Updated: Feb 12
If you are looking for a viable option to stop your hair loss in its tracks look no further than a little pill called finasteride. Commonly prescribed under the brand name Propecia, finasteride is an FDA approved treatment (one of three actually) for men’s pattern baldness. Its effectiveness has been proven by many scientific studies which is why it’s one of the most popular treatments in the world for male pattern baldness.
All of this probably sounds like great news, right? Well it is! Finasteride is a very exciting option for someone who is experiencing hair loss. The problem is that while a lot of people know THAT finasteride works, many do not know HOW or WHY it works.
That’s the issue this article is addressing. By the end of reading this you should have well rounded knowledge about finasteride. Hopefully you can then make an informed decision about whether or not finasteride is right for you.
How does finasteride work?
Whether you’re relatively new to this whole hair loss thing or not you should know that DHT (dihydrotestosterone) is likely the main hormone responsible for male and female pattern hair loss. If you are genetically susceptible to hair loss DHT binds to receptors in your hair follicles, causing them to slowly shrink and die in a mentally excruciating process called “miniaturization”. Finasteride’s defense against hair loss is blocking DHT, here’s how it does it:
Finasteride is what’s called a 5-alpha reductase inhibitor.
5-alpha reductases are enzymes that are involved in steroid metabolism. They are responsible for converting testosterone into DHT. 5-AR’s also participate in 3 metabolic pathways: bile acid biosynthesis, androgenic and estrogenic metabolism. This is where the scientific name for pattern hair loss androgenic alopecia comes from.
By suppressing 5-AR enzymes, finasteride effectively blocks the conversion process of testosterone into DHT. Resulting in a reduction in DHT levels throughout the body, finasteride ensures that susceptible hair follicles are not being exposed to DHT.
How effective is it?
On average, finasteride is able to block up to 70% of DHT production. Of course this varies from person to person as some people are more or less receptive to it. Finasteride’s effectiveness depends entirely on the individual user and how their body reacts to it.
Data from clinical trials showed that finasteride slowed the progression of hair loss in 86% of men that took it, and even better showed that 65% who took it experienced a considerable increase in hair growth.
It goes without saying that the data overwhelmingly proves finasteride’s efficacy, but I believe it is important to dive into dutasteride a little bit.
Dutasteride is another 5-AR inhibitor that is likely more effective than finasteride, you just don’t hear about it as much because it is not FDA approved (yet). Like stated above, finasteride blocks about 70% of DHT, dutasteride has been shown to effectively block up to 90%.
This is because there is two types of 5-alpha reductase, type 1 and type 2. Type 1 is present in the sebaceous glands while type 2 is found on the outer root sheath and the dermal papillae. Type 2 plays more of a role in pattern hair loss and this is what finasteride blocks. Where finasteride falls short is dealing with type 1. Although it is less detrimental to hair, it is much more abundant in the scalp and definitely has a role to play when it comes to hair loss. Dutasteride blocks both types which is why it can be a much more effective treatment.
When will I see results?
Probably not right away. Although there are anecdotal cases of quick results (again everyone responds differently) you will likely have to wait at least three months, and possibly up to a year.
It is most commonly reported that results come at around the three month mark, but these are likely initial results. To determine what the full extent of your results will be you should wait a year.
The reason for this is because of how the hair goes through cycles.
When you are in the process of balding your hairs growth (anagen) phase is being shortened, this results in more hair being in the resting (telogen) phase. For hair to start growing again the old hair needs to fall out, or shed, so that new hair can take its place. This shedding takes place during the transition from the resting to the growth phases. Finasteride helps give hairs the boost that they need to transition from one phase to the next. This is why people who start taking finasteride initially report a “shed” where a bunch of hair falls out in a short amount of time. This is normal and is actually a sign that the medicine is working.
Sometimes hair needs to shed two or three times before the healthiest hair starts growing in. Hair takes time to go through its phases which is why you shouldn’t give up! Consistency is key, the longer you stick with it the likely better results you will have.
Are there any side effects?
There are potential side effects, but they are very rare.
Some of the most commonly reported side effects are sexual. These include decreased sex drive, trouble getting an erection, or ejaculation problems. Although these are important to note, various studies have shown them to be an all but common occurrence. As a matter of fact one large long term analysis showed that the sexual side effects occurred in less than two percent of men. It is reported that oftentimes side effects occur early in the treatment and will either subside after continuous use or if stopped.
These side effects are to be expected because finasteride interferes with androgens. Androgens are linked to increased libido which is why any drug that interferes with them is assumed to induce impotence.
Other side effects include dizziness, weakness, depression, anxiety, and rashes. Although side effects when taking finasteride are rare it is important that you consult your doctor before taking it and that you disclose all medical history.
Will finasteride save my hair by itself?
Potentially, but there’s more that you can do.
Finasteride is undoubtedly one of the most effective treatments available and has the potential to save a lot of your hair. Hair regrowth occurs less commonly with finasteride which is why minoxidil is a good option to use as well. It has been shown to grow new hairs, something that finasteride may not be able to do for you. It is also FDA approved.
Beyond minoxidil it is always a good idea to keep the hair follicles nourished as best as you can. A good hair supplement can do the trick for that (a laser helmet is also a very good option for nourishment of hair if you can afford one, they are quite pricey). Make sure you also use a shampoo made for hair loss that is free of harmful chemicals and will keep your scalp healthy.
Hopefully by now you understand finasteride a little bit better. The time to act is now, talk to your doctor to see if finasteride is the right option for you so that you can save as much hair as possible.