Most men don’t realize it, but there’s a hair loss treatment available today with a 90% chance of stopping your hair loss. That hair loss treatment is called finasteride. In this guide, we’ll dive into everything you need to know about this medication.
What is finasteride?
Finasteride, also known as Propecia, is the most commonly prescribed hair loss medication available today. In 2017 it was the 86th most prescribed medication in the US with almost 10 million prescriptions.
It was initially approved for the treatment of male pattern baldness (androgenetic alopecia) in 1992. It’s an oral medication that reduces the amount of DHT your body produces. Since DHT is the hormone that causes hair loss, reducing DHT helps stop or reverse the hair loss process.
Who can use finasteride?
Finasteride is effective in men diagnosed with male pattern baldness, which is 95% of male hair loss cases. Finasteride is not effective in the other 5% of cases who have hair loss due to other causes, such as certain medical illnesses, medications, or more rare forms of alopecia.
If you have a receding hairline or thinning hair that has been gradually progressing, you likely have male pattern baldness, and finasteride would be worth a try with the approval of a doctor or nurse practitioner.
Finasteride is usually not recommended for men who are already in advanced stages of hair loss with very little hair left. For those men, better results can be seen with other treatments like dutasteride or a hair transplant.
In general, finasteride should not be used by women, although there is some evidence to show that it can be safe and effective in women over 50. However, more research is needed on this subject.
How does finasteride work?
Finasteride works by blocking the conversion of testosterone into a byproduct called dihydrotestosterone (DHT). In men who are genetically susceptible to hair loss, DHT will start to attack hair follicles and cause your hair to miniaturize with every growth cycle until it’s eventually too small to be seen and the follicle dies.
Since DHT is the primary hormone responsible for hair loss in men, the most effective way to prevent hair loss is to block DHT.
When a DHT blocker like finasteride is taken, your body produces 66% less DHT. Less DHT in your body means your hair will stop falling out, and possibly start regrowing.
How effective is finasteride?
Finasteride is one of the most extensively studied medications for male pattern baldness. Clinical studies have found that finasteride stops hair loss for 90% of men, and 65% will also benefit from increased hair growth and thickening of existing miniaturized hairs.
One study from 1998 showed a significant increase in hair count after 2 years of finasteride 1mg daily. At the beginning of the study, the average hair count measured in a 1-inch diameter circular balding area was 876. At the end of the study, the hair count increased to 1,014. That’s a 15% increase in hair in one area.
Keep in mind that it’s unlikely for finasteride to regrow hair in completely bald areas, but it can help thicken up hair in areas where you’ve started to notice miniaturization. That is why it’s important to start treatment at the earliest signs of hair loss since finasteride is more effective at preventing future hair loss rather than regrowing hair.
How long to see results?
Finasteride can begin to show results after 3-6 months. Results may take longer to show in some men, therefore it is important to be patient and not stop the treatment too early on. It’s recommended you stick with treatment for 1 year before measuring the final result.
After 1 year of treatment, you will notice that your hair loss has stopped progressing, and you might see an overall improvement in the appearance of your hair.
If you see no positive results after 1 year of use, you might be one of the few non-responders. In that case, it’s unlikely that finasteride will show any effect going forward and it’s recommended to discontinue the treatment or switch to dutasteride.
Keep in mind that positive results does not necessarily mean regrowing hair. Maintaining the hair that’s already on your head and preventing future hair loss is still considered a positive result of taking finasteride.
What if I stop taking finasteride?
Finasteride works for as long as you take it. If you stop taking it, the hair loss process will resume and the hair that was preserved or regrown while on the medication will start to fall out again.
How to take finasteride?
Finasteride should be taken as a daily dose of 1mg to treat hair loss. You can also choose to quarter finasteride 5mg (Proscar) tablets and take 1.25mg/day. This is just as safe and effective as taking 1mg daily, but much more affordable.
Taking more than the recommended dose will not speed up your results and will only increase your chance of side effects.
What are the side effects of finasteride?
Decades of research shows that finasteride is safe and generally well tolerated by patients. A small percentage of men might experience sexual side effects, but these are rare and generally reversible.
In one clinical study, 3.8% of patients taking finasteride experienced side effects versus 2.1% in the placebo group. That means 1.7% of patients experienced side effects directly related to taking finasteride.
More research shows that side effects stop once the drug is discontinued, and the side effect rate actually drops to 0.3% by the fifth year of treatment.
There is also research done in regards to the relation between finasteride and prostate cancer. In short, finasteride has been found to decrease your overall chances of acquiring prostate cancer. However, in the case that you do acquire it, it may increase the risk of forming a more aggressive form of prostate cancer by 0.5%.
Is finasteride more effective than other treatments?
Finasteride is the safest and most effective medication you can buy to treat hair loss. There are other treatments you can use along with finasteride such as minoxidil (the active ingredient in Rogaine). Minoxidil is a topical solution you apply to your scalp once or twice a day, which has also been clinically proven to regrow hair. Minoxidil can be purchased over the counter without a prescription.
The combined use of oral finasteride and minoxidil is the gold standard when it comes to treating hair loss.
There is another hair loss treatment called dutasteride that works similar to finasteride, but stronger. It’s not officially approved to treat hair loss, but it’s been shown to be even more effective at regrowing hair.
If it’s your first time treating hair loss, we recommend you start with finasteride and topical minoxidil for the first year of treatment. If after one year you’re unsatisfied with the progress, you can switch to dutasteride or even consider surgical options like a hair transplant.
Some men choose to take hair loss supplements like biotin. While these generally won’t hurt to take, there is very little evidence to show that biotin can stop male pattern baldness. Biotin usually only helps if your body is already deficient in this vitamin. Since biotin deficiency is very rare in those who are already eating a normal balanced diet, you’re unlikely to see any benefits.
Is there a difference between Propecia and finasteride?
Propecia is the brand name of the medication, while finasteride is the active ingredient in Propecia. After the patent for Propecia expired, finasteride became a generic drug. You will find that generics are about 80% cheaper than buying brand name Propecia. They are both medically the same – the only difference is the price and the inactive ingredients in the pill.
Essential Clinic prescribes generic medication by default. However, when you buy the medication from the pharmacy, you do have the choice of buying the brand name if you prefer.
How do I get a finasteride prescription?
You can get a finasteride prescription online through Essential Clinic. Just upload photos of your hair, answer a few questions about your health, and one of our clinicians will review your request and determine if finasteride is a safe treatment for you. If your request is approved, we’ll send your prescription to the pharmacy of your choice or have it delivered to your home.
Ready for your hair loss treatment? Get started with your online doctor visit.
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.