FINASTERIDE: FDA-APPROVED HAIR LOSS TREATMENT

For the treatment of male pattern hair loss, finasteride is typically prescribed at a dosage of 1 mg per day. It should be taken at the same time every day. You can take it with or without food.

Most men tolerate finasteride well, and only a small percentage (about 2%) experience any side effects. For those who do experience side effects, the most common are decreased libido, erectile dysfunction, and ejaculation disorder. Less common side effects may include breast tenderness or enlargement, testicular pain, and allergic reactions, such as rash, itching, or swelling. Rare side effects, which require immediate medical attention, can include depression or mood changes, persistent sexual dysfunction after discontinuing the medication, and signs of an allergic reaction, such as difficulty breathing, severe dizziness, or swelling of the face, lips, tongue, or throat.

Finasteride is not approved for use in women, particularly those who are pregnant or could become pregnant, as it is classified as a Pregnancy Category X medication. This means that it has the potential to cause birth defects in a developing fetus. Women experiencing hair loss should consider alternative treatments, such as minoxidil (a topical solution), platelet-rich plasma (PRP) therapy, or low-level laser therapy (LLLT).

Does finasteride work for everyone?

Amongst men who take it regularly, the effectiveness can vary. Some people may see significant improvements in hair growth and thickness, while others may see little to no improvement. Factors such as age, the extent of hair loss, and genetics can all play a role in how much additional hair loss you prevent or how much you get back.

When you schedule a consultation with one of our doctors at the Anderson Center for Hair, we’ll take serial photographs to track your progress over time.

How long does it take to see the results?

Positive effects of finasteride are typically observed after three to six months of consistent use. It’s important to be patient and continue taking the medication as prescribed, even if results are not immediately apparent. Maximum benefits are usually seen after 12 to 24 months of treatment.

Will hair loss resume if I stop taking finasteride?

Yes, discontinuing finasteride will inevitably lead to a reversal of progress. To maintain the benefits of the medication, continuous use is necessary.  As an analogy, if you stop brushing your teeth tomorrow, you may not develop a cavity right away, but dental decay will start quickly and continue unless you do something to stop it.

If you do need to stop taking finasteride, ask your doctor for a plan to step your dosage down slowly to minimize side effects and the chance of rapid shedding. Your patient coordinator can also arrange alternative hair loss treatment options including topical solutions, LLLT, and PRP.

Can finasteride be used with other hair loss treatments?

Finasteride can, and in many cases should, be combined with other treatments, such as minoxidil (a topical solution sold over the counter as Rogaine), low-level laser therapy (LLLT), and/or platelet-rich plasma treatments to minimize future hair loss. Just like you brush your teeth, floss, and use mouthwash, multiple methods of hair loss prevention may be called for depending on the extent of your hair loss and how important it is to you to keep your hair.

Is a prescription required to obtain finasteride?

Yes, finasteride is a prescription medication. We offer a complimentary consultation with one of our doctors to obtain. This ensures that we evaluate your specific hair loss condition, track your progress, and stay up to date on any side effects.

Can I use generic finasteride instead of the brand-name Propecia?

Generic finasteride contains the same active ingredient as brand-name Propecia and is typically more affordable. Both forms of the medication should provide similar results. However, it’s essential to obtain generic finasteride from a reputable source to ensure quality and efficacy.

Is finasteride safe for long-term use?

Finasteride is generally considered safe for long-term use, with many patients taking it for many years without significant issues. However, as with any medication, potential side effects and risks should be weighed against the benefits. You can always contact us at the office or schedule an appointment if you notice changes to your hair or experience new side effects.

What are the chances of experiencing side effects?

Most men tolerate finasteride well, with a small percentage (about 2%) experiencing side effects. The most common side effects are related to sexual function and usually resolve after discontinuing the medication. It’s essential to discuss potential side effects with your doctor before starting treatment, including what to do if you are experiencing side effects.

Can finasteride be used for hair loss in areas other than the scalp?

Finasteride is specifically approved for treating male pattern baldness on the scalp. Anecdotal evidence exists, but its effectiveness in addressing hair loss in other areas, such as the beard, eyebrows, or eyelashes has not been well studied.

I’ve heard dutasteride is stronger and blocks more DHT. Should I take it instead?

The short answer is that finasteride blocks enough DHT in a small, 1mg dose to minimize both your hair loss and any negative sexual side effects while also being approved by the FDA.

The long, science-heavy answer is that finasteride and dutasteride are both medications classified as 5-alpha reductase inhibitors, but they have some key differences in terms of what the enzyme does (specificity) and how long it lasts in your system (half-life):

• Enzyme Specificity: 5-alpha reductase inhibitors function by blocking the transformation of testosterone into dihydrotestosterone (DHT), a more powerful androgen. The enzyme responsible for this conversion comes in two primary forms: Type 1 and Type 2. Finasteride selectively targets Type 2 5-alpha reductase, while dutasteride inhibits both Type 1 and Type 2 enzymes. Consequently, dutasteride is considered a more effective inhibitor, resulting in a more significant decrease in DHT levels.
• Half-Life: A drug’s half-life is the amount of time it takes for half of the substance to be removed from the body. Finasteride possesses a relatively short half-life, averaging 6-8 hours, while dutasteride has a longer half-life of approximately 4-5 weeks. This indicates that dutasteride remains in the body for a more extended period and continues to impact DHT levels even after ceasing treatment.

