Finasteride is one of two currently FDA-approved medicines for the treatment of androgenic alopecia (male pattern hair loss). Developed on the back of insights around male sexual development, it was released in 1997 after over 20 years of development. It works by blocking the production of a hormone which degrades your hair follicles and that, in large-scale studies, has been shown to help maintain (and in some cases, promote) hair growth. However, as with all powerful medical treatments, it should only be taken under medical supervision and after carefully considering the risk of side effects.
The development of finasteride can be traced back to a remote part of the Dominican Republic. In the 1970’s a young researcher Julianne Imperato-McGinley1 MD, traveled there in the early 1970s, following reports of young girls that literally changed into boys at puberty. In a seminal 1974 paper2 she described for the first time an extremely rare condition in which deficiency of an enzyme called 5-alpha-reductase causes genetically male babies to be born with no external genitalia. Instead, male characteristics literally sprout at puberty, causing the locals to dub the condition “Guevedoces”, which effectively translates as “penis at twelve”.
This research was noted by the head of basic research at Merck, Dr. P. Roy Vagelos, who was interested in the prostate-shrinking effects of the condition. He would lead an effort that would first result in the release of finasteride for prostate enlargement (1992) and for the treatment of male pattern hair-loss (1997).
Dihydrotestosterone (commonly referred to as DHT), a derivative of testosterone, is responsible for the development of many male characteristics around puberty. However, in a classic example of a double-edged sword, it also plays a key role in male pattern hair loss later in life. Finasteride works by inhibiting the two of the three different forms of 5α-reductase which convert testosterone into DHT in your body. By reducing the production of DHT by as much as 71%3, it hinders its damaging effect on your hair follicles4.
In three studies5 involving 1,848 men from the ages of 18-41 with mild to moderate hair loss, it was found that after 12 months, 58% of men given a placebo had experienced further significant hair loss compared with 17% taking finasteride. After 2 years, 72% of the placebo group demonstrated hair loss compared with 17% of the men treated with finasteride. This increased to 100% of the men in the placebo group vs 35% of the men under treatment experiencing hair loss by year 5.
The benefit was not strictly limited to maintenance, in men with vertex baldness (hair-loss predominately on the top or crown of the head) growth in new hairs was seen in 48% of men being treated with finasteride at 12 months, rising to 66% of men by 24 months. However, this effect diminishes over time as in the same group of men new hair growth was only evident in 48% at the 5-year mark.
As the clinical studies demonstrate, finasteride helps maintain hair growth in men experiencing male pattern hair loss over an extended period, and in a lucky few it promotes new hair growth over a couple of years. This maintenance effect typically kicks in after 6 months of continuous use and lasts only as long as the user continues to take the treatment. In studies, the effects of finasteride reverse over a period of 12-24 months after a patient stops taking it and their hair reverts to a similar state as those in the placebo group.
The key concern with using finasteride is around the circa 3% compared to of men who experience sexual dysfunction while taking the drug. They can experience erectile and libido problems which, in studies, abate after months of ceasing to take finasteride. Anecdotally, there are reports that these sexual problems can last considerably longer6 and some men experience depression, which is an area under further study.
Finasteride is a powerful tool in the fight against hair loss, which works by blocking the production of DHT before it can damage your hair follicles. However, as it is a serious pharmaceutical, it must be used under the guidance of a medical professional and after careful consideration of the potential side effects. In combination with minoxidil, it can provide a powerful one-two punch to your hair loss and help keep your hair fit and healthy. At Hair Fitness, we are developing affordable and effective treatment programs incorporating finasteride to help you get on top of your hair.
An alternative for Men who want to explore a more natural way of blocking DHT is Saw Palmetto. Widely used in the treatment of enlarged prostates, a condition closely hormonally linked to hair loss, there is good scientific evidence that it significantly reduces free DHT and thus protects your hair.
Learn how Saw Palmetto acts to reduce thinning by disrupting the production of DHT. This can have a powerful impact on its own or it can be used to enhance the effect of other treatments as part of a combined program.
In the short-term Minoxidil will halt further loss in 95% of men after 3 months of a twice-daily routine. Over a few months, 60% of men will report significant regrowth, especially for those that act quickly to stop the loss. After a year of continuous use, you should expect the initial gains to stabilize as you hair bounces back and you get the thinning under control.The key to using minoxidil is to get into and stick with a healthy routine to get on top of your hair and maintain your gains.
The value of the global hair-loss treatment market is a $2.7bn USD in 2017, which is not surprising when you consider how widespread male pattern hair loss is. Unfortunately, a market that largely attracts not only serious research and clinically proven products, but also a host of more dubious “treatments” and, in some cases, completely unscrupulous “cures”. These can range from the seemingly well-intended but ineffective treatments to outright frauds.