Finasteride is a commonly prescribed medication for addressing hair loss, particularly male pattern baldness. A frequent concern among new users is whether finasteride causes an “initial shedding phase,” a period where hair loss appears to worsen before improvement. This potential phase is a common inquiry for those considering this treatment.
Understanding Finasteride and Hair Growth Cycles
Finasteride inhibits 5-alpha reductase, an enzyme responsible for converting testosterone into dihydrotestosterone (DHT). DHT can shrink hair follicles in individuals genetically predisposed to hair loss, leading to thinner, shorter hairs and eventually no hair growth from those follicles. By reducing DHT levels in the scalp, finasteride helps follicles recover and produce healthier hair.
Hair on the scalp undergoes a continuous cycle of growth, transition, and rest. This cycle consists of three main phases: anagen, catagen, and telogen.
The anagen phase is active growth, lasting several years. The catagen phase is a brief transitional period where growth slows and the follicle shrinks. The telogen phase is a resting stage, lasting a few months, during which the hair prepares to shed. A new hair then grows, pushing out the old one in the exogen (shedding) phase.
The Concept of Initial Shedding
An initial shedding phase can occur when starting finasteride treatment. This phenomenon is often a sign that the medication is beginning to work as intended. The shedding happens because finasteride can synchronize hair follicles, prompting hairs that are in the resting (telogen) phase to shed. This accelerated shedding makes way for new, healthier hair growth to emerge.
This temporary increase in hair fall can be observed during activities like washing or brushing hair. While it may seem counterintuitive for a hair loss treatment to cause more hair to fall out, this process is part of the follicle “reset.” Old, weaker hairs are shed to allow follicles to return to a more robust growth phase, indicating the medication is actively influencing the hair growth cycle.
Navigating the Shedding Phase
The shedding phase begins within the first few weeks to a few months of starting finasteride. Many individuals notice increased hair fall around two to three months into treatment. This period of shedding is temporary, lasting for a few weeks to a few months. For most users, any temporary hair loss experienced resolves within six months.
Patience and consistent adherence to the medication schedule are important during this phase. While it can be unsettling to observe more hair loss, this temporary increase is considered a normal part of the process. Continuing the prescribed dosage allows the medication to establish its effects and facilitate the transition to new, healthier hair growth.
Beyond the Shedding Phase
Once the initial shedding subsides, individuals can anticipate a stabilization of hair loss. This is followed by improvements in hair density and quality. Noticeable results, such as a reduction in hair loss and potential regrowth of finer hairs, become apparent after three to six months of consistent use. More significant improvements in hair thickness and overall scalp coverage are observed around six to twelve months.
While shedding is a common experience, some individuals may not experience a noticeable shedding phase, which is normal. If shedding is prolonged beyond six months or appears unusually excessive, consulting a healthcare professional is advisable. Continued consistent use of finasteride is necessary to maintain results, as discontinuing the medication can lead to a reversal of the benefits within a year.