Finasteride for hair loss: benefits, dosage, and risks

Ismail Yusibov
Ismail Yusibov is the founder and content writer of the AlopeciaTips.

 Fact checked by Jessica Anderson

Written by Ismail Yusibov | Reviewed by Dr. Michael Carter


Today, the number one product in the medical treatment of male pattern baldness is Finasteride. So, does Finasteride really stop your hair loss?


FAST FACTS

Finasteride tablets are FDA-approved for treating male pattern hair loss (androgenetic alopecia).

Finasteride works by inhibiting the enzyme 5-alpha-reductase, which converts testosterone into dihydrotestosterone (DHT).

Finasteride does not regrow hair but slows down and stops hair loss by reducing DHT levels.

Finasteride is not approved for use in women due to the risk of birth defects.

Combining Finasteride with Minoxidil is a common and safe approach for hair loss treatment.

A prescription is required to obtain Finasteride, and it should be used as directed by a healthcare provider.

The effectiveness of Finasteride tablets in stopping male pattern hair loss (androgenetic alopecia) has been approved by the FDA.

Today, there are two approved and proven drugs for the medical treatment of male pattern hair loss. One of them is Finasteride and the other is Minoxidil.

What is male pattern hair loss?

Male pattern hair loss refers to baldness starting from the top of the head. The hair on the top thins over time and eventually falls out. Hair loss results in complete baldness of the scalp.

Male pattern baldness is called androgenetic alopecia. More than 95% of men’s hair loss is related to male pattern baldness. According to the WebMD, by the age of 50, 85% of men experience significant hair thinning due to male pattern baldness.

Male pattern hair loss is a condition due to genetic factors and there is no definitive treatment. The course of male pattern hair loss can be slowed down with medications that thicken the hair strands and make the hair follicles healthy.

What are the causes of male pattern hair loss?

Androgenetic alopecia, often referred to as male-pattern baldness or female-pattern hair loss, is primarily influenced by androgenic hormones and genetic factors.

During puberty, androgenic hormones come into play, leading to the shrinkage and “miniaturization” of hair follicles in individuals with a genetic predisposition. This process gradually results in shorter, lighter-colored, and thinner hair strands.

The genetic predisposition for androgenetic alopecia can be inherited from either the mother or the father. Interestingly, while the levels of androgenic hormones in most patients remain within the normal range, their hair follicles exhibit an increased sensitivity to these hormones, contributing to the condition.

Starting treatment for male pattern hair loss earlier leads to more successful results. Consistency in treatment is crucial, as the condition can return to its natural progression when medications are discontinued.

The primary treatment involves using minoxidil, which is applied as a spray or foam to the scalp. Depending on the patient’s needs, additional treatments such as PRP therapy, microneedling, or low-level laser therapy can be considered. In cases where these treatments are ineffective, oral medications may be incorporated into the regimen.

For patients who do not respond to medical treatments, hair transplant is another option to consider.

Can androgenetic alopecia be prevented?

Androgenetic alopecia can be effectively managed with medications. As hair follicles diminish between the ages of 25 and 45, the progression of hair loss can be slowed down through proper treatments, leading to partial prevention of hair loss.

What is Finasteride?

Finasteride is an FDA-approved drug used for hair loss. It is especially used in the fight against male pattern baldness (androgenic alopecia). Today, important brands such as Proscar and Propecia sell Finasteride.

How does Finasteride work?

Finasteride inhibits subtype II of the enzyme called 5-alpha-reductase. This enzyme is responsible for converting testosterone into dihydrotestosterone (DHT).

DHT stimulates hair growth across the body, but it leads to thinning and eventual loss of scalp hair. Thus, when finasteride is used, it thickens thinning hair and prevents further hair loss,  preventing baldness.

Finasteride, which blocks the production of the male hormone that causes the prostate to enlarge in men, slows down and stops hair loss.

Finasteride promotes hair growth on the scalp and does not trigger hair growth anywhere else on the body.

Which part of the scalp does Finasteride work best for?

Finasteride is highly effective in treating male pattern baldness, addressing hair loss across the entire scalp, from the hairline at the top (vertex) of the head to the front middle region, especially in men under 40 years old.

When should I start Finasteride?

You can begin using Finasteride at the first sign of male pattern baldness symptoms, which typically consist of:

  • Thinning or loss of hair on the crown of your head.
  • Thinning or loss of hair around your temples.
  • A receding hairline.

