The first sign of permanent hair loss can be a distressing experience. Fortunately, you are not alone. 50 percent of men will start balding at some point - some in their early twenties — and there is something you can do about it. Finasteride is one of two FDA-approved drugs that combat male pattern hair loss (androgenic alopecia) and stimulate hair regrowth. It was originally produced by Merck & Co. as a prescription drug under the brand name Propecia, but is now widely available as a generic. Finasteride has been at the forefront of fighting androgenic alopecia since it was first medically approved for this purpose in 1997. In the United States, Finasteride is among the top 100 most prescribed medications.
Male-pattern hair loss is almost always genetic and becomes more likely as you age. New hairs don’t grow as fast as old ones fall out, and in the end, new hair growth completely stops.
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.) is addressed.
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 this autoimmune condition.
In addition to treating hair loss, Finasteride is also used to treat an enlarged prostate (benign prostatic hyperplasia or 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.
Finasteride is a 5α-reductase inhibitor in the antiandrogen family. It slows the body’s natural conversion of 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. It is in these two places that excessive DHT conversion can cause problems, by shrinking hair follicles (follicle miniaturization) and enlarging the prostate. By significantly slowing down testosterone conversion to DHT, Finasteride can effectively stop hair loss and even trigger hair regrowth.
For male-pattern hair loss, Finasteride is taken indefinitely at a daily dose of 1mg. It will take at least 3-4 months before you will notice the first positive effects and up to two years before maximum effect is achieved.
Long-term use of Finasteride is tolerated well by the vast majority of patients, There are potential side effects however, and it is important to recognize these. Finasteride can cause temporary (for the duration of the treatment) sexual side effects such as erectile dysfunction and loss of libido in up to 2% of patients. If you are concerned about this prior to taking Finasteride, or notice such symptoms during treatment, ask your doctor for advice. Sometimes you may need to stop the medication. Other times, a medication such as Viagra will be prescribed to combat these side effects.
In short: Yes, Finasteride can regrow hair but not in all patients.
Studies show that Finasteride can effectively stop hair loss related to androgenic alopecia with a success rate of up to 85%. Most men undergoing 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 triggers new hair to growth in addition to stopping hair loss, 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. In one study investigating the effectiveness of Propecia, the average increase in hair count following one year of treatment was 91 hairs per 1-inch diameter.
Talk to your doctor about whether Finasteride could be right for you and how to monitor treatment progress.
Bear in mind that prevention of hair loss and new hair growth will only last as long as you take Finasteride. Within a few months after stopping treatment your genetic predisposition will gain the upper hand and hair loss will resume.