Finasteride (Propecia) for Hair Loss

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If you have already taken more action than most to combat hair loss, you have likely searched for ways to prevent, stop, or reverse it. Perhaps you have tried using topical treatments like minoxidil (better known as Rogaine), as it is an over-the-counter medication that can be purchased without a prescription. 

If hair regrowth is not occurring with the use of minoxidil, maybe you have talked to your hair restoration surgeon about the oral medication finasteride (Propecia), which is proven to be effective for most people who use it.

However, those who have tried almost every hair loss medication in the market (shampoos, creams, supplements, etc.) are usually not convinced that an oral medication would be effective in treating hair loss because of some negative feedback. 

Now, do you want to know what makes this oral medication solution any different from the rest? Let us explain.

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How Propecia Was Developed

Actually, finasteride was originally discovered by accident. The pharmaceutical giant, Merck, developed a medicine named Proscar (in 5-mg doses) to treat symptomatic benign prostatic hyperplasia (BPH) in men with enlarged prostate glands. 

During clinical trials, participants reported an unexpected side effect: additional hair growth. Since the drug was already approved for the initial purpose, Merck decided to repurpose and redevelop it, creating the first oral hair loss medication. Thus, Propecia was born. 

In 1997, it was approved by the Food and Drug Administration (FDA). It was then that Propecia became the first drug of its kind to treat male pattern baldness and remains the first line of choice for people experiencing hair loss issues. 

The recommended dose of Propecia is a 1-milligram tablet taken once daily. Typically, daily use for three months or more is necessary to achieve significant results. Continued use is recommended to treat male pattern baldness. 

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Finasteride (Propecia) for Hair Loss

Does Propecia Actually Work?

One need only walk through a crowded street to see that if a cure for baldness has occurred, surprisingly, many people have not purchased it. Now, the question remains: Does Propecia actually work? 

The short answer is: yes. The good news is that Propecia, or finasteride, is considered the most effective hair loss treatment on the market. As a matter of fact, clinical studies have demonstrated that hair loss progression stopped in 86% of participants. Similarly, 65% experienced a “substantial” increase in hair growth. There’s even proven evidence that finasteride is more effective in its fifth year of use than in the first year. 

The efficacy of finasteride led doctors to prescribe it as the first line in drug treatment for patients experiencing male pattern baldness, even before over-the-counter hair loss treatments like minoxidil. 

It’s important to note that finasteride is most effective with mild to moderate male pattern baldness. If you start early on in treating your hair loss problems, there’s an increased chance of reversing hair loss. However, if you have lost too much hair already, the effect can be much less noticeable. 

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How Does Finasteride Work?

Finasteride works by inhibiting the production…..

Finasteride for Women’s Hair Loss (Not FDA Approved)

Finasteride is not approved by the FDA to treat…..

Finasteride Side Effects

How Does Finasteride Work?

Finasteride works by inhibiting the production of 5-alpha-reductase, an enzyme that converts your body’s testosterone into dihydrotestosterone (DHT). As the primary hormone that causes hair loss in men, some are more sensitive to DHT than others, which explains why some men are more susceptible to losing their hair at a faster rate. 

While some normally lose their hair due to hormone imbalance, nutritional deficiencies, infections, or some psychological conditions, male pattern baldness is caused by hair follicles that are sensitive to DHT. This causes hair follicles to shrink after some time, and as they shrink, they produce fewer hairs. 

As the follicles shrink, hair grows increasingly shorter and finer until no new hair starts to grow. Male pattern baldness is often seen with a receding hairline on the forehead or the area around the crown starts thinning initially (the “bald spot”). This is because the follicles on the top and crown of the head tend to contain DHT-sensitive follicles. 

While DHT explains the hair loss associated with male pattern baldness, some exceptions are the hair follicles on the sides and back of the head. This is the reason for the “horseshoe” baldness pattern. These follicles have a tendency to be more resistant to DHT than those on the front, top, and crown of your scalp. 

To see the results of taking finasteride, you must continue using it for six months. Research shows a significant increase in hair count over one year of continuous treatment with 1 milligram of finasteride per day (the usual finasteride dose for hair loss prevention). If you stop taking the medication, you will develop an increased production of the 5-alpha-reductase enzyme, which then leads to increased DHT production, thus leading to further hair loss.

Now, if you have not seen any significant results after taking finasteride for one full year, then it is time to seek some professional help from your hair restoration physician. He will probably suggest you stop taking finasteride and consider a more permanent solution for your hair loss problems like hair transplants such as follicular unit extraction (FUE). 

Finasteride for Women’s Hair Loss (Not FDA Approved)

Finasteride is not approved by the FDA to treat women’s hair loss. While several drugs may work to a certain extent for some women, our doctors won’t prescribe finasteride for treating female pattern baldness. 

Finasteride belongs to Category X, which means there is risk of causing birth defects in unborn children. This is the reason why it is contraindicated in women who are pregnant or want to become pregnant. 

If your hair loss is considered to be female pattern baldness, your doctor may recommend over-the-counter topical treatments like minoxidil, which is applied directly to the scalp. Similarly, some medications serve completely different purposes to block the production and absorption of DHT. 

To support these findings, a study conducted from 2007-2011 examined 256 patients diagnosed with female pattern hair loss (taking 5 milligrams of finasteride) to study finasteride’s adverse effects on women.

Therefore, if you are experiencing female pattern baldness but you are pregnant or trying to get pregnant, you should not take finasteride. It is considered teratogenic, which means if you get pregnant while taking it, it may cause birth defects.

Finasteride Side Effects

Propecia is widely accepted by those who use it. However, possible side effects are likely to occur with any drug. Finasteride has a variety of possible side effects, classified as mild to severe. 

Some people may have common cold symptoms, like runny nose, drowsiness, or congestion. The good news is that these side effects tend to go away as the body adjusts to the drug. 

However, the most common side effect of finasteride is that it can suppress sexual function. In April 2012, the FDA issued a warning on finasteride which noted that sexual side effects such as decreased libido and inability to have or keep an erection could persist even after the medication is discontinued. 

Therefore, you should consider the risk of sexual symptoms and severe side effects before taking finasteride. Talk to your doctor immediately if you experience any of the following adverse effects:

  • Chills, confusion, or cold sweats 
  • Dizziness or lightheadedness when standing up
  • Swelling in your face or extremities
  • Tingling sensation of your hands or feet
  • Breast enlargement or tenderness
  • Rashes or hives
  • Unusual weight gain or loss

What if Finasteride Doesn’t Work?

Keep in mind that successful hair loss treatment doesn’t come in a quick-fix solution. You have to take time to work on it and it requires consistency and commitment. 

You need to keep on taking finasteride for one full year to experience significant results. You are likely to recognize unwanted outcomes if you stop taking finasteride unexpectedly. It is not uncommon for restored hair to fall out and for hair loss to occur again. 

Reports have confirmed that those who discontinued finasteride treatment lost all restored hair over six to nine months. If this occurs, a hair transplant is likely to be your next step. 

If you are considering getting a follicular unit extraction (FUE), get in touch with us today and schedule your virtual consultation. We would be absolutely delighted to discuss different treatment options with you.

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