What is finasteride?
Finasteride 1 mg (generic for Propecia) is a medication approved by the FDA to treat male pattern hair loss, also known as androgenic alopecia. Finasteride is also used in a 5 mg dose (generic for Proscar) to treat symptoms of Benign Prostatic Hyperplasia (BPH), or an enlarged prostate.
Finasteride works on both the prostate and scalp because it is in those two areas (and a few others) that finasteride blocks the the enzyme that converts testosterone into DHT. It does not affect a very similar enzyme that converts testosterone to DHT in other areas of the body. This makes it selective and less likely to cause unwanted side effects. Notice, we said less likely; every drug can cause side effects and it is important to understand that when looking into any treatment plan.
Finasteride is one of two FDA approved treatments to manage male pattern hair loss. The other FDA approved medication is topical minoxidil. It comes as a foam or a solution. The exact mechanism of how minoxidil stops hair loss is unknown. However, these two medications work better than either one alone.
How it works
Finasteride works by blocking an enzyme that converts testosterone to dihydrotestosterone (DHT). DHT is the hormone responsible for hair loss in men who are genetically predisposed to lose their hair. By blocking the conversion of testosterone to DHT, finasteride can prevent further hair loss, and may even regrow hair.
It does work well for most men in terms of stopping hair loss. In one European study, men treated with 1 mg finasteride over a five year period “led to a 93% decrease relative to placebo in the 5-year likelihood of developing further hair loss.”
It regrows hair less well but does provide a benefit for some men. In another study, the authors found that “the chances of mild to moderate visible regrowth are 61% on the vertex (the top of the head) (with an additional 5% achieving great visible regrowth) after 2 years and 37% on the frontal area after 1 year.”
When deciding on finasteride, it is best to consider slowing and stopping hair loss as your goal with regrowth a bonus if it occurs.
It is best to take it each day at the same time. If a dose is missed, the missed dose should be skipped and the regimen continued the next day. Of course, if off by just a few hours, the medication should be taken and the usual daily pattern resumed. It is important to take finasteride without days of interruption, so planning to carry enough when traveling, on vacation, etc., is vital. Finasteride can be taken with or without food.
The pills should be kept dry and at room temperature between 68˚F to 77˚F (20˚C to 25˚C). The bathroom is a moist environment, so choose another place. They must be stored away from children and pets. Also, broken pills can expose the skin to finasteride. This is category X, meaning that it can cause birth defects. Though they are coated and generally considered safe when unbroken, women should never touch these pills.