Male pattern baldness is extremely common, but it’s prevalence doesn’t make it any less distressing for the men who experience it, particularly when they are young. According to the American Hair Loss Association, approximately 95 percent of hair loss in men can be attributed to androgenic alopecia, or male pattern baldness.
This genetic condition can affect men at any age and commonly causes a receding hairline and thinning hair on the crown of the head.
An estimated two thirds of all American men have been found to experience noticeable hair loss by the age of 35, while an estimated 85 percent of men experiencing significant hair loss by the age of 50.
For some men, hair loss can occur even younger, including during the high school and college years; about 25 percent of men who experience male pattern baldness notice the onset of the condition before the age of 21.
Men who are considering medical treatment for their hair loss even in conjunction with hair transplants have likely heard of finasteride (brand name Propecia), a prescription medication for male pattern balding.
If you’re concerned about the effects of finasteride and its results, here’s a timeline and an idea of what to expect.
What is finasteride?
Finasteride is a prescription medication that is FDA-approved for the treatment of male pattern hair loss, but the drug is also used for the treatment of enlarged prostate (benign prostatic hyperplasia).
Finasteride is sold under several brand names and is also available in an inexpensive generic form but is not available over the counter; the medication is sold as an oral tablet and now has a topical spray as well.
Although finasteride is best known for the treatment of male pattern baldness, it was originally intended as a treatment for benign prostatic hyperplasia.
While researching the effects of the medication, researchers found that one of the side effects of the drug was a regrowth of hair and a slowing of hair loss in men suffering from male pattern baldness.
After this discovery, manufacturers began marketing finasteride as a treatment for male pattern baldness, also known as androgenetic alopecia.
How does finasteride work?
Finasteride works by inhibiting the action of 5-alpha-reductase, which is the enzyme that is responsible for the conversion of testosterone into androgen dihydrotestosterone (DHT).
One of the actions of DHT in the body is to shrink the size of the hair follicles, which can cause baldness over time.
Additionally, DHT can cause the prostate to become enlarged. Men who are predisposed to male pattern baldness lose their hair as a result of elevated levels of DHT in the body.
Finasteride lowers levels of DHT in the scalp by up to 60 percent, which keeps the hair follicles open and prevents hair loss.
Lowering the DHT levels has been clinically proven to stop hair loss and promote hair regrowth in men suffering from male pattern baldness.
Does finasteride work?
Numerous studies have shown that finasteride is clinically proven to be effective in stopping hair loss and encouraging hair regrowth.
Most studies have examined doses of finasteride at 1mg per day, which was found to have positive results for promoting hair growth and preventing additional hair loss in 48 percent of men participating in the study in 12 months and up to 66 percent of study participants in 24 months.
The study also found that 83 percent of study participants taking finasteride showed no further hair loss after two years of taking the medication compared to 28 percent of those receiving the placebo.
How long does it take finasteride to start working?
As noted above, finasteride works by inhibiting the action of the 5-alpha-reductase enzyme, which in turn lowers the amount of DHT in your body.
From your very first dose or application of your finasteride product, the medication starts to inhibit the action of the 5-alpha-reductase enzyme and begins to lower your DHT levels.
Therefore, your level of DHT will start to decrease as soon as you ingest your first dose.
Finasteride has a short half life but builds up in your system over time, which is why taking higher doses than 1 mg per day is not necessary.
Over time, finasteride lowers DHT levels in the body by an average of 70 percent.
Although finasteride starts working right away, most patients don’t achieve any noticeable results until after at least three to four months of use, assuming they are taking the medication as directed.
Preliminary results will begin appearing after three to four months, but significant results may not be apparent for six to nine months after starting the medication.
Hair grows slowly and hair follicles take some time to start producing new hair.
Ultimately, full results are usually realized approximately one year after starting treatment with finasteride and using the medication on a daily basis.
Patients who skip treatment days, weeks, or months may find that the medication does not work as effectively and does not produce the results they were anticipating.
Does finasteride work for everyone?
Finasteride is effective for the majority of people, but it does not work for everyone. However, it is important to note that just because someone does not regrow hair while taking finasteride does not mean the medication is not working.
For some people, finasteride does not cause hair regrowth but instead stops additional hair from falling out.
While this may not be the desired result, people who stop taking finasteride may find that their hair starts falling out again once the medication leaves their system.
Do I have to take finasteride forever?
Finasteride works to stop hair loss and regrow hair by lowering the levels of DHT in the body.
Although the medication can reverse the hair loss associated with male pattern baldness, it must be taken in order to prevent hair loss.
Patients who stop taking finasteride after their hair regrows will find that they start losing hair again once the medication is no longer in their system.
For this reason, even patients who do not experience hair regrowth while using finasteride should take the medication in order to prevent additional hair from falling out.
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Are there any side effects associated with finasteride?
Most people do not experience side effects when taking finasteride at the recommended dose of 1 mg per day, which is the dose for male pattern baldness.
However, regardless of whether the medication is used to treat male pattern baldness or benign prostatic hyperplasia, there are some side effects associated with use of the medication.
Mild side effects associated with finasteride include:
- Skin rash or redness in areas of the application
- Trouble getting or keeping an erection
- Decreased sex drive
- Ejaculation disorder
- Breast enlargement and tenderness
Most people find that their bodies adjust to the use of the medication and the mild side effects that they experience typically disappear over the course of a few days or a few weeks.
If any of the aforementioned side effects become severe or last for a prolonged period of time, patients should contact their healthcare provider.
Some side effects can be more serious and can potentially be life threatening.
Patients experiencing any of the following side effects should contact a doctor right away and should contact 911 if their symptoms feel life threatening.
- Depression
- Nipple discharge
- Swelling of your lips, tongue, throat, or face
- Lumps or pain in your breasts
Are there any risks associated with the use of finasteride?
Finasteride is generally well tolerated, but it does come with several warnings.
Like all medications, finasteride can cause allergic reactions, so patients should use caution when taking the medication if they have had a reaction to any of the active or inactive ingredients in the past.
Finasteride can pass through the skin despite the fact that it is an oral medication.
Because it can cause birth defects in women who are pregnant, women who are pregnant or are planning to become pregnant soon should not handle finasteride.
Pregnant women, who may become pregnant, and women who are breastfeeding should not use finasteride.
Men who have had prostate cancer, currently have prostate cancer, or are at risk of developing cancer should not take finasteride, as the medication can cause prostate cancer to grow faster and is also associated with the development of irregular forms of prostate cancer.
People with liver disease or liver problems may not be able to process finasteride properly, as the medication is processed in the liver.
As a result, people with liver conditions are more likely to experience side effects than others. Your doctor may choose to lower your dose of finasteride to minimize the possibility.
Summary
Men suffering from male pattern baldness can find an effective treatment option by taking finasteride, an oral prescription medication.
Finasteride is available in both brand name and generic forms of the drug and can easily be purchased at your local pharmacy.
Research, Studies, and Sources:
https://www.webmd.com/skin-problems-and-treatments/hair-loss/hair-loss-treatments-men#1
https://pubmed.ncbi.nlm.nih.gov/9951956/
https://www.healthline.com/health/finasteride-oral-tablet#side-effects
https://www.americanhairloss.org/men_hair_loss/introduction.htm
https://pubmed.ncbi.nlm.nih.gov/8846625/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3262531/
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