Although dutasteride is thought to be more potent, it is not approved by the FDA for the treatment of hair loss, while finasteride is. Some studies have shown that dutasteride may have the potential to prove better results with similar side effects, but more research is needed. Please schedule a consultation with one of our doctors to discuss your unique situation.

Does finasteride interact with other medications or supplements?

Finasteride should not be taken alongside other 5-alpha reductase inhibitors such as dutasteride because it increases the risk of side effects, given both drugs have similar mechanisms of action.

Finasteride has few other known drug interactions, but can potentially affect certain blood test results:

• Prostate-Specific Antigen (PSA) Test: Finasteride is known to reduce the levels of prostate-specific antigen (PSA) in the blood by approximately 50%. PSA is a protein produced by the prostate gland and is often used as a marker for prostate cancer screening. If you are taking finasteride, your doctor should be aware of it, as it may affect the interpretation of your PSA test results.
• Hormone Levels: Finasteride works by inhibiting the conversion of testosterone to dihydrotestosterone (DHT), a hormone responsible for hair loss and prostate enlargement. As a result, blood tests measuring testosterone, DHT, or other related hormones may show altered levels when you are taking finasteride. Let your doctor know about all the medications you take before starting new medications or supplements.

Is finasteride effective for all types of hair loss?

Finasteride is specifically approved to treat male pattern baldness (androgenetic alopecia) and is most effective for this type of hair loss. It may not be effective for other types of hair loss, such as alopecia areata, telogen effluvium, or traction alopecia. If you believe you have one of these types of hair loss (or you don’t know what type of hair loss you have), please schedule a consultation with one of our doctors for a full diagnosis and treatment recommendations tailored for your needs.

How does finasteride compare to natural hair loss remedies?

While some natural remedies may help slow hair loss or support the appearance of the hair once it’s grown above the scalp, they lack any clinical evidence or proof of effectiveness like finasteride does. Finasteride is one of only two FDA-approved hair loss remedies in the United States. Information about the drug and its studies are published clearly on the FDA’s website and can be accessed here.

Can I switch from minoxidil to finasteride, or should I use both?

Finasteride and minoxidil are the only two drugs approved by the FDA for the treatment of androgenetic alopecia. They have each been shown to be effective in treating hair loss, but they work through different mechanisms: minoxidil is a vasodilator that widens the blood vessels and increases blood flow to the hair follicles, while finasteride inhibits the conversion of testosterone to DHT, a hormone that can cause hair loss. As such, using both medications together may provide a more comprehensive approach to treating hair loss.

If you are considering switching from minoxidil to finasteride, or vice versa, it is important to discuss this decision with your doctor first. They can help you understand the potential benefits and risks of each medication and can provide guidance on how to safely transition between the two.

How do I know if finasteride is the right treatment for me?

The best way to determine if finasteride is the appropriate treatment for your hair loss is to consult your doctor, preferably one specializing in hair restoration. At the Anderson Center for Hair, we have virtual and in-person consultation options available at multiple locations for your convenience. Our team can diagnose the cause of your hair loss, discuss potential treatment options, and provide guidance on whether finasteride is suitable for you.

Is finasteride covered by insurance?

Coverage for finasteride varies depending on your insurance plan. Some plans may cover finasteride for the treatment of male pattern baldness, while others may only cover it for benign prostatic hyperplasia (BPH). You’ll need to check with your insurance provider to determine your specific coverage.

You can also compare drug prices with or without insurance on GoodRx.

Can I use finasteride if I have a history of prostate cancer?

In 2020, a systematic review and meta-analysis of eight studies was completed that included 54,335 cases of patients that used finasteride and 9,197 patients who served as placebo controls. The study confirmed that finasteride significantly reduced the risk of prostate cancer. However, the malignant degree of prostate cancer increased. Studies with larger sample sizes are needed to better clarify the correlation between finasteride use and prostate cancer. Talk to your prescribing doctor for more information on your specific case before starting any new medications.

What should I do if I experience side effects while taking finasteride?

If you experience any side effects while taking finasteride, contact your doctor at the office to discuss. They can help determine whether the side effects are temporary, recommend appropriate management strategies, and discuss alternative treatment options.

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Zhou Z, Song S, Gao Z, Wu J, Ma J, Cui Y. The efficacy and safety of dutasteride compared with finasteride in treating men with androgenetic alopecia: a systematic review and meta-analysis. Clin Interv Aging. 2019 Feb 20;14:399-406. doi: 10.2147/CIA.S192435. PMID: 30863034; PMCID: PMC6388756.

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