Finasteride is a common oral medication used to treat male pattern hair loss, medically known as androgenetic alopecia. Since this medication counteracts the underlying hormonal process that causes thinning, the timing of when to start is important for maximizing its benefits.
How Finasteride Treats Pattern Hair Loss
Finasteride functions as a specific inhibitor of the Type II 5-alpha reductase enzyme. This enzyme converts testosterone into dihydrotestosterone (DHT). DHT is the primary hormone driving androgenetic alopecia, causing hair follicles to gradually shrink, a process known as miniaturization.
By inhibiting the 5-alpha reductase enzyme, finasteride significantly lowers the concentration of DHT in the serum and the scalp. Studies indicate finasteride can reduce serum DHT concentrations by approximately 70%. This reduction reverses the miniaturization process, allowing affected hair follicles to regain size and produce thicker, longer hairs.
The medication effectively slows or halts the progression of hair loss by protecting the follicles from DHT damage. While it can promote regrowth in some areas, its primary strength lies in preventing further loss and maintaining existing hair.
Deciding the Best Time to Begin Treatment
The best time to start finasteride is as soon as the first signs of male pattern hair loss become noticeable. Early intervention, typically in mild to moderate stages (Norwood Scale I to III), offers the greatest potential for success. It is easier to preserve existing hair than to regrow hair from follicles that have been dormant for an extended period.
In the early stages, finasteride helps maintain the current hairline and density, preventing the condition from advancing. Clinical studies show that patients with earlier-stage hair loss (Norwood I-III) demonstrate greater improvement than those with advanced stages (Norwood IV-VII). The goal at this stage is preventative, focusing on maintaining the current hair status.
The medication is approved for men aged 18 and older with a confirmed diagnosis of androgenetic alopecia. It can still be beneficial for those who start treatment later or at a more advanced stage (Norwood Scale IV or V). In severe cases, the primary expectation shifts from significant regrowth to stabilization and preventing further recession.
Regardless of the stage, a professional diagnosis from a physician or dermatologist is necessary before beginning finasteride. The hair loss must be confirmed as androgenetic alopecia, as finasteride only targets the hormonal mechanism of this specific condition. This consultation ensures the hair loss is not due to other medical causes requiring a different therapeutic approach.
Essential Medical and Lifestyle Considerations
Before starting finasteride, a detailed discussion with a healthcare provider about one’s complete medical history and current medications is necessary. This helps identify any pre-existing conditions or potential drug interactions that might influence the decision to start treatment.
It is necessary to discuss potential side effects, even though they are generally rare. The most commonly reported side effects include sexual issues, such as decreased libido, erectile dysfunction, and problems with ejaculation. Less common side effects include breast tenderness or enlargement, and mood changes like depression, which should be reported to a doctor.
A long-term commitment is required for finasteride, as it is a treatment, not a permanent cure. The hair-preserving and regrowing effects depend on continuous use. If the drug is stopped, the benefits typically reverse, and hair loss usually resumes within 6 to 12 months, returning the hair status to the stage it would have reached without treatment.
What to Expect After Starting Finasteride
Once finasteride treatment begins, the initial phase often involves hormonal adjustment that can lead to increased hair shedding for some individuals. This initial shedding, typically occurring within the first one to three months, is a sign that the medication is resetting the hair growth cycle. While unsettling, it is temporary and part of the process where older hairs are shed to make way for new, healthier ones.
The first visible signs of stabilization, where the rate of hair loss slows, usually become apparent within three to six months of consistent use. Early thickening and a reduction in shedding are often noticeable by the six-month mark. This period allows hair follicles enough time to respond to the reduced DHT levels.
Maximum cosmetic results, including potential regrowth or significant density improvements, require a longer commitment, often taking 12 to 18 months of daily use. Because hair grows slowly, patience and strict adherence to the daily dosing schedule are necessary to fully assess effectiveness. Continued use is necessary to maintain the achieved results over time.