The hair loss on your crown often takes on a circular pattern, while a receding hairline tends to form an “M” shape. As your hair loss progresses, the thinning areas on your crown and temples may blend together, forming a “U” shape.

How long should I take Finasteride?

Finasteride works well when you use it for a long time. A lot of people have used Finasteride for more than 10 years. Your doctor will tell you how much Finasteride to take and when to stop if your hair gets better from it.

Side effects & reactions of Finasteride

Just like all medicines, Finasteride can cause problems for some people. These problems with Finasteride are not common, and they are usually not very serious.

Here are some of the problems you might have with Finasteride:

  • It might be hard to get or keep an erection.
  • You might feel sad or not very happy.
  • Your testicles might hurt.
  • You might not want to have sex as much as before.
  • It might be tough to ejaculate, and you might have fewer sperm.
  • Your nipples might be sensitive or sore.

Even though it’s very unlikely, Finasteride could lead to permanent sexual problems.

Does finasteride regrow hair or just stop hair loss?

Finasteride slows hair loss. The drug blocks the conversion of the testosterone hormone to dihydrotestosterone (DHT). While DHT enables rapid hair growth, it also causes thinning and thinning of the hair strands. DHT is linked to hair loss in both women and men.

Finasteride doesn’t make hair grow more. But when you use Finasteride, it lowers DHT levels, which can help new hair grow.

In certain situations, Finasteride can actually stop hair loss caused by hormones. However, this isn’t because of Finasteride itself. It happens because DHT is no longer blocking hair growth.

Does Finasteride work in all men?

Finasteride stops hair loss in 90% of men, and hair regrows in more than half of men within 2 years.

Does Finasteride cause gynecomastia?

Yes. Finasteride may cause gynecomastia in men at a rate of 1 in 1000. Finasteride may also cause existing gynecomastia to grow larger. This type of effect may be seen in the first 3 months of Finasteride use.

Does Finasteride cause breast cancer?

There is evidence suggesting that finasteride can lead to male breast cancer. It’s essential to regularly check for unusual lumps in your chest area while using this medicine.

Taking 5mg of finasteride daily may reduce your chances of developing prostate cancer, although the cancer that does occur might be slightly more severe.

Using finasteride can impact the results of a blood test used to detect prostate cancer, known as the PSA test. When you’re on finasteride and need a PSA test, be sure to inform your doctor. Always consult a healthcare professional for the most current information on the risks and benefits of finasteride.

Does Finasteride reduce male fertility?

There’s proof that a medicine called finasteride might make it harder for guys to have babies. Recent studies show this could happen because finasteride messes with a hormone called prostaglandin. Prostaglandin is important for how calcium works in sperm.

It has been reported in a scientific study that Finasteride reduces sperm count in men.

But here’s the thing, even with this info, no one has seen any problems in babies born to guys who used finasteride.

So, if you’re a guy who wants to have a baby, it’s a good idea to quit using finasteride 2-3 months before trying to make a baby.

Does Finasteride trigger depression and anxiety?

Finasteride can cause a change in mood in people suffering from low mood and anxiety. Studies have proven that Finasteride causes mood changes, including depression and anxiety.

Finasteride effect on hormones

Finasteride impacts hormones. One of the main things it does is raise estrogen levels in the body. In the first 3-6 months, it boosts testosterone levels, but over a longer period of 12-16 months, it keeps testosterone in balance.

Can I have a hair transplant while using Finasteride?

Men using Finasteride can have a hair transplant. The use of Finasteride does not affect the hair transplant procedure. While using Finasteride before hair transplantation will not increase the success of the procedure, using Finasteride afterward will ensure that the newly grown hair will be healthier and thicker.

Can women use Finasteride?

The FDA has not given approval for women to use Finasteride for treating hair loss, and they haven’t specified the right amount to take.

However, research involving women who are both before and after menopause suggests that women with hormone-related hair loss (Androgenetic Alopecia) can benefit from Finasteride. It helps improve the quality of their hair. The typical dose for women in clinical studies is 1-1.25 mg.

Women who think about using Finasteride should be cautious while using it. Finasteride is harmful to the development of embryos and can cause birth defects in babies.

Pregnant women should avoid touching Finasteride tablets altogether. If they accidentally touch them, they should wash the affected area with soap and water immediately. Additionally, doctors should closely monitor the developing baby in the womb.

