Hair loss is super common and affects millions of people worldwide. There are many different causes and hair loss can affect individuals across all races, age groups and genders. Despite how common and natural it is, hair loss can have significant psychological effects including low self-esteem and confidence. There are as many different treatments as there are causes each with varying rates of success. Amongst these, Finasteride is a powerful option for combating hair loss, particularly in men but also in women where other options have failed. In this guide, we explore how Finasteride can treat hair loss, its effectiveness for regrowth, who its best for and potential side effects. We’ll also compare Finasteride with other hair loss treatments and the best way to use use it.
What is Finasteride?
Finasteride, commonly known under the brand names Propecia and Proscar, is a prescription only medication. It was initially developed in the late 1980s by the pharmaceutical giant Merck & Co. The original approval for Finasteride for the treatment of benign prostatic hyperplasia (aka an enlarged prostate gland). Like many other drugs, scientists accidentally discovered another therapeutic role for it during clinical trials. The researchers discovered that Finasteride also had a positive effect on hair growth which lead to its approval by the FDA for the treatment of male pattern baldness (androgenetic alopecia) in 1997.
Finasteride works by inhibiting the action of 5-alpha-reductase. This is an enzyme responsible for converting testosterone into dihydrotestosterone (DHT). DHT is a hormone that shrinks hair follicles which leads to hair thinning and eventual hair loss. By reducing DHT levels in the scalp, Finasteride helps to prevent further hair loss and promotes hair regrowth in both men and some women.
Effectiveness of Finasteride for Hair Loss in Men & Women
Numerous clinical studies have demonstrated the effectiveness of Finasteride in hair regrowth for male pattern baldness. For example, a five-year study involving over 1,500 men showed that 48% of participants experienced increased hair growth and 42% maintained their existing hair. Only 10% of the participants continued to experience hair loss.
Although Finasteride’s main use is for male pattern baldness, its effectiveness in treating female pattern baldness has also been studied. However, studies exploring the effectiveness of Finasteride for hair loss in women have shown mixed results. Several research papers indicate that Finasteride may help increase hair density in women with androgenetic alopecia, especially postmenopausal women. However, the evidence is not as robust or conclusive as it is for men. Furthermore, it’s best not to use Finasteride in premenopausal women due to the risk of teratogenic effects. This is because it can lead to birth defects if a woman becomes pregnant while taking the medication.
Form & Strength
Both oral and topical forms of Finasteride can treat hair loss and aid regrowth. Oral Finasteride, taken in tablet form, is the most common and well-studied method of administration. It has shown substantial effectiveness in reducing DHT levels and promoting scalp hair regrowth in men. However it can carry a risk of systemic side effects which we’ll discuss later. Topical Finasteride, works directly on the follicles but minimises systemic absorption which reduces the risk of side effects. Early studies on topical Finasteride have shown promising results, with significant reductions in scalp DHT levels and improvements in hair density. In fact, several studies have demonstrated that topical Finasteride was as effective as the oral form in increasing hair count and hair thickness in men.
For women with androgenetic alopecia, research suggests that topical Finasteride can also improve hair regrowth and density comparable to oral form. Whilst it carries lower risks of systemic side effects, it is generally still best to avoid using it for women of childbearing age.
The recommended dosage for Finasteride in the treatment of hair loss is 1 mg per day though this is dependent on sex of the patient, weight and other individual health factors. Finasteride treatment is available orally (often alongside other hair loss treatments like Minoxidil) or topically often in a formula containing other hair regrowth ingredients.
Risks & Side Effects
Finasteride is a very useful medication but like any medication, associated with potential side effects. If used correctly for the right patient, serious side effects are thankfully rare however it is important to understand them fully if you’re considering treatment. General side effects of Finasteride include:
- Allergic Reactions: Although very rare, some individuals may experience allergic reactions to Finasteride hair loss treatment. Symptoms can include rash, itching, swelling, severe dizziness, or difficulty breathing.
- Sexual Dysfunction: These are more likely to occur in men. Some users may experience decreased libido, erectile dysfunction, or reduced ejaculate volume. These side effects are generally rare and often resolve after discontinuing the medication. Studies have shown that the incidence of sexual side effects is around 2-4%, and they usually diminish over time even while continuing the medication.
- Depression and Anxiety: There have been reports of mood changes, including depression and anxiety, although these are less common. We don’t fully understand the exact mechanism by which Finasteride might influence mood. However, the evidence hints it may be related to its impact on neurosteroids in the brain. For this reason it is not suitable for people with a history of depression.
- Cognitive Effects: There have been reports suggesting possible cognitive side effects such as memory problems or foggy thinking. However, these claims still require further research.
- Gynecomastia & Breast Changes: In rare cases, men may develop breast tenderness or enlargement due to hormonal changes caused by Finasteride. Similar to men, women may experience breast tenderness or enlargement. This side effect is relatively rare but needs close monitoring.
- Local Irritation: Users may experience scalp irritation, itching, redness, or dryness with topical Finasteride at the application site. These side effects are typically mild and usually easy to manage.
