Finasteride for Hair Loss

  • Best Results4-6 months
  • Treatment RecoveryNA
  • Procedure TimeNA
  • Skin SpecialistMedical dermatologist
  • Duration of ResultsDecades
  • AnaestheticNA
  • Back to WorkNA
  • Cost$

Finasteride for Hair Loss

Finasteride & dutasteride are potent blockers of enzymes that convert testosterone to dihydrotesterone. These tablets are highly effective in the management of androgenic alopecia in both males and females. Oral and topical forms are available. Discuss with your treating dermatologist the best option based upon your lifestyle. 

FactsFacts on Finasteride & Dutasteride for Hair Loss

  • Both are inhibitors of 5 alpha reductase enzymes
  • Finasteride is TGA approved for hair loss
  • This can be prescribed orally as a tablet or topically as a lotion
  • Topical finasteride has lesser side effects compared to oral
  • Topical finasteride is often combined with minoxidil
  • Both finasteride & dutasteride need to be taken long term to remain clinically effective
  • These drugs should also be continued after FUE hair transplantation

How does finasteride & dutasteride work?

Both drugs work by reducing a molecule called dihydrotesterone or DHT. DHT is responsible for male pattern hair loss & causes accelerated shrinkage of the hair follicle. DHT is also partially responsible for female pattern hair loss.

Why is blocking DHT the answer to stopping hair loss?

Androgenic alopecia is caused by DHT—a derivative of testosterone. DHT causes hair follicles to shrink and lose the ability to create long, thick, pigmented hairs in a process called “miniaturization.” Testosterone is converted into DHT by an enzyme called 5-alpha reductase. Finasteride & dutasteride stop the conversion of testosterone to DHT by blocking 5-alpha reductase.

Which is better, topical or oral finasteride?

Initial reports show that oral finasteride was better than topical formulations. On this basis most dermatologists will encourage oral use, however recent papers have shown high efficacy with topical finasteride lotion. Topical finasteride had less side effects.

The combination of minoxidil & finasteride is considered Gold Standard topical therapy for male pattern hair loss.

How long does it take to work?

Results are seen in 3 to 6 months & continue to improve till the 12 month mark. Studies up to 5 years have shown a slight taper with efficacy at 5 years, however still way higher hair counts compared to baseline.

Unlike minoxidil (which increases blood flow to the follicle), paradoxical effluvium or hair fall is not seen with finasteride or dutasteride.

Davin’s Viewpoint on Finasteride & Dutasteride

These ‘antihormone’ medications have been the gold standard oral medication for hair loss for over a quarter of a century. In fact, the two main FDA approved medications are minoxidil & finasteride, with dutasteride an off label indication.

The big debate is whether the side effect profile of each is greater than the benefits. In the vast majority of times, side effects are reversible upon cessation, however in the minority, long lasting sequelae are seen. Regardless of the efficacy the side effect ratio of finasteride & dutasteride are similar. A sensible approach may be to consider oral medications (after a discussion with your dermatologist), however a more conserivate approach is to consider topical minoxidil & finasteride.

The studies of both medications show long term efficacy beyond the five-year mark. This applies to male pattern hair loss, however new data also suggests that these medications are equally effective as an off label treatment for female pattern hair loss. The risks of these potentially teratogenic medications need to be discussed with your dermatologist. The flipside is that given the short half-life (between 6 to 8 hours), the drug is out of your system within a month of cessation (even shorter).

I personally use topicals & oral medications to slow down my hair loss, namely minoxidil & finasteride lotion, with dutasteride tablets orally over the weekend. Be guided by your dermatologist as to the best formulation for you.

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