Men who are taking Finasteride and have pregnant partners should use condoms because a small amount of Finasteride can be present in their semen.

Can I use Finasteride and Minoxidil at the same time?

You can use Finasteride and Minoxidil together. It’s safe and can make your hair loss treatment work better. Minoxidil and Finasteride work in different ways. When you use them together, they boost each other’s effects.

How do I take Finasteride?

You can take Finasteride with or without food, but it’s best to take it at the same time every day and drink plenty of water. Your doctor will decide how much to take based on how much hair you’ve lost.

Your body absorbs Finasteride through your lungs and skin. It’s important to know that pregnant women or those who might get pregnant should not use Finasteride. Using it during pregnancy can lead to unusual development of the baby’s genitals.

What’s the dosage for Finasteride?

The drug Finasteride is not only used for hair loss. Therefore, the normal dosage of the drug is determined by the doctor. If you are considering using Finasteride for hair, your doctor will determine the normal dosage according to the course of your hair loss.

How long does it take to see the results of Finasteride?

The effects of medications vary from person to person. Finasteride, used for hair loss, shows its effect within 6-12 months. The drug reduces or stops hair loss by 70% in the first year. It is recommended to use the drug for many years for it to have a better effect.

Most people who use Finasteride for male pattern hair loss have used the drug for 5-10 years.

In case of long use, Finasteride stops and can reverse male pattern baldness.

What happens if you stop taking Finasteride?

If you stop using Finasteride, your hair loss will begin again. Finasteride blocks DHT, but if you stop using the drug, DHT levels in your scalp will rise again and your hair follicles will become thinner and smaller.

According to a scientific study, when you stop using Finasteride, you may experience loss of libido, erectile dysfunction, penis shrinkage, penis curvature, gynecomastia, cognitive impairment, depression, anxiety, and rapid mood changes.

Remember that when you stop using Finasteride, your hair will fall out faster than before.

What is the difference between Propecia and Finasteride?

Propecia and finasteride are both used to treat hair loss, but they have different names. Propecia is the fancy name for this medicine, and finasteride is the plain name. The reason it’s called finasteride is because that’s what actually works in the medicine. Sometimes people call finasteride “generic Propecia.”

If you’re taking Propecia 1mg every day and want to switch to Proscar (which has 5mg of finasteride), you have two options. You can either take 1/4 of a Proscar pill every day or 1/2 a pill every other day. But if you decide to break the pills, be careful because crushed tablets can be harmful to pregnant women.

Can Finasteride be used to treat anything else other than hair loss?

Finasteride is used to treat these problems:

  • Hair loss
  • Enlarged prostate gland (non-cancerous)
  • Acne caused by testosterone in transgender patients
  • Excessive hair growth
  • Hair loss in a specific pattern

Does finasteride cause weight gain?

Finasteride does not cause weight gain. The drug has no weight gain effect. A study showed that Finasteride used for 12 weeks had no effect on body weight and adiposity index.

Post finasteride syndrome 

Stopping the use of Finasteride causes serious side effects. This condition is known as 

Post-finasteride syndrome (PFS). Many men who stop using Finasteride experience persistent side effects such as sexual dysfunction and depression.

How to reduce side effects of finasteride

To reduce the problems caused by Finasteride, you should live a healthy life. Eat good foods, stop drinking alcohol and smoking, exercise, and take your vitamins regularly. Doing these things can help lessen the side effects of Finasteride, like feeling sad, worried, or having mood swings.

If you’re having problems from using Finasteride, here’s what you can do:

  • Get some exercise often.
  • Eat foods with lots of vitamins and minerals.
  • Spend time with friends and family.
  • Eat foods with plenty of protein.
  • Sleep at the same times every day.
  • Drink a lot of water.
  • Try to get rid of stress from your life.

How to get finasteride?

Finasteride is not available without a prescription. If you are experiencing male pattern baldness and want to start using Finastride, you will first need to see a dermatologist and get a prescription.

If your specialist dermatologist approves and prescribes your use of Finasteride, then you can take Finasteride.

Do you need a prescription for finasteride?

Finasteride is available with a prescription written by a dermatologist and is prohibited for sale without a prescription. When your healthcare provider determines that you need Finasteride for your hair loss, he or she will prescribe it.

