Finasteride - Hair Loss & Hair Transplant Surgery Guide

One of the challenges for people with male-pattern baldness is finding the product or treatment that is right for them. A large part of that will involve considering your lifestyle. For example, cosmetic concealers are not great if your favourite pastime is swimming. The other consideration will simply be ‘what works for me’? There are still a lot of mysteries surrounding baldness and the treatments for it. So sometimes, you cannot always know whether a product or treatment will work for you unless you have tried it.

Currently, there are only two medicines that are FDA-approved treatments for male-pattern baldness. The first is Minoxidil which you can read more about in a separate article on this site. The second is Finasteride, which this article looks at in detail. What is Finasteride? Is it successful? What results can you expect if you undergo a course of treatment?

What is Finasteride?

Firstly, let’s go back and look at some of the factors that cause male-pattern baldness. We talked elsewhere on the site about recent research which has shown a genetic link within families. This genetic make-up means that individuals with male-pattern baldness produced increased levels of a chemical called dihydrotestosterone (DHT). DHT has the effect of weakening the hair follicles, so that when the hair falls out it is too weak to grow back.

Armed with that information, let’s take a closer look at Finasteride. Finasteride is one of a class of drugs called 5-alpha reductase inhibitors. Manufactured by Merck, it was originally approved in 1992 as a treatment for prostate enlargement. It was noticed that Finasteride had the side effect of being able to treat male-pattern hair loss and, in 1997, Finasteride was approved as a treatment for hair loss. Merck now markets it under the brand name Propecia.

How does Finasteride work?

Finasteride works by targeting the hormone testosterone and halting its conversion into DHT. Stopping its production means that DHT is unable to affect the hair follicles, which allows them to regain their original strength and keep on growing.

As with Minoxidil, Finasteride does not work for every person. But it is, on the whole, a successful treatment depending on the expectations of the individual. It’s fair to say that much more research is needed, but current estimates state that around 66% of men who take finasteride enjoy some thickening of their hair. Even for the third of men who do not get the results they hoped for, ongoing baldness is usually arrested.

What does the treatment involve?

Finasteride is an oral antiandrogen, which means that you take it in tablet form. Men are required to take one table per day and it usually takes between four and six months for the treatment to be effective. Full hair growth, if it is possible, will occur within one or two years. If you stop taking the tablets each day, then the condition of your hair will continue to deteriorate.

Finasteride is only available through private prescription. As it is not considered an essential treatment, it is not available through the NHS.

What are the possible side effects?

Negative side effects of finasteride are generally rare and finasteride is known to be safe when used for long periods.

The first point to make is that Finasteride stops testosterone being converted in DHT. While this reduces the amount of DHT in the body, it also has the opposite effect of increasing the amount of testosterone. This is an accepted side effect of Finasteride and is not generally a problem. However, over long periods of time, continual high levels of testosterone can have possible negative side effects.

The primary side effect that most men report when taking finasteride is a low sex drive, including erectile dysfunction. This side effect is only experienced by a very small number of people taking the drug – in fact, research showed it was less the 1% of the men surveyed.

Finasteride is not advised or recommended as a treatment for women with alopecia. The FDA have registered Finasteride in Pregnancy Category X, which means that it can be responsible for defects in babies still in the womb. Pregnant women must not touch or take finasteride tablets, especially if they are damaged. Finasteride also has implications for blood donors, and people planning to donate blood are normally advised to stop taking finasteride for at least a month.

The final side effect of Finasteride which may be of concern to some people is its impact on sporting performance. Professional sports organisations have banned finasteride as they believe it can be taken to disguise steroid use. In fact, a number of well-known athletes have been banned for using finasteride, even though they publicly claimed that they were taking it for hair loss. The most famous case probably involves the Brazilian world-cup winning footballer Romário.

What does it cost?

Finasteride can be an expensive treatment and you need to think how committed you are to continuing the treatment. As we mentioned above, it takes up to six months and up to two years for most men to get the results that they hope for. On top of that, you will also need to carry on taking Finasteride to maintain your new head of hair – if you stop the treatment then male-pattern baldness will continue.

Normally, Finasteride (marketed as Propecia), costs around £30-£50 per month.

Where can I find out more?

If you would like to find out more about Finasteride, you can do so by visiting

However, as Finasteride is a prescribed drug, the best place to start is by consulting your doctor. More and more, doctors understand the issues surrounding male-pattern baldness and they will be able to recommend a course of treatment.

Alternatively, you can consult a hair loss specialist. Finasteride is often used to arrest male-pattern baldness before other treatments are recommended.

What is Male Pattern Baldness?

Male pattern baldness, also known as androgenetic alopecia, is a common condition, which causes men to lose hair. It normally begins between the ages of twenty and forty- five and can take between five and twenty- five years to make someone bald. Male pattern balding affects most men during their lifetime.

How Does Hair Growth Normally Occur

Hair normally grows from individual follicles under the skin. Each hair normally lives for between three and eight years before being replaced by a new hair in the same follicle.

Male pattern baldness occurs where the follicles fail to produce strong, thick hair eventually causing baldness. There are no dangers or health risks of male pattern baldness although it is believed that it could be an indicator of heart disease in a minority of sufferers.

How Does Male Pattern Baldness Progress?

Male pattern baldness normally begins at the front of the hair around the temples. The hair begins to thin in this area and also on the top of the head, which usually causes a bald patch in the middle of the head. The receding hairline and the bald patch grow as more hair is lost leaving the top of your head completely bald. This leaves a border of hair around the side and back of the head. In some men, this hair remains whereas in others this also begins to thin and eventually leaves them with no hair at all. This affects the majority of men by the time that they have reached the age of sixty- five and can also effect post- menopausal women.

What Are The Causes of Male Pattern Baldness?

Male pattern baldness occurs when hair follicles weaken meaning that they can no longer support thick, strong hair. This occurs, as the follicles become smaller meaning that when the old hairs are replaced the newer hair is much more fine than the original. This new hair also grows much less than normal hair meaning that it falls out in less than three years. As this progresses, the hair gets to the stage where it is unable to reach the surface of the skin meaning that a bald patch appears in the area.

It is believed that the cause of this is the conversion of testosterone to dihydrotestosterone in the hair follicles, which makes them more sensitive to the hormone. This causes the follicles to shrink making the hair thinner and weaker.

In 2008, it was discovered that male pattern balding was a genetic condition, which resides in one specific gene. It is not known why this gene only affects the hair on the head, or why it affects areas of the scalp in a certain time order.

How is Male Pattern Baldness Treated?

Most people with male pattern baldness do not treat the condition as balding is seen as a normal part of the aging process, which does not have a negative impact on everyday life. For others going bald can be a traumatic process causing them to opt for treatment. There are two forms of medical treatment for baldness one of which is finasteride and the other is minoxidil.

Finasteride works by preventing the conversion of testosterone into dehydrotestosterone, which allows the hair follicles to revert to their normal size. It is successful in preventing further hair loss and most patients also begin to grow hair in bald areas.

Minoxidil is a less effective treatment although it is believed to delay further hair loss for about 50 % of men. In a small minority, it is also believed to cause hair growth although many men who use minoxidil continue to lose hair.

Other men chose to combat male pattern balding either using a wig or through hair transplant surgery. Hair transplant surgery is an expensive treatment and has variable success rates.

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