Finasteride is used to treat men with male pattern hair loss. It is most effective on the crown of the scalp and, although it will increase the number of scalp hairs, it will not increase the amount of body hair. Based in Glasgow, Dr Bonaros specialises in advanced hair restoration, including the use of finasteride for hair loss.
Book a Zoom consultation with Dr Bonaros to find out how this medication can be used to treat hair loss for your unique case.
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Male pattern baldness is related to your sex hormones and genes. Hormonal changes, genetics, or ageing can cause a receding hairline, as well as a pattern of hair thinning on the crown.
What is finasteride, and how can it help with this? Finasteride is a prescription drug used to treat male hair loss, particularly male pattern baldness, and promote scalp hair growth.
As a hair loss treatment, finasteride is perhaps the most extensively studied medication for male pattern baldness. Finasteride is also used as a treatment for benign prostatic hyperplasia (an enlarged prostate), although the dose is typically higher. It has also been studied for its prevention of low-grade prostate cancer.
In this article, we discuss the use, dosage, mechanism of action and side effects of finasteride, so you have a better understanding of its uses as a common male pattern baldness treatment.
FDA-approved and approved in the UK, finasteride prevents the androgen-dependent miniaturisation of hair follicles. It does this by blocking the type II 5 alpha reductase enzyme, 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 the hair follicles, causing them to shrink and eventually die. Taking oral finasteride in 1mg doses can lower serum and scalp DHT levels by 60%.
The first questions many of our patients have are, “Does finasteride stop hair loss?” or “How effective is finasteride for hair loss?”
For most patients, the answer is yes — when using finasteride for hair loss, a comparison will show distinct results. However, finasteride's long-term results can vary between patients.
Finasteride medication is proven to prevent further hair loss in over 95% of men who take it. Clinical studies have shown that for 83% of participants with crown balding, the finasteride results after 2 years of treatment included a complete halt in hair loss.
In addition to this, a 10-year follow-up study examining finasteride's long-term efficacy suggests significant lasting increases in hair growth after long-term finasteride use.
A finasteride hair treatment 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.
Alongside improved hair counts, finasteride can lead to increased hair thickness. This extra thickness can give the impression of a fuller head of hair, resulting in a more satisfactory finasteride before and after comparison.
Baldness results from your hair follicles slowly shrinking over time, creating finer, wispier hair. Eventually, hair follicles will not grow new hair. That being said, as long as the follicle remains intact, patients can grow new, thicker hair when using finasteride for hair growth.
Hair regrowth from finasteride may be possible in some patients. As finasteride is most effective on the vertex scalp, finasteride crown regrowth is more commonly seen than that of the temporal regions or frontal scalp.
A total of 66% of patients will achieve moderate finasteride hair regrowth, and 5% will achieve marked finasteride regrowth.
Many male patients exploring solutions for their hair loss ask Dr Bonaros questions like “How long does finasteride take to work?” and “When does finasteride start working?”
Patients should continue finasteride hair loss treatments for at least 1 year so the finasteride results can be assessed effectively. Long-term studies have found that the patient’s finasteride results after 1 year may predict its effectiveness going forward. Patients who fail to respond within the first 12 months are likely to be non-responders in the long term, too.
It is important to note that finasteride needs to be continued indefinitely to maintain efficiency. The medication has a short half-life and only works while it is used.
This medication is suitable for men over the age of 18. It is not usually recommended for women. It’s important only to take finasteride under a doctor’s instructions.
You can only get finasteride with a prescription in the UK. The typical dose prescribed by doctors for the treatment of male pattern hair loss is 1mg/day. It is important to note that only a qualified healthcare provider, such as Dr. Bonaros, can adjust your dosage based on your individual case and response to the treatment. Dr. Bonaros may monitor your progress and adjust the dosage as needed to optimize results while ensuring your safety and well-being. Lowering the dosage, if necessary, can still yield positive outcomes under proper medical supervision. It is crucial to follow the prescribed dosage and any adjustments recommended by your healthcare provider for the best results in managing male pattern hair loss.
A finasteride tablet may be orally administered with or without meals, as the absorption is not affected by food. However, your doses should ideally be taken at the same time each day.
Finasteride is generally well-tolerated, but there are some side effects to be aware of. Side effects associated with finasteride can include sexual dysfunction, such as low libido, erectile dysfunction, reduced ejaculatory volume and temporary reduction in sperm count. These sexual side effects typically resolve with finasteride discontinuation.
Men taking finasteride may also experience testicular pain, gynecomastia (overdevelopment of breast tissue in men), or mood disturbances, such as an unusually low mood or depression. In rare cases, finasteride side effects can also include breast cancer.
