Medical Review by Jennie Stanford, MD, FAAFP, DipABOM
Summary:
- Finasteride treats male pattern baldness by reducing DHT, a hormone that causes hair loss.
- It’s usually best to start early when hair loss first begins, since this is more effective at preserving hair that hasn’t fully been lost yet.
- Results take time—it often takes 3–12 months to see noticeable improvement, so be patient!
- Common side effects include decreased libido, erectile dysfunction, and gynecomastia (enlarged breast tissue). Talk to a medical professional before starting or stopping treatment.
- Regular follow-ups with your healthcare provider are essential for monitoring progress and managing side effects.
Here’s what to prepare for when you start taking finasteride for hair loss
When you’re starting finasteride, its branded form Propecia®, or any other medication for hair loss, it’s normal to have some questions. How long will it take to start working? Is there anything I can do to help ensure the best results? What kinds of side effects should I expect?
Below, we share some information you can use to develop realistic expectations for using finasteride and guide conversations about it with healthcare practitioners. Keep reading to learn what you should expect when starting finasteride for hair loss.
What kind of hair loss does finasteride treat?
Finasteride is an FDA-approved hair loss medication used to treat androgenetic alopecia in men. Androgenetic alopecia is a genetic condition that causes hair to thin and fall out of the scalp in adults. Most men experience this as hair loss near the crown and temples.
When you have androgenetic alopecia, receptors in your scalp called androgen receptors become activated and shorten the growth phase of nearby hair follicles. This makes the affected hairs become shorter and thinner, to the point where they can no longer grow through the skin on top of your head and you experience balding.
One of the hormones most likely to activate your androgen receptors is called dihydrotestosterone (DHT). An enzyme in your body called 5-alpha-reductase is responsible for converting testosterone into DHT—but finasteride is one of several medications called 5α-reductase inhibitors that help prevent this conversion.
That means when you take finasteride, less of your testosterone is converted into DHT. In turn, this helps prevent your androgen receptors from becoming activated and can slow down the progression of hair loss.
When to start finasteride
Because finasteride has not been shown to be safe or effective for use in children, you won’t be able to get a prescription for it unless you’re at least 18 years old. If you’re an adult who is interested in taking finasteride, you’ll need to talk to a healthcare provider who can prescribe it to you.
Finasteride can slow the progression of androgenetic alopecia and cause partial hair regrowth in about two thirds of men. But the key word there is partial—so if you wait until you’ve lost a lot of hair before you start taking finasteride, you might be less likely to get it all back.
So the short answer is: there’s no “right” time to start finasteride, but taking it as soon as you start to notice your hair thinning or falling out might be the best way to preserve the hair you have left.
Making finasteride more effective
If you want finasteride to work as well as possible, it’s important to follow your healthcare provider’s instructions closely. This also means making sure finasteride is right for you and the type of hair loss you have. Consider the following:
- Finasteride is only proven to be effective for mild to moderate hair loss in the scalp and vertex. If you have lost too much hair or your hair loss started somewhere else, it may not work as well.
- Finasteride is only approved for use in men. It’s not a hair loss treatment for women or children.
- Finasteride might be more effective when combined with minoxidil, another popular hair loss medication. Ask your doctor whether combining these two medications might be right for you.
Learn more about finasteride and minoxidil here.
Monitoring your progress on finasteride
You’ll need to talk to your healthcare provider before starting or stopping finasteride, and check in with them regularly during use. They’ll be able to help you look out for potential side effects and adjust your medication as needed.
Remember: take only the amount of finasteride prescribed to you, and take it exactly as directed. Do not attempt to adjust your dosage by yourself, and don’t take extra finasteride if you miss a dose.
When to expect results
Most men who take finasteride to help with hair loss need to wait at least three months before they start to see results—but it can take up to a year in some cases.
If you don’t see any results from taking finasteride after the first year of treatment, it may not be the right hair loss medication for you. Talk to your healthcare provider at this point to see if they can recommend something else.
Common risks of finasteride
Finasteride, like all other medications, comes with a risk of certain side effects. Some of these are mild and more common, whereas others are rarer and more serious.
Common side effects of finasteride include:
- Loss of libido
- Erectile dysfunction (experienced by 2% to 4% of men taking finasteride)
- Ejaculation problems
- Gynecomastia (enlarged breast tissue)
Orthostatic hypotension (low blood pressure after getting up)
You might also experience a sudden drop in blood pressure after getting up from a sitting or standing position. This is more common when you’re still starting finasteride therapy, and can be more severe if you’re also taking other alpha-blockers at the same time.
Post-finasteride syndrome
Some people have reported that their side effects seem to continue even after they stop taking finasteride. This has been called post-finasteride syndrome when it lasts longer than three months.
However, there is still debate in the medical community about whether post-finasteride syndrome actually exists, since many of those who report it have also had other conditions that could produce similar side effects.
For a complete list of finasteride’s potential side effects, explore our other article on the subject:
Understanding Finasteride’s Side Effects in Men
Find guidance for finasteride with Lemonaid Health
If you’re losing your hair, finasteride can be a useful treatment—but you’ll set yourself up for the best possible results if you know what to expect before starting. Use the information above to educate yourself and have informed conversations with your healthcare provider about this popular medication.
Our team at Lemonaid Health is ready to help. We can connect you with US-based healthcare practitioners via private online consultations so you can have your questions about finasteride answered by experts, and provide prescriptions for FDA-approved hair loss medications in clinically indicated cases. Get started today and find a plan for dealing with hair loss that works for you.
Propecia® is a registered trademark of Johnson & Johnson.
