Finasteride Proper Use and Dosage

Published February 9th, 2021 by Erik Rivera
Fact Checked by
Camille Freking
Medically Reviewed:
Gerardo Sison
Updated Date: Mar 10th, 2021

Male pattern baldness, or androgenetic alopecia, is responsible for 95 percent of hair loss in men, according to the American Hair Loss Association. Male pattern baldness is a hereditary condition that causes the characteristic thinning of hair on the crown of the head, lack of hair growth, and receding hairline that plague so many men as they age. Although some men will not experience the effects of male pattern hair loss until they are later in life, many will experience baldness at a much younger age. 

Hair loss often occurs long before most people think. An estimated one out of every four men who experiences male pattern baldness will start to lose their hair before their 21st birthday. The percentage of men experiencing hair loss only increases with age. By 35 years of age, two out of every three American men who experience male pattern baldness have started to lose significant amounts of hair, and 85 percent will have experienced significant hair loss by the age of 50. Despite how common male pattern baldness is, the condition can cause a loss of self confidence and significant embarrassment for men who are self conscious about their hair loss.  

Men don’t have to accept hair loss from male pattern baldness as inevitable. Oral finasteride tablets offer a prescription treatment option that can help balding men regrow their hair, with noticeable results for many in just a few months. In order to achieve your desired results, proper use and dosage of finasteride is critical.

Finasteride Overview

Finasteride is a prescription medication (cannot be purchased over the counter) that is used for the treatment of hair loss called by male pattern baldness and enlarged prostate, or benign prostatic hyperplasia (BPH). Finasteride is a generic medication, and many patients may be more familiar with the medication under its brand name for hair loss, called Propecia. When finasteride is used for benign prostatic hyperplasia, it is sold under the brand name Proscar. The medication is available in the form of an oral tablet and was not originally intended for the treatment of hair loss.

It might seem strange that a medication would be used for two seemingly unrelated conditions like male hair loss and enlarged prostate, but finasteride was actually developed for the treatment of benign prostatic hyperplasia. As the medication was being researched during clinical trials, scientists studying the effects of the drug found that the medication reduced hair loss and increased hair regrowth as a side effect by acting on the same enzyme that contributes to enlarged prostate. Since the initial clinical trial, finasteride has been studied specifically to examine its effectiveness as a treatment for hair loss.

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How Finasteride Works

Finasteride belongs to a class of drugs called 5-alpha-reductase inhibitors. Drugs in this class work by inhibiting the activity of 5-alpha-reductase, which plays a critical role in the conversion of testosterone. The body uses 5-alpha-reductase to convert testosterone into androgen dihydrotestosterone (DHT), which has a number of effects on the body. 

Although it was once believed that finasteride contributed to the risk of high-grade prostate cancer or breast cancer, studies have shown that finasteride does not statistically increase the presence of prostate cancer or breast cancer, and can even help prevent prostate cancer in men over 55.

Rising levels of DHT in the body cause the hair follicles shrink, which results in hair loss as the hair is squeezed out of the follicle. Hair regrowth is also inhibited. Rising levels of DHT also cause the prostate to become enlarged, which explains why finasteride, which helps lower the levels of DHT in the body, is an effective treatment for both male pattern baldness and enlarged prostate. Rising levels of DHT are known to contribute to the onset of male pattern baldness in men who are genetically predisposed to the condition. 

Finasteride works by reducing the amount of DHT in the body, which helps to stop hair loss and promote hair regrowth. The medication is capable of lowering the amount of DHT in the scalp by up to 60 percent, which minimizes shrinking that occurs in the hair follicles. At this time, the only clinically proven way to stop hair loss and promote hair regrowth in men with male pattern baldness is to lower the levels of DHT in the scalp.

Finasteride Proper Use and Dosage

Finasteride is available in both oral and topical forms, and both should be stored at room temperature. Proper use of finasteride depends on which form of the medication is being used. Oral finasteride is most commonly prescribed at a dosage of 1 mg per day for the treatment of hair loss associated with male pattern baldness. 