You can also obtain the prescription through an online consultation with your expert dermatologist.

Is finasteride covered by insurance?

Your insurance will pay for finasteride if it’s prescribed for prostate enlargement. But if your doctor prescribes finasteride for male pattern hair loss, your insurance won’t cover it.

Switching from finasteride to dutasteride shedding 

Dutasteride is a good choice for treating hair loss, even though it’s not officially approved for this purpose. People often use it alongside other hair loss treatments like minoxidil to get better results.

In scientific research, taking dutasteride capsules by mouth has shown positive results in stopping hair loss and encouraging new hair to grow.

Both dutasteride and finasteride block DHT, a hormone linked to hair loss. If you’re thinking about switching from finasteride to dutasteride, you might notice some hair loss initially, but don’t worry, it’s temporary.

Alternatives to Finasteride

Finasteride is a medication that has been proven to work in treating hair loss. However, it can cause problems with a man’s sexual function and mental well-being.

The most common serious issues it can cause in men are trouble getting or maintaining an erection, reduced interest in sex, strong feelings of sadness, nervousness, and shifts in mood.

Because of these side effects, a lot of folks might decide not to use Finasteride.

If you’d rather not use Finasteride, there are other options available to you.

Saw Palmetto vs Finasteride 

Saw Palmetto has the same function as Finasteride. Just like Finasteride, Saw Palmetto works by blocking 5-alpha reductase, causing hair to thicken. Although Saw Palmetto is generally used after hair transplantation, it can also be used at the beginning of male pattern baldness.

Saw Palmetto benefits:

  • It reduces DHT levels.
  • It treats sexual dysfunctions.
  • It supports hair thickening.
  • It has fewer side effects compared to Finasteride.
  • It is cheaper compared to Finasteride.

Saw Palmetto disadvantages:

  • Compared to Finasteride, there is less scientific evidence for Saw Palmetto’s effect on hair growth.
  • It is difficult to find its pure form.
  • Using Saw Palmetto alone has little effect on the hair.
  • It is not effective in female pattern hair loss.

The effectiveness of Saw Palmetto in treating medical conditions remains uncertain. The FDA has not granted approval for its use as a medical treatment. Saw Palmetto is available as an herbal supplement and does not require a prescription for purchase.

Dutasteride vs Finasteride 

Dutasteride blocks the conversion of testosterone to DHT similarly to Finasteride, but is stronger and may be more effective for BPH.

Even though both drugs are used for hair growth, Dutasteride is not FDA-approved for hair loss. Dutasteride is available in 0.5 mg capsules and is usually taken once a day.

A study published in the Journal of the American Academy of Dermatology found that after one year of treatment, 91% of men taking Dutasteride experienced an increase in hair count, compared to 68% of men taking Finasteride.

Dutasteride benefits:

  • It works well for stopping hair loss.
  • It helps with an enlarged prostate and the problems it causes.
  • It boosts testosterone by 20% in men with male pattern baldness.

Dutasteride disadvantages:

  • Just like Finasteride, Dutasteride can make men feel sad and moody.
  • Like Finasteride, it can lead to less interest in sex, trouble getting or keeping an erection, and problems with ejaculation.
  • It can make breasts grow or make existing breast growth worse, which is called gynecomastia.

Finasteride Spray vs. Pill 

Finasteride is a helpful medicine that can help hair grow back, often used for male pattern baldness. You can take it as a pill (oral finasteride) or apply it as a spray (topical finasteride).

Research shows that using topical finasteride by itself or with minoxidil can reduce hair loss.

It’s important to know that topical finasteride isn’t officially approved yet, unlike oral finasteride. And there’s still not a lot of research done on it.

What’s good to hear is that studies suggest topical finasteride tends to cause fewer side effects compared to taking it in pill form.

In some studies, people using topical finasteride didn’t report any side effects.

We don’t have a clear answer yet on which type of finasteride is better, but both can help your hair grow. Plus, most men who use the topical version don’t have as many side effects as those who take the pill.

THE BOTTOM LINE

Finasteride is the most popular medication used for male pattern baldness and hair loss. It has been FDA approved since 1997 and its effectiveness in stopping hair loss has been proven. Finasteride stops male pattern hair loss in the medium and long term. Finasteride can be used orally or topically.
Ismail YusibovIsmail Yusibov is the founder and content writer of the AlopeciaTips.

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