Finasteride, known by the brand names Propecia or Proscar, is a 5-alpha reductase inhibitor. It works by blocking the enzyme that converts testosterone into dihydrotestosterone (DHT). Since excessive DHT levels are linked to male pattern baldness and an enlarged prostate, finasteride is prescribed to address both conditions. Who can write a prescription depends on the condition being treated and the medical environment.
Traditional Prescribing Physicians
The most common path for obtaining finasteride involves consulting with a medical doctor. Primary Care Physicians (PCPs) frequently prescribe this medication, especially for uncomplicated cases of male pattern baldness or to manage long-term, stable prescriptions for either indication. A patient’s PCP serves as a general gatekeeper for most chronic medications and can initiate or continue treatment following a health assessment.
When the concern is specifically related to hair, a Dermatologist is often the most appropriate specialist. Dermatologists possess focused expertise in conditions of the skin and scalp, including androgenetic alopecia (male pattern baldness). They typically prescribe the lower, 1-milligram dose of the medication, which is specifically approved for hair loss.
Conversely, for issues concerning the prostate, a Urologist is the specialist best suited to manage the prescription. Urologists specialize in the urinary tract and male reproductive system, making them experts in treating Benign Prostatic Hyperplasia (BPH), or an enlarged prostate. For BPH treatment, they prescribe the higher, 5-milligram dose, which aims to shrink the enlarged gland and alleviate urinary symptoms.
How the Condition Determines the Specialist
The specific medical condition being treated directly dictates the required dosage and often determines the necessary specialist. Androgenetic alopecia is typically a visual diagnosis requiring the lower 1-milligram dosage, focused on preventing further hair miniaturization caused by DHT. While a PCP can handle this, a dermatologist provides specialized diagnostic confirmation and long-term scalp monitoring.
Benign Prostatic Hyperplasia requires a comprehensive diagnostic approach and the 5-milligram dosage to achieve a therapeutic effect. Diagnosing and monitoring BPH often involves physical exams, such as a digital rectal exam (DRE), and blood tests to check Prostate-Specific Antigen (PSA) levels. This need for specialized monitoring makes a Urologist or an experienced PCP better equipped to manage the higher-dose prescription.
The two distinct dosages reflect different treatment goals. The lower dose effectively targets the hair follicle’s sensitivity to DHT, while the higher concentration is required to reduce the size of the prostate. The higher dose is not used to achieve better results for hair loss and may increase the risk of side effects. Patients should not attempt to self-adjust their dosage across these two approved indications.
Telehealth and Online Prescribing Access
The rise of telehealth has created a convenient new avenue for accessing finasteride prescriptions, particularly for hair loss treatment. Many specialized online platforms offer virtual consultations with licensed healthcare providers who can assess a patient’s condition and issue a prescription. This streamlined process is highly effective for androgenetic alopecia, where the diagnosis can often be made through a detailed medical history and photographic assessment.
However, the suitability of telehealth changes when the medication is sought for BPH. Conditions that require a physical examination or complex lab monitoring often present a limitation for purely virtual care. Since BPH management necessitates in-person procedures like a DRE and regular PSA blood work to screen for prostate cancer and monitor treatment efficacy, a traditional, in-person visit with a Urologist or PCP is usually required.
While the prescription can sometimes be initiated via telehealth, the long-term management of the 5-milligram dose for BPH typically requires coordination with an in-person provider. Patients seeking the hair loss dosage (1 milligram) generally find the online access to be a complete and convenient solution. Regardless of the access point, the prescription must always be issued by a licensed medical professional following a proper medical evaluation.