Finasteride
The History
Finasteride, a medication initially developed to treat benign prostatic hyperplasia (BPH), was discovered in the 1980s by Merck & Co. Its hair loss benefits were identified during clinical trials for prostate enlargement, as patients reported regrowth of thinning hair. In 1997, the FDA approved finasteride under the brand name Propecia for the treatment of androgenetic alopecia (male pattern baldness). Since then, it has become one of the most widely prescribed medications for hair loss, offering a systemic approach to combating the condition.
The Good
Finasteride works by inhibiting the enzyme 5-alpha reductase, which converts testosterone into dihydrotestosterone (DHT). Elevated levels of DHT are known to shrink hair follicles, causing hair loss. By lowering DHT levels, finasteride can help slow or stop hair loss and, in some cases, regrow thinning hair. Studies have shown that finasteride reduces DHT levels by as much as 60% and can prevent further hair loss in up to 90% of men. Additionally, about 65% of users report some level of regrowth after consistent use for one year.
The Bad
While effective, finasteride does come with potential side effects. Commonly reported issues include decreased libido, erectile dysfunction, and reduced semen volume. These side effects occur in a small percentage of users (around 1-2%) and are typically reversible upon discontinuation of the drug. Rarely, some men experience persistent side effects even after stopping finasteride, a condition referred to as post-finasteride syndrome, though this remains a topic of ongoing debate in the medical community.
The Ugly
You’ll likely need to take finasteride indefinitely to maintain its benefits. Once you stop taking the medication, DHT levels return to their original state, and hair loss often resumes within 3-6 months. This means that finasteride is a long-term commitment for those looking to maintain their results. It’s important to weigh this reality against the benefits and consult a healthcare provider to determine if it’s the right choice for you.
How to Get It
Finasteride is primarily available in an oral tablet form and is usually prescribed in a 1 mg daily dose for treating hair loss. Recently, topical finasteride formulations have emerged as an alternative for those looking to minimize systemic exposure while targeting hair loss directly on the scalp. Both forms require a prescription, so consulting with a healthcare provider is necessary.
Which Works Better: Oral vs. Topical?
Oral finasteride is the standard, FDA-approved treatment for androgenetic alopecia and has extensive clinical evidence supporting its efficacy. Topical finasteride, while newer, has shown promising results in reducing scalp DHT levels with fewer reported systemic side effects. Studies comparing the two indicate that topical formulations may be a viable option for individuals concerned about systemic side effects, but long-term data is still limited.
Conclusion
Finasteride has been a game-changer in the treatment of androgenetic alopecia, offering a proven solution to slow hair loss and, in many cases, promote regrowth. However, like any medication, it comes with its risks and requires a long-term commitment. Whether considering oral or topical formulations, consulting with a healthcare provider is crucial to determine if finasteride aligns with your hair restoration goals and overall health.