The medication is taken once daily, should be taken at the same time every day, and can be taken with or without food. Men who are taking finasteride for male pattern baldness may require at least three months of treatment before beginning to see any effects from the drug. It should be noted that while finasteride can stop hair loss and promote hair regrowth, the medication is only as effective for as long as it is used. Finasteride has a half-life of only 6 to 8 hours. In the incidence that the medication is stopped, the new hair will fall out within one year. 

When finasteride is used for the treatment of benign prostatic hyperplasia, the medication is also taken once a day and can be taken with or without food. The standard dose of finasteride for treatment of enlarged prostate is 5 mg per day. Men using finasteride for enlarged prostate may need up to six months to experience the full effect of the medication. As is the case with male pattern baldness, finasteride will only work to treat benign prostatic hyperplasia as long as the medication is used. Following discontinuation of treatment, the prostate will resume growing within a few months. 

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Finasteride Effectiveness

Finasteride is the only prescription medication that is approved by the U.S. Food and Drug Administration (FDA) for the treatment of male pattern baldness. Numerous studies have been conducted over the past several decades that confirm that finasteride is clinically proven to be effective in stopping hair loss and encouraging hair regrowth for many men. 

Clinical studies typically examine the effectiveness of finasteride at a dose of 1 mg per day, which is the baseline recommended dose of the medication for the treatment of male pattern baldness, although higher dosing such as finasteride 5 mg is possible when prescribed by a healthcare provider.

A 1 mg dose of finasteride taken once per day was found to encourage the growth of new hair in nearly one half of study participants in one year and approximately two thirds of study participants in two years. The drug was also found to be effective in stopping hair loss. After two years, 83 percent of study participants who were treated with finasteride showed no further hair loss compared to 28 percent of those receiving the placebo.  Finasteride was also shown to be well tolerated and did not cause side effects for most study participants.

Finasteride Side Effects

Clinical studies have shown that most men tolerate finasteride well during the course of treatment for hair loss. However, some people may experience side effects while using the drug. Patients are likely to experience the same side effects regardless of whether they use the medication for the treatment of male pattern baldness or benign prostatic hyperplasia; however, the adverse effects are more likely to be experienced at the higher doses of the drug required for the treatment of an enlarged prostate gland. 

Mild side effects associated with finasteride include:

  • Skin rash
  • Sexual side effects such as ejaculation disorder, ejaculation impairment, or reduced ejaculate
  • Breast enlargement and tenderness to the touch
  • Testicular pain
  • Trouble getting or keeping an erection (erectile dysfunction)
  • Decreased sex drive (sexual dysfunction)

Most patients treated with finasteride find that any pharmacology side effects they experience typically diminish over the course of a few days or weeks as their body adjusts to the lower DHT levels caused by the drug. However, some patients may find that their side effects are particularly troublesome. 

If you experience severe or prolonged side effects of finasteride after several weeks of taking the drug, contact your doctor. Most of the side effects associated with the drug, including those related to sexual function, should disappear if use of the drug is stopped. 

If you stop taking the medication and are still experiencing side effects, seek medical advice from a healthcare professional. 

Medical professionals should also be made aware of any potential drug interactions so they can make clean any contraindications. Finasteride should not be prescribed to women, especially pregnant women.

Most side effects associated with finasteride are mild, but in rare cases, they can be severe and potentially dangerous. Patients experiencing any of the following side effects should contact a doctor right away and should contact 911 if their symptoms feel life-threatening.

  • Swelling of your lips, tongue, throat, or face
  • Lumps or pain in your breasts
  • Nipple discharge
  • Depression

Summary

Finasteride is an effective treatment for male pattern baldness when taken at a dose of 1 mg per day every day for as long as the medication is used. Most people find finasteride effective and tolerate the drug well, but some patients may experience unpleasant side effects.  Finasteride is available in both brand name and generic forms of the drug and is affordable for most people, particularly when purchased using a pharmacy discount card.

Sources:
https://pubmed.ncbi.nlm.nih.gov/11050579/ 
https://pubmed.ncbi.nlm.nih.gov/29464847/ 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5803857/ 
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

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