Finasteride treats male pattern baldness. It addresses hair thinning and loss by targeting specific hormonal pathways. While many people find it effective in slowing hair loss and promoting regrowth, an initial period of increased hair shedding can occur. This shedding is often a temporary and expected part of the treatment process.
Understanding Initial Shedding
Initial shedding after starting finasteride typically begins within the first three to six months of treatment. Some individuals might experience it as early as two to four weeks, while for others, it could be closer to two or three months.
This temporary increase in hair fall can be alarming, as it may appear counterintuitive for a hair loss treatment.
The shedding might manifest as more hairs noticed in the shower, on pillows, or during brushing. These shed hairs are often finer or weaker, making way for new, healthier hair. Shedding varies; some may lose up to 300 hairs daily, compared to the normal 50-100. This visible increase in hair fall is generally a positive indication the medication is working.
Why Shedding Occurs
Hair growth occurs in a continuous cycle involving distinct phases: anagen (growth), catagen (transition), telogen (rest), and exogen (shedding). Most scalp hairs are in the anagen phase, actively growing for several years.
Finasteride works by inhibiting the enzyme 5-alpha reductase, which is responsible for converting testosterone into dihydrotestosterone (DHT). High levels of DHT contribute to hair follicle miniaturization, shortening the hair growth cycle and leading to thinner, weaker hairs.
By reducing DHT levels, finasteride helps “reset” the hair growth cycle. This encourages follicles prematurely in the telogen (resting) phase to re-enter the anagen (growth) phase. As new, stronger hairs prepare to grow, they often push out older, weaker hairs. This accelerated expulsion causes the temporary increase in shedding, making room for healthier growth.
Managing the Shedding Phase
Experiencing increased hair shedding can be disconcerting when starting a treatment intended to stop hair loss. However, it is a normal and often expected response, signaling that finasteride is initiating changes in the hair follicles.
Maintaining consistency with the medication is important during this period; stopping treatment due to shedding can interrupt the process and hinder potential long-term benefits.
Understanding that this phase is temporary can help individuals cope emotionally. Focusing on the long-term goal of improved hair density and reduced hair loss can provide reassurance.
If shedding appears excessively severe, persists beyond typical timelines, or causes significant emotional distress, consulting a healthcare professional is advisable. They can assess the situation and rule out other potential causes of hair loss.
Beyond the Shedding Phase
The initial shedding phase with finasteride typically resolves within a few weeks to a few months, usually by the six-month mark. After this period, individuals can expect to see a stabilization of hair loss, with the shedding gradually decreasing.
Many users begin to observe initial signs of improvement, such as decreased hair loss and the emergence of new growth, around three to six months into consistent treatment.
More noticeable improvements in hair density and volume often become apparent after six to twelve months of continuous finasteride use. It is important to continue taking finasteride as prescribed to maintain these benefits, as discontinuing the medication will likely lead to a reversal of the improvements. While finasteride is effective in preventing further hair loss for many, the extent of hair regrowth can vary, and it may not fully restore hair in severely balding areas.