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Finasteride and Male Pattern Baldness: How It Works to Preserve Hair

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Written by

Science&Humans

Medically approved by

Medically approved by

Maria Jacob

Last updated

Thursday, February 22, 2024

Read in 30s

  • Finasteride is the second most prescribed drug for male pattern baldness. 
  • It functions by preventing testosterone from being converted to DHT, a hormone that causes hair follicles to shrink.
  • Persistent use may cause rare allergic reactions, breast discomfort, and sexual problems.
  • While it offers promise for male pattern baldness, informed decision-making and personalized healthcare guidance are crucial

Introduction

Finasteride is a compound used to combat male pattern baldness, available under the brand names Proscar and Propecia. It stands as the second most favored choice for hair growth, following minoxidil. In 2017, physicians in the United States issued nearly 10 million prescriptions for this medication, securing its position as the 86th most prescribed drug.

However, navigating the complexities of this medication can be daunting. This blog seeks to simplify the information, providing insights into the workings of the therapy. The goal is to empower users to make informed decisions to address hair loss.

While it is also FDA-approved for treating benign prostate hyperplasia, the main focus of this blog will be its application in male baldness.

How does finasteride work?

Finasteride, a synthetic compound known as a 4-azasteroid, works by inhibiting the enzyme called steroid Type II 5α-reductase. This enzyme is crucial for converting testosterone, a key hormone in men, into 5α-dihydrotestosterone (DHT). Male secondary sexual traits like facial hair, a deeper voice, and muscle growth are all influenced by DHT. 

For men genetically prone to pattern baldness, an imbalance in DHT dynamics occurs. Excessive DHT production negatively impacts hair follicles, causing them to slowly shrink. This process, referred to as miniaturization, results in thinner hair and, ultimately, leads to baldness.

Finasteride hair growth benefits stem from its ability to impede the conversion of testosterone to DHT, thereby interrupting this crucial mechanism. It tries to stop the chain of events that causes hair loss by lowering the body's levels of DHT. This interference is crucial because DHT is the primary hormone responsible for the progression of male pattern baldness.

The mechanism of action brings about a significant reduction in DHT levels, with studies indicating up to a 66% decrease. This reduction holds promise for those seeking to prevent further hair loss and, perhaps, stimulate the regrowth of hair. When DHT production is curtailed, the assault on hair follicles is stopped, allowing them to recover and potentially resume their normal hair production cycle.

Finasteride hair growth efficacy in addressing male pattern baldness is well-documented. It usually slows down hair loss, and in some cases, even promotes regrowth. However, individual responses may vary, and noticeable results may take several months.

What are the primary finasteride uses?

It is typically recommended for adult males experiencing progressive hair thinning and seeking to address baldness. There are two major formulations of finasteride online- pills and topicals.

The decision to prescribe this medication hinges on various factors, encompassing the individual's health history, the degree of hair loss, and an evaluation of potential finasteride benefits and risks.

Can finasteride really regrow hair?

Clinical studies have shown that the treatment is effective for male hair loss. This was demonstrated in a study involving 1,553 men with pattern baldness, where the treatment significantly increased hair regrowth compared to a placebo.

Additionally, another study showed a remarkable change in target area hair count after six months with a topical finasteride solution.

Even at minimal daily doses of 0.2 mg, the treatment exhibited a substantial decrease in scalp skin DHT levels, ranging from 14.9% to 69.4%. 

In a separate development, a novel 0.25% concentration solution (P-3074) demonstrated significant scalp DHT reduction. Once-daily application achieved up to a -52% decrease.

The treatment is more successful for mild to moderate hair loss that started within the last five years. However, its effectiveness is limited or may take longer in cases of prolonged hair loss.

The effects of this treatment vary from person to person.  It works best when taken consistently for at least six months, with visible outcomes in up to a year. 

Side effects of finasteride

Like any medication, a certain percentage of individuals may experience side effects. It's imperative that individuals considering or currently using this medication comprehend the potential side effects.

Here's an overview of the common pills and topical finasteride side effects:

Sexual Side Effects:

Some men using this medication might observe sexual side effects such as a decrease in libido (sexual desires), difficulty in achieving or maintaining an erection, or a reduction in ejaculate volume. The majority of men who experience these effects report that they usually go away after stopping the medicine, but they are usually uncommon.

Breast Tenderness or Enlargement:

A small percentage of men may encounter breast tenderness or enlargement. Similar to sexual side effects, these symptoms usually diminish once the medication is no longer taken.

Allergic Reactions:

In rare instances, some individuals may experience an allergic reaction, presenting as a rash, swelling, itching, extreme dizziness, or difficulty breathing. If any signs of an allergic response emerge, immediate medical assistance is crucial.

Depressive Symptoms:

There have been anecdotal reports associating depressive symptoms with the treatment. However, it's essential to note that there isn't robust evidence firmly linking this medication to depression. Further research is necessary to gain a clearer understanding of this potential connection.

While these are commonly reported side effects, if any unrelated symptoms manifest during the medication's use, seeking prompt consultation with a healthcare provider is crucial.

