Finasteride is an oral medication prescribed for male pattern baldness, also known as androgenetic alopecia. Many individuals wonder if it might paradoxically cause hair loss. While this is a common concern, finasteride works to prevent further hair loss and promote hair regrowth by targeting the underlying cause. This article explores how finasteride works and its effects on hair, including initial changes.
How Finasteride Works
Finasteride inhibits the enzyme 5-alpha-reductase, which converts testosterone into dihydrotestosterone (DHT). DHT is a potent androgen that causes hair follicle miniaturization on the scalp, leading to thinner hair and eventual hair loss.
By reducing DHT levels, finasteride helps reverse or halt this follicle miniaturization. This allows hair follicles to recover and produce thicker, healthier hair. Over time, this can stabilize hair loss and lead to noticeable hair regrowth.
Understanding Initial Hair Shedding
Some individuals may experience initial hair shedding when starting finasteride. This can be concerning, but this phenomenon, often called “shedding” or “telogen effluvium,” indicates the medication is initiating a new, healthier growth cycle, not permanent hair loss.
Hair follicles cycle through anagen (growth), catagen (transition), and telogen (resting) phases. Finasteride synchronizes these cycles, causing older, weaker hairs to fall out prematurely. This allows new, stronger hairs to enter the active growth phase. This initial shedding is temporary, lasting a few weeks to a few months, and is a positive sign the medication is working.
Other Potential Side Effects
Beyond initial shedding, finasteride can have other potential side effects, though not everyone experiences them. Some individuals report sexual side effects, including decreased libido, erectile dysfunction, or ejaculation issues. These effects are typically reversible upon discontinuing the medication.
Less common side effects include breast tenderness or enlargement, and mood changes such as depression. The incidence of these side effects varies among individuals. Any new or concerning symptoms should be discussed with a healthcare professional.
What to Expect and Important Considerations
Results from finasteride are not immediate and require consistent use. It often takes three to six months to observe hair loss stabilization. Noticeable hair regrowth, if it occurs, typically becomes apparent after 12 months or more of continuous treatment.
Finasteride generally requires ongoing use to maintain its benefits. If the medication is stopped, the positive effects on hair loss will likely reverse within 6 to 12 months, and hair loss may resume.
It is important to consult a healthcare professional before starting finasteride, as it is not suitable for everyone. It is contraindicated for women, particularly pregnant women, due to the risk of birth defects in male fetuses. A medical professional can discuss individual risks, benefits, and suitability for treatment.