All About Finasteride for Hair Loss

What is Finasteride?

Finasteride is a prescription drug that is used by millions of men across the world to treat pattern baldness (androgenic alopecia). The medication works through reducing the conversion of testosterone into another hormonal substance called dihydrotestosterone (DHT). When it comes to inherited pattern hair loss, DHT is the chief culprit because it damages hair follicles, which then shed the hair growing in them. By limiting DHT production, Finasteride halts the follicle destruction and hair loss, and it can even stimulate new hair growth. Studies have shown that for 65% of Finasteride users, who take 1mg of Finasteride daily for several years, some hair does indeed regrow.

Another common use of Finasteride is to treat enlarged prostate (benign prostatic hyperplasia) and to prevent prostate cancer. For this use, a 5mg tablet of Finasteride is the recommended daily dosage. The different dose — 1mg for hair loss and 5mg for prostate treatment — is the reason for why there are two popular branded Finasteride products: Proscar (5mg) and Propecia. Both dosages are available as generic versions, too.

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How fast does Finasteride stop hair loss?

Balding is a gradual process and so is stopping it. During the first 2-3 months of a 1mg Finasteride treatment plan you won’t be able to see any significant improvements. It’s only by the 4th month that first effects become notable. Most progress is made between the 4th and 8th month. If Finasteride triggers hair regrowth, this is also the time period when most of that regrowth will happen. Following this fast improvement period, progress tends to slow down and peak out after about 12-14 months of the treatment. After that, it’s all about protecting your existing hair line and prevent future balding. This is what the timeline looks like:

First 3 months: no major signs of improvement, you’ll need to be patient
4th to 8th month: fast visible improvement
8th-14th month: improvement speed decelerates and peaks
After 14th month: maintain existing hair

One important note about Finasteride: your hairline is only protected as long as you keep on using Finasteride. Once you discontinue Finasteride, you’ll start balding again within a month and any improvements you made during your previous Finasteride treatment will be reversed within a year’s time.

What are Finasteride side effects?

Finasteride has been in the market as a FDA approved drug for a couple of decades
And has a long record of being well tolerated by the millions of me who’ve take it over the years. However, there are some side effects you should better be aware of. The most common but generally mild side effects are:

Vertigo
Moderate disorientation
Swollen limbs and face
Skin rashes
Weight gain or loss
Mild abdominal pain
Tenderness in the breast tissue.

Such side effects tend to occur during the first 3-4 weeks of Finasteride treatment but later on decrease in intensity or completely go away as your body grows more accustomed to the drug. If you continue feeling such side effects after 3 months of using Finasteride, discuss with your doctor if Finasteride is still right for you and whether there are alternative treatment options.

Finasteride can have more severe side effects but these are rare — they only occur in 1% of or even fewer users. They usually are reversible, i.e., they will go away a couple of months after you’ve stopped taking Finasteride. These rare side effects include:

Impotence
Erectile difficulties
Decreased sexual appetite
Lower sperm volume
Breast enlargement (typically in patients who take the 5mg daily dosage)
Depression
Allergic reactions

Again, as with the more common side effects, these severe side effects usually are most pronounced during the beginning of a Finasteride treatment. If you experience any of them, make sure to bring it up with your doctor.

Long-term use of Finasteride can also increase the risk of getting rare forms of prostate cancer. Even though — as a 7-year study by the National Cancer Institute (NCI) has shown — long-term Finasteride use lowers the general risk of getting prostate cancer by 25%, it paradoxically seems to raise the risk of getting rare aggressive cancer types. Whether this indeed is the case and to what extent is still debated by the medical community, but it’s something to be aware of.

Talk to your usual doctor or dermatologist (baldness belongs to their area of specialization) to learn more about the potential side effects of Finasteride and their occurrence rates.

Can I use Rogaine (minoxidil) together with Finasteride?

One of the advantages of Finasteride is that it doesn’t have a lot of contraindications with other medications. So, you can take minoxidil and Finasteride simultaneously. Since they differ in the way they tackle hair loss, they actually complement each other well.

References:

Adil, Areej, and Marshall Godwin. “The Effectiveness of Treatments for Androgenetic Alopecia: A Systematic Review and Meta-Analysis.” Journal of the American Academy of Dermatology, vol. 77, no. 1, 2017, pp. 136-141.e5, www.ncbi.nlm.nih.gov/pubmed/28396101, 10.1016/j.jaad.2017.02.054. Accessed 31 Jan. 2020.

Finasteride Male Pattern Hair Loss Study Group. “Long-Term (5-Year) Multinational Experience with Finasteride 1 Mg in the Treatment of Men with Androgenetic Alopecia.” European Journal of Dermatology?: EJD, vol. 12, no. 1, 2002, pp. 38–49, www.ncbi.nlm.nih.gov/pubmed/11809594. Accessed 31 Jan. 2020.

Singh, Meena K, and Marc Avram. “Persistent Sexual Dysfunction and Depression in Finasteride Users for Male Pattern Hair Loss: A Serious Concern or Red Herring?” The Journal of Clinical and Aesthetic Dermatology, vol. 7, no. 12, 2014, pp. 51–5, www.ncbi.nlm.nih.gov/pmc/articles/PMC4285451/. Accessed 31 Jan. 2020.