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.
When starting treatment, shedding while using finasteride is sometimes reported. However, initial hair shedding on finasteride is completely normal and only short-term.
So, when asking “Does finasteride cause shedding?” it is key to remember that any shedding is simply the result of the reactivation of dormant hair follicles and is actually a positive sign that finasteride works.
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.
Contact us at info@drbonaros.com to learn more about finasteride and how it can help with your hair loss restoration journey.
Studies suggest that patients who showed improvement after the first year of finasteride treatment are more likely to improve or maintain their 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.
Finasteride tablets are available under the brand name Propecia or as a generic option. The generic version of Propecia contains the same active ingredient (finasteride). One film-coated tablet of Propecia contains 1mg of finasteride.
Besides finasteride, there are also other medicines and alternative hair loss treatments that patients can consider. A finasteride alternative is minoxidil (also sold as Rogaine and Regaine).
Both oral finasteride and topical minoxidil are safe, commonly-used treatments for mild to severe male androgenetic alopecia. However, finasteride appears to be more effective.
The mechanisms of action of minoxidil and finasteride treatments are different. Finasteride blocks DHT, while minoxidil seems to work partly by increasing blood flow on the scalp. Thus, a combination of topical minoxidil and oral finasteride is possible and can be considered for greater efficacy in carefully selected patients.
Clinical studies have suggested that a combined treatment with finasteride 1mg and 5% minoxidil topical solution may lead to better improvement than monotherapies when prescribed under a qualified doctor’s supervision. In most cases, the two drugs are safe to use simultaneously.
Topical administration of finasteride offers the potential to reduce systemic effects related to the finasteride mechanism of action by preferentially inhibiting 5 alpha reductase in the scalp.
Only a limited number of randomised controlled trials look at finasteride as a topical treatment for androgenetic alopecia. However, the data from those studies show promising results and non-inferiority compared to systemic delivery (finasteride tablets).
Men who are uncomfortable with oral finasteride in a 1mg tablet form may find topical finasteride to be a good alternative.
Dr Bonaros is often asked, “Does topical finasteride work?” along with, “Is topical finasteride safe?”
Topical finasteride results in significantly improved hair count compared to a placebo and is well tolerated. Its effect is similar to oral finasteride but with markedly lower systemic exposure and less impact on serum DHT concentrations.
Several topical finasteride studies found an overall decrease in the rate of hair loss. Finasteride as a topical treatment may work to increase your total and terminal hair counts.
The conversation of topical vs oral finasteride is best had on a case-by-case basis because the right hair loss treatment will differ for each patient.
When having this discussion with your doctor, it is important to first know the answer to the question, “How does topical finasteride work?” Generally speaking, when compared to a finasteride tablet prescription, topical finasteride only decreases scalp DHT levels in a localised area rather than affecting serum DHT levels in the body.
Due to its localised treatment, studies have indicated a potential decrease in the systemic side effects of topical finasteride. Side effects reported by patients are still the same as that of finasteride tablets, but may be less likely.
Currently, topical finasteride and minoxidil is a treatment commonly used for hair loss. Some versions of topical finasteride and minoxidil can be applied as one solution from a dropper bottle. Various formulations that combine topical minoxidil and finasteride also exist.
Typically, it is recommended to apply up to 1 ml of the solution onto balding areas in the morning and at night.
If this is the right treatment for you and a topical finasteride prescription is warranted, Dr Bonaros will advise you on how to apply topical finasteride for your specific treatment areas, including the frequency and method of use.
If you are a man who has decided on hair transplant surgery, it is important to think about the long-term maintenance of the procedure. Even though the transplanted new hair grows permanently, there is always the chance that you will continue losing your native hair.
Taking finasteride after a hair transplant surgery is a good way to prevent future hair loss and regrow any thinning hairs. For this reason, as a long-term hair loss treatment, the results of finasteride may be promising for many men.
Book an online consultation with Dr Bonaros to find out more about our male hair loss treatment options and to take the first step in regaining your hair and your confidence.
At our clinic in Glasgow, we offer a full spectrum of male hair loss treatment solutions to suit your needs, preferences and budget. This includes hair transplants and medical treatment with finasteride.
In your first hair loss consultation, Dr Bonaros will discuss the benefits and possible side effects of finasteride for hair loss with you and advise whether it is a suitable option for you.
If you’re ready to find a solution to your hair-thinning problem, contact our clinic in Glasgow or book an online consultation below. Alternatively, fill out our free online assessment form and get advice directly into your inbox.