Things to know before taking finasteride for hairloss

Before considering finasteride for hairloss, individuals should be well-informed about various aspects of the intervention. Here's a list of crucial considerations to be aware of before undergoing this treatment:

Consultation with a Healthcare Professional:

Before beginning treatment, consult a qualified healthcare professional (dermatologist or general practitioner) who will assess the medical history, overall health, and potential risk factors to determine the suitability of finasteride. If you are seeking a finasteride prescription online, ensure consultation with a well-qualified practitioner.

Understanding Male Pattern Baldness:

Individuals considering the treatment should have a clear understanding of the nature and progression of male pattern baldness.

Exclusion for Women and Children:

This treatment is not recommended for use by women or children. Its efficacy and safety profile have been extensively studied in adult men, and its use in other populations has not been well-established. Women who are pregnant or may become pregnant should especially avoid handling crushed or broken finasteride tablets, as exposure to the medication during pregnancy may cause harm to the developing male fetus.

Discussion of Sexual Health:

Individuals should openly discuss their sexual health with their healthcare provider before starting the treatment. This includes any pre-existing conditions or concerns related to sexual function.

Management of Expectations:

It's important to have realistic expectations about the outcomes of the treatment. While the intervention has shown efficacy in slowing hair loss and, in some cases, promoting regrowth, individual responses can vary. Importantly, it doesn't treat autoimmune diseases, nutritional inadequacies, or chemotherapy-induced hair loss.

Compliance and Ongoing Use:

This treatment is typically a long-term approach, and its benefits are sustained with continuous use. People should be ready to adhere to the recommended treatment plan consistently. Additionally, discontinuing may lead to a reversal of its effects, and ongoing use is typically necessary to maintain benefits.

Is finasteride more effective than other treatments?

Addressing male baldness involves inhibiting the conversion of testosterone to DHT, a well-established approach. Apart from finasteride, various medications and treatments are utilized for managing this condition.

Now, let's compare the intervention with other common treatments for hair loss:

Minoxidil:

It is an over-the-counter topical treatment applied directly to the scalp to promote hair growth.

It works by widening blood vessels and opening potassium channels, enhancing blood flow to hair follicles.

Combining finasteride and minoxidil may have a synergistic effect.

In a recent study, individuals using combination therapy showed a 94.1% improvement after one year.

Hair Transplantation:

It is a surgical procedure that relocates hair follicles from donor areas to areas with hair loss.

Effective for individuals, especially those with advanced hair loss.

Finasteride and hair transplantation can be used together for enhanced results.

In a study involving 79 men, significant improvements in scalp hair were demonstrated with finasteride pills taken after transplant.

Low-Level Laser Therapy (LLLT):

It employs low-level lasers or light-emitting diodes to stimulate hair follicles, aiming to promote hair growth.

The effectiveness of LLLT varies among individuals, and its overall efficacy is not universally established.

To achieve optimal results, it requires frequent application several times per week.

LLLT can be a costly option, particularly when considering home-use devices.

Diet and Lifestyle Changes:

A balanced diet and a healthy lifestyle contribute to overall well-being, indirectly influencing hair health. 

Hair loss can be linked to nutritional deficiencies or underlying health conditions. 

In a 12-week trial, supplementation with specific nutrients demonstrated improved clinical efficacy in addressing hair loss conditions

Yet, it is generally a more favorable choice if one is already undergoing other treatments specifically targeted at addressing hair loss.

Topical Steroids:

Doctors may suggest using steroids to ease inflammation and itching in certain types of hair loss, such as alopecia areata. 

Yet, steroids don't tackle the hormonal imbalances responsible for hair loss. 

When it comes to male pattern baldness, steroids are not a stand-alone solution as they have limited effectiveness in promoting hair growth.

Ultimately, the choice of treatment depends on factors like age, the cause and extent of hair loss, and potential side effects. In many cases, a combination of treatments may be recommended for optimal results.

Is finasteride safe?

Acknowledged for its safety and effectiveness, a careful evaluation of potential risks is essential for those considering the use of the medicine. By reducing DHT levels, this intervention influences sexual function. Topical finasteride side effects include a decrease in libido and sperm production, potentially affecting neurotransmitters and hormones and contributing to issues like erectile dysfunction (ED) and altered ejaculation. 

Some reports suggest a potential link to severe prostate cancer. However, more studies are needed to confirm this association.

Research indicates that users may experience sexual side effects (SSEs) ranging from 1% to 16%, with ED being the most common (6-10%). Higher doses are linked to an increased SSE risk, but the standard finasteride tablets of 1mg are generally considered low-risk. In a systematic review, a 1.57-fold risk of sexual dysfunction was linked to the use of 1mg/day finasteride pills for hair loss. 

Yet, it's important to note that most side effects of this treatment are usually mild and tend to go away after discontinuing the treatment.

Conclusion

While finasteride benefits offer a promising avenue for addressing male pattern baldness, informed decision-making and personalized healthcare guidance are pivotal to achieving optimal outcomes. In navigating the landscape of hair loss treatments or searching for efficacy of finasteride online, individuals are encouraged to actively engage in discussions with healthcare professionals, ask questions, and express any concerns.

References

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