Finasteride (Propecia) as a treatment for hair loss

Finasteride-based treatments are best represented by the adage “an ounce of prevention is worth a pound of cure.” While they can be quite effective in delaying the progression of male pattern baldness, they do very little for people that already have extensive hair loss. Nevertheless, 5AR inhibitors like Propecia and Proscar are currently the strongest weapons available to fight the war on miniaturization.

History

In 1992, finasteride was approved by the FDA for the treatment of Benign Prostatic Pyperplasia (BPH). In 1997 Merck and Company marketed the product as a hair loss treatment (albeit at a different dosage) after noticing its positive effects on hair growth. Thirteen years later, finasteride remains 1 of only 2 FDA approved medications for the treatment of Androgenetic Alopecia.

Method of Action

The enzyme 5-alpha-reductase is involved in the conversion of testosterone into its active form of dihydrotestosterone (DHT – the androgen primarily responsible for male pattern baldness). Over time, DHT shrinks hair follicles until they no longer produce visible hairs. Finasteride is a 5AR inhibitor. By reducing circulating levels of DHT, androgen receptors in the hair follicle are protected from its adverse effects.

Usage

Finasteride is generally administered in the form of once-daily pills. Results are not typically visible for period of about 6 months (with optimal results occurring around 12 months). After a period of 5-6 years, these results steadily diminish. Like minoxidil, finasteride is especially effective in the vertex and crown areas of the scalp. The effects of finasteride on the hairline have not been verified in any clinical setting.

Cost

Finasteride cannot be purchased without a prescription from a doctor. A month’s supply of Propecia 1 mg tablets generally costs about 50 US dollars. Bulk-rates and generic versions of finasteride are also available.

Finasteride treatments are known to have many side effects ranging from gynecomastia (abnormally large mammary glands in males resulting in breast enlargement) to permanent erectile dysfunction. Consult with your doctor before adding finasteride to your regimen.