Specific Risks for Men
In addition to the above, there are some side effects and risks of using Finasteride specifically for men. These include:
- Male Breast Cancer: There have been reports of extremely rare cases of male breast cancer in association with Finasteride use. Although there isn’t yet a direct causal relationship it is important to monitor this.
- Prostate-Specific Antigen (PSA) Levels: Finasteride can affect PSA levels, which is an important market for screening for prostate cancer. It can lower PSA levels, potentially masking the detection of prostate cancer. You need to let your healthcare providers know of this effect so they can interpret PSA test results accurately.
- Fertility Concerns: Some studies have suggested that Finasteride may have an impact on male fertility by affecting sperm count and quality. While these effects are generally reversible upon discontinuation, men who are planning to conceive should discuss this potential risk with their doctor.
Specific Risks for Women
As well as the general side effects, Finasteride carries additional risks especially in pre menopausal women. These include:
- Teratogenic Effects: Finasteride can cause severe birth defects in a developing male foetus if taken by a pregnant woman. For this reason, women of childbearing potential should not use Finasteride. Even handling crushed or broken tablets or contact with topical formulas can be risky if absorbed through the skin.
- Menstrual Irregularities: There have been reports of menstrual cycle disruptions in women taking Finasteride, although these are rare and not well-studied.
Topical Finasteride hair loss treatments can reduce the risk of systemic side effects like those mentioned above but they do not completely negate them. To mitigate and manage side effects, it is vital to consult with a healthcare provider before starting Finasteride. Regular monitoring and open communication with your clinician can help address any concerns or side effects early on.
Finasteride vs. Other Non Surgical Hair Loss Treatments
Finasteride is often compared with Minoxidil which is an even more popular treatment for hair loss that is also available in tablet and most commonly topical form. Minoxidil stimulates hair follicles and promotes hair growth by increasing blood flow to the scalp. You can use both treatments together (and often are) for enhanced results. Unlike Finasteride, you can also safely use in women of all ages as well as men. It doesn’t carry the same hormonal side effects as Finasteride. It is also available in lower strengths without prescription in the form of Regaine®. At higher strengths it is as a prescription only medicine.
Spironolactone, is a diuretic, that has anti-androgen properties. This makes it effective in treating hormone related hair loss, especially in women. It works by blocking androgen receptors and reducing androgen production, which can help in conditions like female pattern baldness. Spironolactone is often preferred for women over Finasteride due to its safer profile regarding reproductive health. It doesn’t pose the same risks of birth defects. However, Spironolactone is generally not used for male pattern baldness due to potential feminising effects.
Dutasteride is another 5-alpha-reductase inhibitor. It is similar to Finasteride but more potent, as it inhibits both type I and type II 5-alpha-reductase enzymes. This broader inhibition makes Dutasteride more effective in reducing DHT levels and potentially more effective for hair regrowth. However, its increased potency also raises the risk of side effects. This makes it a second-line treatment typically reserved for cases where Finasteride is ineffective.
Typically hair loss treatments may contain a combination of these ingredients either separately or in a single formula. It may be used in tablet and/or topical form. The choice of treatment is best tailored to individual needs and medical history under the guidance of a healthcare professional.
Post-Finasteride Syndrome (PFS)
This us is a term used to describe a collection of symptoms that persist in some individuals after discontinuing Finasteride. These symptoms can include sexual dysfunction, psychological effects and physical issues (such as fatigue and muscle weakness). Although Post-Finasteride Syndrome is a controversial and not universally recognised condition, it has been reported by a subset of users. The exact cause of PFS remains unclear. Ongoing research aims to better understand its mechanisms and develop effective treatment strategies.
How Long it Takes to See Results of Finasteride for Hair Loss
To achieve the best results, it is vital to take Finasteride consistently, as skipping doses can reduce its effectiveness. Most users begin to see noticeable improvements within three to six months of regular use. However, it can take up to a year to achieve optimal results. It is really important to understand that you will need to stay on this treatment to maintain your results. If you continue Finasteride (or any non surgical hair loss treatments), this can lead to a reversal of its effects. Hair loss may restart within several weeks or months of stopping the medication.
Where to Get Finasteride Hair Loss Treatments
Finasteride is a prescription only medicine regardless of the dose or form it comes in. You would need an assessment with a medical provider (e.g. a doctor) either in a physical or online hair loss clinic to diagnose the cause of your hair loss and potential suitable treatments. They will then decide whether Finasteride is suitable for you and in what dosage or form as well as whether it can be used alone or needs other medications. Your clinician will either give you a prescription to take to a pharmacy or most likely if they’re a specialist provider, they will send your prescription to a specialist pharmacy who will dispense your treatment.
Finasteride is an effective treatment for male pattern baldness. It is also useful in some cases of androgenetic hair loss in post menopausal women. Its to promote hair regrowth is backed by extensive clinical research and has well-established safety profile. That being said, its a prescription only medicine. This means it must only be used under careful guidance and monitoring by a medical provider. This is due to serious potential side effects exist which can be reduced if it is used correctly and appropriately.
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