Widely regarded as the gold standard in medical hair restoration, Finasteride is a clinically proven medication designed to halt male pattern baldness by targeting its hormonal root cause.
Disclaimer: This content is meant for informational purposes and is not a substitute for professional medical advice.
Finasteride is a prescription drug used to treat male pattern baldness.
It is also used at higher doses to treat benign prostatic hyperplasia (an enlarged prostate), and has been researched for helping prevent low-grade prostate cancer.
Licensed in the UK and FDA-approved, finasteride prevents the androgen-dependent miniaturisation of hair follicles. It does this by inhibiting type II 5-alpha reductase, thereby preventing the conversion of testosterone to dihydrotestosterone (DHT).
DHT is an androgen produced from testosterone. It is the hormone responsible for male pattern hair loss. In men susceptible to male-pattern hair loss, DHT can bind to receptors in hair follicles, causing them to shrink and eventually die. Taking 1mg doses can potentially lower serum and scalp DHT levels by 60%.
Finasteride medication is proven to prevent further hair loss in the majority of men who take it. However, finasteride’s long-term results can vary between patients.
Along with improved hair counts, finasteride can also increase hair thickness. This extra thickness can give the impression of a fuller head of hair, resulting in a more satisfying finasteride before-and-after comparison.
In long-term clinical studies, most men with crown hair loss taking finasteride 1 mg daily experienced no further hair loss after 2 years. This was seen in over 80% of patients, compared with 28% on placebo. More recent trials continue to support its effectiveness.
In addition, a 10-year follow-up study examining finasteride’s long-term efficacy suggests significant, sustained increases in hair growth after long-term use.
Finasteride is most effective on the vertex scalp, less on the frontal scalp, and least effective on the temporal regions. This means that if you are using finasteride for your crown, the results are more likely to be positive than if you use finasteride for a hairline that’s receding.
Compared with oral finasteride, topical finasteride decreases scalp DHT levels locally rather than systemic DHT levels.
Due to its localised treatment, studies have suggested a potential decrease in systemic side effects with topical finasteride. Side effects reported by patients are still the same as those of finasteride tablets, but may be less common.
The discussion of topical vs. oral finasteride is best handled on a case-by-case basis, as the right hair loss treatment will differ for each patient.
Finasteride is generally well-tolerated, but there are some side effects to be aware of.
Depression is a noted adverse reaction to taking 1 mg of finasteride tablets. Explore more side effects written up in the patient information leaflet.
Uncommon sexual side effects (affecting around 1 in 100 men) may include:
Male infertility and/or low quality of semen is a lesser-known factor, but included in the leaflet.
Other reported side effects (frequency unknown) include:
Post-finasteride syndrome (PFS) has been a recently reported issue. This term refers to the continuation of adverse effects despite the discontinuation of therapy. Further investigational studies of PFS are currently underway.
Finasteride has long been linked to concerns about prostate cancer, but current studies have largely ruled this out.
Disclaimer: This content is meant for informational purposes only and is not a substitute for professional medical advice. You should consult with a registered specialist before beginning any new treatment plan.
Generally, topical finasteride side effects are less severe than those of capsules, but they follow a similar pattern. Two randomised controlled trials tested the efficacy of topical finasteride compared with the oral treatment as the control.
With a test group of 32 men, the overall finding was that certain doses of the solution are potentially minimising the negative sexual side effects of the capsule.
These are the potential side effects identified:
Finasteride is not licensed in the UK for the treatment of female pattern hair loss (FPHL). However, it may be considered as an off-label option under careful medical supervision for women who don’t respond to other treatments.
How finasteride works for female pattern hair loss isn’t fully understood. A 2020 research review suggests it may help by increasing a compound that supports hair growth and by reactivating dormant hair follicles. This could explain why some women experience improved hair density with treatment.
Research shows promise, though results aren’t conclusive. Important findings in women with normal hormone levels include:
Finasteride is used in women only under strict medical supervision, due to the potential for serious adverse outcomes.
It is strictly contraindicated in pregnancy. The manufacturer warns that even skin contact with crushed tablets can be harmful, potentially affecting fetal development, particularly male sex organs.
Some known side effects in women may include:
Finasteride can also alter the oestrogen-testosterone balance, so women with a family history of breast cancer should avoid treatment.
Explore our answers to frequently asked questions about finasteride to better understand its uses as a common treatment for male pattern baldness.
Disclaimer: This content is meant for informational purposes and is not a substitute for professional medical advice.
No, there is currently no evidence that finasteride promotes beard growth. A retrospective study of 453 men found that 96.9% experienced no change in beard thickness after at least 12 months of therapy with finasteride or dutasteride.
Finasteride is primarily indicated for adult men experiencing male pattern baldness or benign prostatic hyperplasia to help stimulate hair regrowth and reduce prostate size. While it is generally avoided in women of childbearing age due to significant risks to fetal development, it may be prescribed off-label for postmenopausal women under strict medical supervision.
It’s important to discuss your options with a registered medical professional before taking any medication.
Some patients experience temporary shedding when they start taking finasteride. Note that any shedding is the reactivation of dormant hair follicles and is a positive sign that finasteride is working.
Typically, the oral or topical finasteride shedding phase will subside within a few months as hair regrowth becomes more evident. The finasteride hair shedding and regrowth cycle is a normal part of the treatment process that your doctor will walk you through.
While finasteride is highly effective for most men, it is still possible to experience thinning if your hair follicles are exceptionally sensitive to even residual levels of DHT.
Studies suggest that patients who showed improvement after the first year of finasteride treatment are more likely to maintain or improve hair growth after 10 years.
Patients who do not see improvement or continue to lose hair after the first year are less likely to experience improvement in hair growth at 10 years and can be considered non-responsive to long-term therapy.
If this is the case, your doctor can work with you to discuss alternative options.
Topical finasteride is a localised version of the hair loss medication applied directly to the scalp as a solution to target hair follicles while minimising systemic absorption. This delivery method aims to provide the same hair-regrowth benefits as the oral tablet but with a significantly lower risk of systemic side effects like mood changes or sexual dysfunction.
Disclaimer: This is meant for informational purposes and is not a substitute for professional medical advice.
