Finasteride, in medical terms, is a relatively new product to treat hair loss. It has been approved to treat hair loss since 1997. It blocks the second of the two types of the enzyme called 5-alpha reductase and therefore reduces the conversion of testosterone to dihydrotestosterone (DHT). DHT leads to the miniaturization and loss of genetically sensitive hair on the top of the head, which is seen in the typical (androgenetic) pattern of hair loss.
So far, Finasteride appears to be quite safe. 1% —2% of men will experience temporary sexual side effects such as decreased sex drive or trouble with erections. These side effects go away within days of stopping the medication. There is data showing a good safety record if Finasteride is used for five years for hair loss and Finasteride has been used in the treatment of Prostate disease since 1984. We cannot know for certain about the safety of using Finasteride for thirty or forty years.
Finasteride does not grow new hair on completely bald skin. It can make even very fine hair become more coarse, more dark and can make it grow longer.
According to studies, if Finasteride is used for two years, 99% of men will feel they have not experienced further hair loss. The hair in the crown will look the same in roughly a third of men, mildly better in another third and moderately better in another third. In the front, the hair will look slightly better in 38% of men and moderately better in 5%. Finasteride does not give the dramatic improvement that hair transplantation does. The peak effect is seen after one to two years of use. There is a sustained benefit for men who take Finasteride for five years compared to those who do not take it.
The benefits of Finasteride last only as long as there is continuous use. Finasteride should therefore be regarded as a temporary measure to slow down hair loss. Until more information about long-term safety is known, it is prudent to base one’s long-term plan for hair restoration on the premise that one will stop Finasteride in the future and therefore lose its benefits.
Some men choose not to use Finasteride because they feel the uncertainty about long-term safety and the expense and inconvenience of taking daily medicine outweigh the temporary benefit.
Many men choose to use Finasteride in conjunction with hair transplantation. Often hair transplantation is performed to provide long-lasting substantial improvement of the frontal hair and possibly the mid-scalp and Finasteride is used to help the crown. They plan to use Finasteride for five years in the hope that it will be proven safe for longer use or a new treatment option will be developed in that five-year period.
Finasteride does not affect the DHT — “immune” donor/transplanted hair positively or negatively. Finasteride can therefore be used before, during and after hair transplantation for the non-transplanted hair.
At the Seager Hair Transplant Centre, we do not push Finasteride nor do we advise against it. Rather we present the current facts, as we know them and let patients decide, and then, if requested, prescribe it.BACK