediately.

To use Combination Spray:

  1. Make sure your scalp is dry before applying the solution

  2. Apply 6 sprays (1ml) to the affected area/s of the scalp once daily

  3. Wash your hands thoroughly after use

Avoid contact with the eyes, broken skin and sensitive areas. If accidentally applied to these parts, wash with plenty of water.

Do not use more than 1ml Combination Spray daily (do not spray it on your scalp more than once a day). Exceeding the recommended dose will not re-grow your hair any more quickly and you may risk side effects.

Always wash your hands thoroughly after applying minoxidil and rinse other areas that have come into contact with it.

Side-effects of Combination Spray

Stop using Combination Spray if you get any of the following:

  • The MHRA (Medicines and Healthcare products Regulatory Authority) has received reports of depression and, in rare cases, suicidal thoughts in men taking finasteride. If you develop symptoms of depression, you should immediately stop taking finasteride and inform a healthcare professional.

  • Decreased sex drive and erectile dysfunction have also been reported (which in some cases continued after treatment was stopped)

  • Cases of male breast cancer have been reported. If you notice any changes in breast tissue such as lumps, pain or nipple discharge, you should promptly report this to your doctor.

  • Blood pressure changes

  • Rapid heartbeat

  • New or worsening pain in the chest (please go to A+E if you experience chest pain)

  • Dizziness, light-headedness, or fainting

  • Unexplained rapid weight gain of more than 2 kg or 5 pounds

  • Swelling or puffiness of the hands or feet

  • Persistent redness or irritation of the scalp

Finasteride can affect the results of a blood test called PSA (prostate-specific antigen). If you have a PSA test done, you should inform your healthcare professional that you are taking finasteride.

Combination Spray can cause skin irritation (e.g. local redness, itching, dryness, scalp flaking). Although this might only be a temporary effect, stop using the product if it persists.

Stop using this spray if you notice changes in hair colour and/or texture.

Combination Spray may cause a burning sensation and irritation if you get it in the eye. If you get minoxidil in your eye, mouth or on a cut or damaged skin, wash the area well with lots of cool tap water.

Unwanted non-scalp hair has sometimes been reported after using Combination Spray. Always wash your hands thoroughly after application and if accidentally applied to parts of the body other than the scalp, rinse thoroughly with water.

Keep Combination Spray out of reach of children. If anyone (including a child) ingests Combination Spray, take them to the hospital immediately with the bottle (so the doctor can see how much they have ingested).

If you experience any other side effects not mentioned on this safety information page, you should consult your doctor.

Treatment interruption

Hair loss and hair growth are slow processes. To be effective, Combination Spray needs to be used regularly for many months. However short breaks in use should not change the outcome as the treatments work over a long period of time. If you have any further questions, please contact [email protected].

How to store Combination Spray

Keep the bottle in a safe place, below 25°C (normal room temperature).

Keep out of the reach and sight of children. When empty, dispose of the bottle safely. To properly dispose of a partially-used bottle, empty as much of the contents as you can into a sink, and wash away with running water. Never try to burn a bottle of Combination Spray.

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