Let’s Talk Finasteride

Written by Bronwyn Gibson

Let’s Talk Finasteride. What is It? 

Finasteride is a prescribed, oral medication used to treat male pattern hair loss, commonly sold under its 1mg Propecia and 5mg Proscar brand name options.

Originally approved for medical use in 1992 to treat benign prostatic hyperplasia, an enlarged prostate or BPH, Finasteride is currently the only FDA approved oral medication proven to treat male pattern hair loss.

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How it Works

In addition to genetics and family history, dihydrotestosterone, or DHT, is a key factor in hair loss and is the sex hormone responsible for shrinking hair follicles of the crown, top and front of the scalp. When the hair follicle is too small in diameter and length, a healthy, typical hair cannot grow.

Finasteride works as a 5-alpha reductase inhibitor, or antiandrogen, to decrease the amount of DHT produced by the body by up to 70%. Essentially, the use of Finasteride as a long-term solution to inhibit the formation of DHT in the scalp not only helps reduce further hair loss, but also allows for the regrowth of visible hair.

While there is evidence to support Finasteride works to treat mild-to-moderate male pattern hair loss of the vertex and anterior mid-scalp regions, sufficient evidence to support the drug works against a receding hairline at the temple regions has yet to be recognized.

Using Finasteride

Although a 5mg tablet is often prescribed to treat BPH, when treating hair loss, Finasteride is recommended in a 1mg tablet daily dose to be taken either morning or night, with or without food. 

Finasteride is prescribed as a long-term solution for hair loss and if the medication is stopped, the benefits seen will also subside. 


The Results

Similar to other hair loss treatment options, results may vary and do not happen overnight. An increase in hair shedding during the first three to six months is common, and often indicative that the medication is working. The benefits of Finasteride typically become visible after three months of treatment and may even take up to one year.

As mentioned, Finasteride is prescribed as a long-term solution for hair loss. When the FDA conducted a five-year clinical trial for Finasteride, 90% of the men taking a 1mg daily dose either benefited from a pause in hair loss or the regrowth of lost hair. At the end of the five-year trial, the difference in hair count was also significant, showing the men taking Finasteride with an average of 277 more hairs per one-inch circle on the scalp than those men taking a placebo. 


Side-Effects, Warnings & Contraindications

Every drug has the potential for side-effects, and Finasteride is no different. Decreased sexual desire, difficulty achieving or maintaining an erection, ejaculation difficulties, testicular pain, and depression have been reported in a small percentage of patients. 

Symptoms of an allergic reaction have also been reported, including skin rash, hives, itching, swelling of the face and lips, and difficulty swallowing and breathing. 

Children and women that are pregnant should not touch or handle Finasteride, as the medication can be absorbed through the skin. 

Those at risk for liver disease or prostate cancer should thoroughly discuss with a doctor before considering Finasteride. 

 This article is intended for informational purposes only and should not be used as the basis for any patient treatment. Always consult your primary care physician regarding any medical questions and advice, or before beginning any treatments.

Medline Plus. Finasteride. Accessed August 28, 2019. 

Medline Plus. Male pattern baldness. Accessed August 28, 2019. 

Medline Plus. Hair loss.

American Academy of Dermatology. Hair loss. Accessed August 28, 2019.

FDA. Propecia Clinical Pharmacology. Accessed August 28, 2019.