Does Finasteride work for hair loss?

All you need to know about how Finasteride works and how effective it is.

What is Finasteride used for?

Noticing the first signs of permanent hair loss is a distressing experience. Fortunately, you are not alone — some 50 percent of men will start balding at some stage in their life, for some of us as early as in our twenties — and there is something you can do about getting your hair back. Finasteride is one of two U.S. FDA approved drugs that combat male pattern hair loss (androgenic alopecia) and stimulate hair regrowth. Produced by Merck & Co. as a prescription drug under the brand name Propecia (but now also widely available in generic versions), Finasteride has been at the forefront of fighting androgenic alopecia since it first was medically approved for this use in 1997. In the United States, Finasteride is among the top 100 most prescribed medications. 

 

Male pattern hair loss usually has genetic causes and with growing age becomes apparent in shrinking hair follicles, which in turn leads to thinner and shorter hair. New hairs don’t grow as fast as old ones fall out and in the end, new hair growth completely stops. 

 

Aside from male pattern hair loss, doctors don’t recommend Finasteride for other forms of hair loss, such as stress-induced temporary hair loss, medication-related hair loss, or postpartum hair loss in women. This sort of temporary balding tends to correct itself once the underlying cause (stress, drugs. etc.) has been stopped.   

 

Finasteride is not effective against autoimmune conditions leading to hair loss, such as alopecia areata which occurs when the body’s immune system attacks its own hair follicles. Talk to your doctor to learn about available treatments for such autoimmune baldness. 

 

In addition to treating hair loss, Finasteride is also used to treat enlarged prostate (benign prostatic hyperplasia, BPH) and to prevent prostate cancer. In fact, Finasteride initially was developed for BPH treatment and approved for this purpose (branded by Merck as Proscar) in 1992. Finasteride can also treat excessive hair growth in women like facial hirsutism and finds use in hormone replacement therapy for transgender females. 

 

How does Finasteride work?

Finasteride is a 5α-reductase inhibitor in the antiandrogen family. It slows the body’s natural conversion of the testosterone hormone into dihydrotestosterone (DHT) by up to 70-80 percent. Most of this DHT conversion happens in the prostate gland and hair follicles of the scalp and it is in these two places that excessive DHT conversion can cause us problems, by shrinking hair follicles (follicle miniaturization) and enlarging the prostate. By significantly slowing down the DHT conversion, Finasteride effectively stops hair loss and even triggers hair regrowth.

 

For male pattern hair loss Finasteride typically is taken for multi-year durations with a daily dose of one 1mg tablet. It will take at least 3-4 months before you will notice the first positive effects on hair growth and these effects likewise last for several months after you stop taking Finasteride. The use of Finasteride thus has a delayed response on hair growth. 


 

As with most 5α-reductase inhibitors, long-term use of Finasteride is tolerated well by the vast majority of patients, as has been proven in numerous studies. There are some mild side effects and in rare cases, Finasteride can cause temporary (for the duration of the treatment) sexual side effects such as erectile dysfunction and loss of libido. If you are concerned about this prior to taking Finasteride or notice such symptoms during treatment ask your health specialist for medical advice. For Finasteride no contraindications have been found with Viagra, which could be used to counteract the sexual side effects if they occur.  

 

Does Finasteride regrow hair?

In short: Yes, Finasteride does regrow hair but not in all patients. 

 

Studies show that Finasteride effectively stops hair loss related to androgenic alopecia within several months of starting the treatment with a success rate of up to 85%. Most men undergoing a finasteride treatment report that within six months they stop losing hair and their hair quality visibly improves. Finasteride is most effective on the vertex, i.e., the upper surface of your head, but it works on all parts of the scalp.

 

Whether Finasteride not just stops existing hair from falling out but actually triggers new hair to grow depends on whether it can successfully reverse follicle miniaturization. One study shows that for 65 percent of participants it did just that. But the amount and quality of new hair grown during the trial period varied widely from patient to patient. The maximum improvement in hair regrowth is achieved within the first two years of treatment. In one study done on the effectiveness of Propecia the average increase in the hair count of participating men following one year of treatment was 91 hairs per 1-inch diameter.

 

Talk to your doctor about whether Finasteride could be right for you to regrow your hair and how to monitor treatment progress. 

 

Bear in mind that the effects of Finasteride for preventing hair loss and supporting new hair growth only last as long as you take Finasteride. Within a few months after stopping treatment your genetic predisposition will gain the upper hand again and hair loss will resume. 

  

References

  1. Habif, Thomas P. Clinical Dermatology a Color Guide to Diagnosis and Therapy. St. Louis, Mo.] Elsevier, 2016, p. 934.
  2. Leyden, J, et al. “Finasteride in the Treatment of Men with Frontal Male Pattern Hair Loss.” Journal of the American Academy of Dermatology, vol. 40, no. 6 Pt 1, 1999, pp. 930–7, www.ncbi.nlm.nih.gov/pubmed/10365924, https://doi.org/10.1016/s0190-9622(99)70081-2. Accessed 22 Nov. 2019. 
  3. 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, https://doi.org/10.1016/j.jaad.2017.02.054. Accessed 22 Nov. 2019.

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